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弥合科学与公共卫生之间的差距:利用巴西在烟草控制方面的经验为制定针对非传染性疾病风险因素的政策提供信息。

Bridging the gap between science and public health: taking advantage of tobacco control experience in Brazil to inform policies to counter risk factors for non-communicable diseases.

机构信息

Center for Studies on Tobacco and Health-National Public Health School-FIOCRUZ, Rio de Janeiro, Brazil.

出版信息

Addiction. 2013 Aug;108(8):1360-6. doi: 10.1111/add.12203. Epub 2013 May 7.

DOI:10.1111/add.12203
PMID:23651292
Abstract

AIMS AND DESIGN

The historical and economic involvement of Brazil with tobacco, as a major producer and exporter, was considered an insurmountable obstacle to controlling the consumption of this product. Nevertheless, the country was able to achieve significant progress in implementing public policies and to take an international leadership position, meeting its constitutional commitment to protect public health. In this paper we provide a brief historical overview of tobacco control (TC) in Brazil, and analyse the factors that contributed to the major decline in tobacco consumption in the country over the last 20 years, as well as identify the challenges that had to be overcome and those still at play.

FINDINGS

The Brazilian case demonstrates how cross-sectorial collaborations among health-related groups that capitalize on their respective strengths and capacities can help to influence public policy and overcome industry and population resistance to change. Although Brazil still lags behind some leading TC nations, the country has an extensive collaborative TC network that was built over time and continues to focus upon this issue.

CONCLUSIONS

The tobacco experience can serve as an example for other fields, such as alcoholic beverages, of how networks can be formed to influence the legislative process and the development of public policies. Brazilian statistics show that problems related to non-communicable diseases are a pressing public health issue, and advocacy groups, policy-makers and government departments can benefit from tobacco control history to fashion their own strategies.

摘要

目的和设计

巴西作为一个主要的烟草生产国和出口国,在历史和经济上都与烟草有着密切的联系,这被认为是控制这种产品消费的一个不可逾越的障碍。然而,该国能够在实施公共政策方面取得重大进展,并在国际上占据领导地位,履行了保护公共健康的宪法承诺。本文简要回顾了巴西的烟草控制(TC)历史,并分析了导致该国在过去 20 年烟草消费大幅下降的因素,以及确定了需要克服的挑战和仍在发挥作用的挑战。

结果

巴西的案例表明,健康相关团体之间的跨部门合作,利用各自的优势和能力,可以帮助影响公共政策,并克服行业和公众对变革的抵制。尽管巴西在某些领先的 TC 国家之后仍有差距,但该国拥有一个广泛的合作 TC 网络,这个网络是随着时间的推移建立起来的,并继续关注这个问题。

结论

烟草经验可以为其他领域(如酒精饮料)提供一个范例,说明如何建立网络来影响立法过程和公共政策的制定。巴西的统计数据显示,与非传染性疾病相关的问题是一个紧迫的公共卫生问题,倡导团体、政策制定者和政府部门可以从烟草控制历史中受益,制定自己的策略。

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