Cigarette butts to estimate the illicit cigarette consumption proportion in a major Brazilian city.

Background: Illicit cigarette consumption (ICC) results in cheaper cigarettes and lost tax revenue. Although several methods estimate the ICC proportion, the one based on cigarette butt (CB), the most littered item worldwide, is less common. This study aimed at estimating the ICC proportion of Guarujá, a major Brazilian city, based on littered CBs.

Bitter taste of the tobacco industry interference in Brazil.

Objective: Although Brazil became the first country worldwide to ban the sale of all tobacco products with any additive that could alter their flavours and tastes in 2012, its implementation was effectively halted by tobacco industry lawsuits, including a constitutional challenge filed in the Federal Supreme Court in 2013. This study aimed at examining, for the first time in the country, the evolution over time of the new registrations of tobacco products with additives that would have been banned if not for the tobacco industry's interference ('counterfactual scenario').

Methods: We used the newly available public database on the registration of tobacco products developed by the Health Regulatory Agency (from 2008 onwards).

Maternal Smoking Prevalence in Brazil in 2013 and 2019: Not What We Expected When They Were Expecting!

Introduction: Monitoring tobacco use during pregnancy is critical for achieving the United Nations Sustainable Development Goals. We examined changes between 2013 and 2019 in the relative differences in smoking prevalence rates between pregnant and nonpregnant women aged 18-49 years.

Aims And Methods: We used data from a nationally representative health survey conducted in Brazil in 2013 and 2019.

[What does the Brazilian National Health Survey have to say about the influence of cigarette spending on household income?].

In a country whose indicators of population impoverishment continue to increase, it is concerning that individuals spend money to buy cigarettes instead of using this resource in actions that strengthen aspects of the well-being of their lives and that of their families. Based on the Brazilian National Health Survey conducted in 2019, the influence of spending on manufactured cigarettes on the family budget in households with at least one smoker was estimated, stratified by sociodemographic characteristics. Brazilian smokers allocated around 8% of their average per capita monthly household income to the purchase of manufactured cigarettes.

[The sale of single cigarettes in Brazil from 2008 to 2019: one more cause of concern?].

In Brazil, the sale of cigarettes is only allowed in closed packages with 20 units. The evolution over time of the proportion of adult smokers who purchased single manufactured cigarettes in their last purchase was evaluated. Data from the Global Adult Tobacco Survey conducted in 2008 and the Brazilian National Health Survey conducted in 2013 and 2019 were used.

[Is information on social rights accessible to cancer patients?].

Brazilian legislation provides for rights for cancer patients in order to assist with their treatment and mitigate the expenses they face during their illness. This study aimed to calculate the proportion of individuals undergoing cancer treatment at a Brazilian Unified National Health System (SUS) referral center who reported being aware of 15 specific legal rights, according to the population subgroup eligible to request each right. All adult cancer patients starting treatment at the Juiz de Fora Women's Association for Preventing and Fighting Cancer Hospital (ASCOMCER), Minas Gerais State, from March to July 2022, were interviewed (n = 62).

The cigarette market in Brazil: new evidence on illicit practices from the 2019 National Health Survey.

Objective: To explore new evidence on illicit practices, such as selling legal brands below the minimum legal price (MLP), and smugglers selling illicit brands at or above the MLP.

Methods: For the first time in Brazil, self-reported information on cigarette brand name and price paid per pack in smokers' last purchase from a nationally representative survey conducted in 2019 was used to distinguish the illicit and the legal markets. We estimated the proportion of illicit cigarette consumption, using the combination of brand and price.

Law compliance, why do we need it? Comparative data from the Brazilian National Survey of School Health (PeNSE) on adolescents' access to cigarettes.

In recent decades, Brazil has made significant progress in fighting the tobacco epidemic. However, recent national data suggest a probable stagnation in the reduction of smoking initiation among youth and adolescents. The objective of this study was to evaluate the evolution over time of compliance with the law that prohibits the sale of cigarettes to minors in Brazil.

Patterns of Birth Cohort‒Specific Smoking Histories in Brazil.

Introduction: Smoking prevalence has decreased considerably in Brazil from 34.8% in 1989 to 12.6% in 2019 owing to the implementation of strong tobacco control policies.

Recent evidence on the illicit cigarette trade in Latin America.

The tobacco industry continues to present the illicit trade of tobacco products as a reason to slow, stop, or reverse tobacco control efforts in Latin America, including increasing tobacco excise taxes. In most cases, industry estimates of illicit trade, usually non-transparent and flawed, dwarf those of independent, rigorous research. Often, independent studies find that the levels of illicit trade are mostly non-consequential or easily manageable (<12%).

Indicators related to smoking cessation in Brazil, National Health Survey, 2013 and 2019 editions.

Objective: To describe the indicators of smoking cessation in 2013 and 2019 for Brazil and federative units, according to sociodemographic variables, collected in the National Health Survey (PNS).

Methods: Cross-sectional, population-based and descriptive study with data from the 2013 and 2019 PNS, a household survey collected by trained interviewers. The prevalence of ex-smokers and the proportion of smokers who tried to quit smoking in the 12 months prior to the interview, and respective confidence intervals (95%CI) were calculated, according to sociodemographic variables.

Cigarette butts in two urban areas from Brazil: Links among environmental impacts, demography and market.

