1
|
Reynales-Shigematsu LM, Barnoya J, Cavalcante T, Aburto TC, Romieu I, Stern MC, Barquera S, Corvalán C, Hallal PC, Canelo-Aybar C, Alvarado-Villacorta R, Espina C, Feliu A, Rivera JA. Latin America and the Caribbean Code Against Cancer 1st edition: Tobacco and nicotine-related products, secondhand smoke, and alcohol and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102413. [PMID: 37852726 DOI: 10.1016/j.canep.2023.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 10/20/2023]
Abstract
Tobacco, secondhand smoke (SHS), and alcohol, all carcinogens, are leading preventable cancer risk factors in Latin America and the Caribbean (LAC). Since 2000, smoking and SHS exposure have significantly decreased in the region. Yet alcohol consumption remains high. The entry of nicotine-related products such as electronic cigarettes (e-cigs) threatens achievements made in tobacco control and chronic diseases prevention, including cancer. E-cigs use is likely associated with smoking initiation among adolescents who had never smoked and dual use with combustible tobacco products. Therefore, the LAC Code Against Cancer recommends to the public actions they can take to reduce their risk of cancer: 1. Don't smoke or use any type of tobacco. If you do, quitting is possible, with professional help if needed. Don't use e-cigarettes either, as they lead to tobacco use. 2. Make your home a smoke-free place. Respect and promote laws that ensure smoke-free spaces to protect our health. and 3. Avoid drinking alcoholic beverages. This helps prevent several types of cancer. The Code recommends to policymakers a package of cost-effective policies based on the MPOWER and SAFER to prevent cancer at the population level. It also recommends that primary care health professionals: 1. Ask all their patients and their families whether they smoke or vape, inform them about the harms of smoking and vaping, and promote tobacco and nicotine related products cessation strategies among users. 2. Inform about the harms of exposure to SHS, especially among children, and promote smoke-free environments, and 3. Prevent alcohol use by their patients and their families, use tools to assess use, intensity, and frequency, and apply brief counseling intervention to support alcohol abstinence in primary care.
Collapse
Affiliation(s)
- Luz Myriam Reynales-Shigematsu
- Tobacco Control and Preventive Department. Center for Population Health Research. National Institute of Public Health. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico.
| | - Joaquin Barnoya
- Integra Cancer Institute, Guatemala, 9ª calle 4-52 zona 10, Guatemala, Guatemala
| | - Tania Cavalcante
- Instituto Nacional del Cáncer, INCA, Brasil.Pr. da Cruz Vermelha, 23 - Centro, Rio de Janeiro, RJ 20230-130, Brazil
| | - Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, CP 62100 Cuernavaca, Mexico
| | - Isabelle Romieu
- Center for Population Health Research, National Institute of Public Health, CP 62100, Cuernavaca, Mexico
| | - Mariana C Stern
- Department of Preventive Medicine and Urology, Keck School of Medicine of USC, 90033 Los Angeles, USA
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, CP 62100 Cuernavaca, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Macul, Chile
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, United States
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberossssamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Rosa Alvarado-Villacorta
- Department of Clinical Epidemiology and Public Health, Iberossssamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, CP 62100, Cuernavaca, Mexico
| |
Collapse
|
2
|
Perez C, Cavalcante T, Mendes F, Szklo A, Fong GT, Craig L, Yan M, Li G. Reasons for e-cigarette use and perceptions of harm in Brazil: findings from the ITC Brazil Wave 2 (2012-13) and 3 (2016-17) surveys. Tob Induc Dis 2018. [DOI: 10.18332/tid/83960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
3
|
Perez C, Kaai SC, Cavalcante T, Szklo A, Craig L, Li G, Quah ACK, Fong GT. Evaluating the impact of health warnings in Brazil over 7 years (2009 - 2016): findings from the ITC Brazil Wave 1-3 surveys. Tob Induc Dis 2018. [DOI: 10.18332/tid/83942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
4
|
Szklo A, Perez C, Cavalcante T, Almeida L, Craig L, Kaai S, Quah A, Fong G. Increase of electronic cigarette use and awareness in Brazil: findings from a country that has strict regulatory requirements for electronic cigarette sales, import, and advertising. Tob Induc Dis 2018. [DOI: 10.18332/tid/83860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
5
|
