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Epidemiology and policy
P1-350 A snapshot of the striking decrease in cigarette smoking prevalence in Brazil between 1989 and 2008
  1. A Szklo1,
  2. L Almeida1,
  3. M Sampaio1,
  4. D Malta3,
  5. S Mirza4,
  6. R Caixeta2,
  7. V Figueiredo5,
  8. M Szklo1
  1. 1Brazilian National Cancer Institute, Rio de Janeiro, Brazil
  2. 2Health Surveillance Agency, Brasilia, Distrito Federal, Brazil
  3. 3Center for Disease Control, Atlanta, Georgia, USA
  4. 4Panamerican Health Organization, Washington, DC, USA
  5. 5Federal University of Rio de Janeiro, Rio de Janeiro, Brazil


Objective To evaluate the differences in cigarette smoking prevalence in Brazil between 1989 and 2008.

Methodology We compared absolute and relative differences in smoking prevalence, overall and stratified by selected socio-demographic variables and birth cohort (20-year interval from 1925 to 1934 onwards). Data were obtained from National Household Survey on Health and Nutrition (1989, n=39 969) and Global Adult Tobacco Survey (2008, n=38 461). Generalised linear models with binomial family distribution, and either gaussian or logarithmic link function, were specified in order to obtain estimates, as well as to assess potential effect modification.

Results Crude and adjusted overall differences in smoking prevalences between 1989 and 2008 were, respectively: absolute, 15.4% and 11.8; relative, 47.5% and 38.7%. We observed the highest declines in smoking prevalences among individuals aged 25–34 years-old (additive or multiplicative interaction ps<0.001) and those with 8 years of schooling or more (multiplicative interaction p<0.001). Moreover, while stratifying by birth cohort, we found that, only in the absolute scale and with the exception of the youngest birth cohort (ie,1965–1974), men presented higher reductions than women (additive interaction terms <0.001).

Conclusions A large amount of laws against tobacco consumption have been adopted in Brazil since 1986, which may have contributed to the observed decline in smoking prevalence. It is of paramount importance to better understand the effectiveness of tobacco control actions implemented in a country and the evolution of its tobacco epidemic in order to improve/develop actions targeted to those who continued to smoke and/or started smoking in a “more hostile” environment.

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