Brazil's Smoking Population Reduced by Half
Antismoking policies helped prevent 420,000 smoking-related deaths in the country.
-- by Jenara Nerenberg
The GistGetting people to stop smoking is hard work, especially with the prevalence of cigarette advertising and smoking on television. Despite these kinds of difficulties, Brazil has managed to drastically reduce its population of smokers in a short amount of time with some hard-hitting policies. New research released today in PLOS Medicine shows that smoking rates in Brazil have been reduced by half over the past twenty years. The most effective policy was a tobacco price increase, followed by smoke-free air laws, restrictions on tobacco marketing, tobacco health warnings, antismoking mass media campaigns, and particular treatment programs to help get people to stop smoking. And all of the above helped prevent 420,000 smoking-related deaths, a number that is projected to increase to 7 million by 2050.
The Expert Take"The lesson learned from Brazil is that you need a strong combination of policies, including taxes, marketing restrictions, and media campaigns," said lead author David Levy of Georgetown University in an interview with Healthline. "The Framework Convention for Tobacco Control has set out the policies, and Brazil shows that if they are followed, there will be success in saving lives."
But Levy indicates that even stricter tobacco laws, such as an increase in tobacco taxes, would save an additional 1.3 million lives by 2050.
"Brazil provides one of the outstanding public health success stories in reducing deaths due to smoking, and serves as a model for other low and middle income nations," said Levy. "However, a set of stricter policies could further reduce smoking and save many additional lives."
Levy adds that "most of the measures that Brazil has undertaken cost the government limited resources and, in the case of taxes, generate revenue." This fact should help incentivize other nations to follow Brazil's model.
Source and MethodResearchers from Lombardi Comprehensive Cancer Center of Georgetown University in Washington D.C. and the Brazilian National Cancer Institute in Rio de Janeiro used a simulation model called Brazil SimSmoke to assess smoking rates before and after antismoking measures—such as cigarette package warnings, advertising restrictions, and smoke-free air laws—were implemented in the country. In 1989, 34.8 percent of Brazilian adults smoked, and in 2008, that percentage dropped to 18.5 percent of adults in Brazil.
The TakeawayBrazil's dynamic, multipronged approach to reducing smoking rates has proven exceptionally effective and has helped prevent early deaths due to smoking. The results of this study indicate that it is in the interest of the global public's health for other countries to attempt the same. Professionals in government, media, advertising, and merchant associations can all help implement antismoking measures and, as a result, reduce early deaths.
“Brazil’s accomplishments demonstrate that, even for a middle income nation, reducing tobacco use is a 'winnable battle' that carries huge dividends in terms of reducing mortality and morbidity," said Levy.
And, in particular, "the one policy that Brazil has used with special effectiveness appears to be health warnings on cigarette packages," said Levy. "These can be targeted at young as well as older smokers."
Other ResearchA case study by the American Journal of Public Health examining California's efforts at reducing smoking presents similar findings—namely, that both antismoking media campaigns and increased tobacco taxes are effective at discouraging smoking. The study concludes that the scale of effectiveness depends on the amount of media output and amount of tax increase.
Additionally, a different study by Tobacco Control looking at support for banning smoking from movies indicates that antismoking advertising influences viewers to support banning smoking from movies.
And another Tobacco Control study supports the conclusion from the Brazil study that increased taxation and consumer education help prevent smoking, especially in young people.