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“国内烟草去正常化”:巴西实施室内工作场所禁烟令的贡献。

"Tobacco denormalization at home": the contribution of the smoking ban in enclosed workplaces in Brazil.

机构信息

Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brasil.

出版信息

Cad Saude Publica. 2022 May 6;38Suppl 1(Suppl 1):e00107421. doi: 10.1590/0102-311X00107421. eCollection 2022.

Abstract

Estimates suggest that exposure to environmental tobacco smoke is related to 1.2 million deaths per year worldwide. Synergy between various anti-smoking legislative and educational measures is essential to stimulate cessation and prevent initiation. This article aimed to explore how legislative protection from exposure to environmental tobacco smoke in enclosed workplaces in Brazil, whose strengthening occurred in a phased manner between 1996 and 2014, possibly contributed to the protection from passive smoking at home. We evaluated, via generalized linear models, the absolute and relative differences in the proportion of individuals living in smoke-free homes between those exposed and not exposed to passive smoking in enclosed workplaces, both crude and adjusted by sociodemographic and smoking behavior variables, and stratified by non-smokers and smokers. Data from three national surveys conducted in 2008, 2013, and 2019 were used. Regardless of smoking status and year when the data were analyzed, individuals who were employed in smoke-free workplaces were more likely to live in smoke-free homes than smokers who were employed in workplaces that allowed smoking. Adjusted absolute difference increased from +5.5% in 2008 to +10.5% in 2013 among non-smokers, and from +7.1% in 2013 to 15.6% in 2019 among smokers (p-values for additive interaction ≤ 0.05). Strengthening the Brazilian smoke-free legislation was likely associated with a reduction in passive smoking at home, which, therefore, may also reduce the burden of mortality, morbidity, and costs for society related to smoking.

摘要

据估计,全球每年有 120 万人因接触环境烟草烟雾而死亡。各种反吸烟立法和教育措施的协同作用对于刺激戒烟和预防开始吸烟至关重要。本文旨在探讨巴西在封闭工作场所中对接触环境烟草烟雾的立法保护,这种保护是分阶段于 1996 年至 2014 年逐步加强的,这可能有助于防止在家中被动吸烟。我们通过广义线性模型评估了在暴露于和未暴露于封闭工作场所被动吸烟的个体中,居住在无烟家庭的比例的绝对和相对差异,包括未调整和调整了社会人口统计学和吸烟行为变量的差异,并按不吸烟者和吸烟者进行了分层。使用了 2008 年、2013 年和 2019 年进行的三项全国性调查的数据。无论吸烟状况和分析数据的年份如何,在无烟工作场所工作的个体比在允许吸烟的工作场所工作的吸烟者更有可能居住在无烟家庭中。调整后的绝对差异从 2008 年的+5.5%增加到 2013 年的非吸烟者的+10.5%,从 2013 年的+7.1%增加到 2019 年的吸烟者的+15.6%(附加交互作用的 p 值均≤0.05)。巴西无烟立法的加强可能与在家中被动吸烟的减少有关,因此,这也可能减轻与吸烟有关的死亡率、发病率和社会成本的负担。

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