Portes Leonardo Henriques, Machado Cristiani Vieira, Turci Silvana Rubano Barretto
Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2018 Feb 19;34(2):e00017317. doi: 10.1590/0102-311X00017317.
This study analyzes Brazil's tobacco control policy from 1986 to 2016, seeking to describe the policy's history and discuss its achievements, limits, and challenges. The study adopted a political economics approach and contributions from public policy analysis. Data were based on a search of the literature, documents, and secondary sources and semi-structured interviews with stakeholders involved in the policy. Factors related to the domestic and international contexts, the political process, and the policy's content influenced the institutional characteristics of tobacco control in the country. The study emphasizes the consolidation of Brazil's social rejection of smoking, government structuring of the policy, action by civil society, and Brazil's prestige in the international scenario. Inter-sector tobacco control measures like price and tax increases on cigarettes, the promotion of smoke-free environments, and the enforcement of health warnings contributed to the important reduction in prevalence of smoking. Implementation of the World Health Organization Framework Convention on Tobacco Control in Brazil, beginning in 2006, contributed to the expansion and consolidation of the national policy. However, tobacco-related economic interests limited the implementation of some strategic measures. The challenges feature the medium- and long-term sustainability of tobacco control and the solution to barriers involving crop diversification on current tobacco-growing areas, the fight against the illegal cigarette trade, and interference in the policy by the tobacco industry.
本研究分析了1986年至2016年巴西的烟草控制政策,旨在描述该政策的历史,并讨论其成就、局限性和挑战。该研究采用了政治经济学方法以及公共政策分析的成果。数据基于对文献、文件和二手资料的检索,以及对参与该政策的利益相关者的半结构化访谈。与国内外背景、政治进程和政策内容相关的因素影响了该国烟草控制的制度特征。该研究强调了巴西社会对吸烟的排斥的巩固、政府对政策的构建、民间社会的行动以及巴西在国际舞台上的声望。提高香烟价格和税收、推广无烟环境以及实施健康警示等跨部门烟草控制措施,有助于大幅降低吸烟率。2006年起在巴西实施的《世界卫生组织烟草控制框架公约》,推动了国家政策的扩展和巩固。然而,与烟草相关的经济利益限制了一些战略措施的实施。挑战包括烟草控制的中长期可持续性,以及解决当前烟草种植地区作物多样化、打击非法香烟贸易和烟草行业对政策的干扰等障碍。