Environmental impacts are currently linked to smoking cigarette behavior, as cigarette butts (CBs) represent the most common litter item in natural areas. Despite this, even the best ranked Brazilian cities, in terms of urban cleaning, have no information about urban littered CBs. Thus, CBs were monitored in Santos and Niterói cities, aiming to assess contamination, Cigarette Butt Pollution Index (CBPI) and the illegal market size.

Brazilian smokers are ready for the ban on flavour additives in tobacco to be implemented.

Brazil became the first country to approve a national policy to ban all flavour additives in all tobacco leaf products in 2012. However, as of February 2022, the policy remained to be implemented. Cross-sectional data come from the International Tobacco Control (ITC) Brazil Wave 3 Survey among adult smokers (N = 1216) in 2016-2017.

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

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.

Achievements, challenges, priorities and needs to address the current tobacco epidemic in Latin America.

Most Latin American countries have signed and ratified the FCTC, although implementation has been uneven. Countries across the region were relatively quick to adopt mandatory smoke-free workplace policies, but regional progress in other areas has been slower. In taxation, for example, Uruguay and Brazil have made considerable progress while Paraguay and Bolivia have relatively weak policies.

Prevalence of electronic nicotine delivery systems and waterpipe use in Brazil: where are we going?

Objective: To describe the prevalence of use of electronic nicotine delivery systems (ENDS) and waterpipe in Brazil, by population subgroups, and to evaluate the trend between 2013 and 2019.

Methods: We used data from the 2019 National Health Survey to estimate the prevalence of lifetime and current use of ENDS and current use of waterpipes by socio-behavioral characteristics. Differences in prevalence over time were calculated using data from the III Brazilian Household Survey on Substance Use-2015 and the National Health Survey-2013.

Straw cigarette branding: misleading descriptors and a new Marlboro man.

Background: Straw cigarettes are hand-rolled tobacco in a corn straw, common in Brazil and believed to be less harmful by consumers. Traditionally consumed in rural areas and by men, a recent increase in use among young people in urban areas was observed. This study assessed marketing appeals of straw cigarette packaging in Brazil.

Contributions of the analysis of discarded cigarette packages in household waste in the Brazilian city of Rio de Janeiro, Brazil, to estimate the illegal market.

The illicit trade of tobacco products, by enabling access to cheaper cigarettes, favors smoking initiation and hinders its cessation, minimizing the effects of price policy and taxes on reducing the demand for tobacco. This is especially the case among populations with lower income and schooling, where smoking is concentrated. Its confrontation requires multisectoral actions, aligned with the World Health Organization Framework Convention on Tobacco Control, supported by estimates of the illicit trade magnitude and the analysis of its characteristics.

[Electronic nicotine delivery systems in Brazilian state capitals: prevalence, profile of use, and implications for the National Tobacco Control Policy].

The objectives of this study were to estimate the prevalence of use of electronic nicotine delivery systems (ENDS) and to explore the potential impact of ENDS use on smoking initiation with conventional cigarettes. We used data from the Risk and Protective Factors Surveillance System for Chronic Non-Comunicable Diseases Through Telephone Interview (Vigitel), 2019 edition, which interviewed 52,443 individuals 18 years or older in Brazil's 26 state capitals and the Federal District. Point prevalence rates and confidence intervals (95%CI) were calculated for current and ever use of ENDS in each state capital, and the profile of ENDS users were described.

Knowledge of and attitudes toward the WHO MPOWER policies to reduce tobacco use at the population level: a comparison between third-year and sixth-year medical students.

Objective: To evaluate third- and sixth-year medical students in Brazil in terms of their knowledge of and attitudes toward the WHO MPOWER policies to reduce tobacco use.

Methods: The WHO Global Health Professions Student Survey was applied in five cohorts of medical students evaluated in their third and sixth years of medical school, between 2008 and 2015. Comparisons were drawn between the two years of medical school in terms of the proportions of students who experimented with or used tobacco products in the last 30 days prior to the survey; knowledge of and compliance with smoke-free policies on the university campus; formal training on smoking cessation strategies; and self-recognition as role models for patients/society.

[Interference by the tobacco industry in data on cigarette consumption in Brazil].

The tobacco industry normally overestimates the illegal market's size in order to reinforce the idea of its direct relationship to the choice to increase taxes by the internal revenue administration. In Brazil, the last increase in taxes on tobacco products was in 2016. The growth of demand for illegal cigarettes has other macrosocial determinants that the industry does not take into account, such as the increase in the economic capacity to purchase legal cigarettes.

Cross-validation of four different survey methods used to estimate illicit cigarette consumption in Brazil.

Objective: To cross-validate estimates of the size of the illicit cigarette trade based on the results of four different survey methods.

Methods: In 2018/2019, four non-industry-funded, large-scale studies were conducted in selected Brazilian cities: packs discarded in household garbage/PDG (1 city), packs littered in the streets/PLS (5 cities), a phone survey of tobacco users' purchase behaviors/VIGITEL (5 cities), and a face-to-face household survey of tobacco users' purchase behaviors/FTF-household (2 cities). The proportions of illicit cigarettes consumed were based on the price paid by smokers in their last purchase (VIGITEL or FTF-household) and/or direct observation of brand names and health warnings (PDG, PLS or FTF-household).