Perez C, Chung-Hall J, Craig L, Yan M, Cavalcante T, Mendes F, Szklo A, Fong GT. A pre-post evaluation of and public support for smoke-free policies at the 2016 Rio Olympics: findings from the ITC Brazil survey, 2012 - 17. Tob Induc Dis 2018. [DOI: 10.18332/tid/83964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
6
|
Leal Teixeira AP, Cavalcante T. Brazil responses to the strategies used by the tobacco industry to resist Tobacco Control National Policy. Tob Induc Dis 2018. [DOI: 10.18332/tid/84701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
7
|
Gravely S, Fong GT, Cummings KM, Yan M, Quah ACK, Borland R, Yong HH, Hitchman SC, McNeill A, Hammond D, Thrasher JF, Willemsen MC, Seo HG, Jiang Y, Cavalcante T, Perez C, Omar M, Hummel K. Awareness, trial, and current use of electronic cigarettes in 10 countries: Findings from the ITC project. Int J Environ Res Public Health 2014; 11:11691-704. [PMID: 25421063 PMCID: PMC4245638 DOI: 10.3390/ijerph111111691] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 10/24/2014] [Accepted: 10/28/2014] [Indexed: 11/23/2022]
Abstract
Background: In recent years, electronic cigarettes (e-cigarettes) have generated considerable interest and debate on the implications for tobacco control and public health. Although the rapid growth of e-cigarettes is global, at present, little is known about awareness and use. This paper presents self-reported awareness, trial and current use of e-cigarettes in 10 countries surveyed between 2009 and 2013; for six of these countries, we present the first data on e-cigarettes from probability samples of adult smokers. Methods: A cross-sectional analysis of probability samples of adult (≥ 18 years) current and former smokers participating in the International Tobacco Control (ITC) surveys from 10 countries. Surveys were administered either via phone, face-to-face interviews, or the web. Survey questions included sociodemographic and smoking-related variables, and questions about e-cigarette awareness, trial and current use. Results: There was considerable cross-country variation by year of data collection and for awareness of e-cigarettes (Netherlands (2013: 88%), Republic of Korea (2010: 79%), United States (2010: 73%), Australia (2013: 66%), Malaysia (2011: 62%), United Kingdom (2010: 54%), Canada (2010: 40%), Brazil (2013: 35%), Mexico (2012: 34%), and China (2009: 31%)), in self-reports of ever having tried e-cigarettes (Australia, (20%), Malaysia (19%), Netherlands (18%), United States (15%), Republic of Korea (11%), United Kingdom (10%), Mexico (4%), Canada (4%), Brazil (3%), and China (2%)), and in current use (Malaysia (14%), Republic of Korea (7%), Australia (7%), United States (6%), United Kingdom (4%), Netherlands (3%), Canada (1%), and China (0.05%)). Conclusions: The cross-country variability in awareness, trial, and current use of e-cigarettes is likely due to a confluence of country-specific market factors, tobacco control policies and regulations (e.g., the legal status of e-cigarettes and nicotine), and the survey timing along the trajectory of e-cigarette awareness and trial/use in each country. These ITC results constitute an important snapshot of an early stage of what appears to be a rapid progression of global e-cigarette use.
Collapse
Affiliation(s)
- Shannon Gravely
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - K Michael Cummings
- Medical University of South Carolina, 171 Ashley Ave, Charleston, SC 29425, USA.
| | - Mi Yan
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Ron Borland
- The Cancer Council Victoria, 615 St. Kilda Road, Melbourne, Victoria 3004, Australia.
| | - Hua-Hie Yong
- The Cancer Council Victoria, 615 St. Kilda Road, Melbourne, Victoria 3004, Australia.
| | | | - Ann McNeill
- King's College London, Strand, London, WC2R 2LS, UK.
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - James F Thrasher
- Arnold School of Public Health, University of South Carolina, Colombia, SC 29208, USA.
| | - Marc C Willemsen
- Maastricht University (CAPHRI), P. Debyeplein 1, 6229 HA Maastricht, the Netherlands.
| | - Hong Gwan Seo
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Yuan Jiang
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Tania Cavalcante
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Cristina Perez
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Maizurah Omar
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Karin Hummel
- Maastricht University (CAPHRI), P. Debyeplein 1, 6229 HA Maastricht, the Netherlands.
| |
Collapse
|
8
|
Malta DC, Silva MMAD, Albuquerque GM, Lima CMD, Cavalcante T, Jaime PC, Silva Júnior JBD. A implementação das prioridades da Política Nacional de Promoção da Saúde, um balanço, 2006 a 2014. Ciênc saúde coletiva 2014; 19:4301-12. [DOI: 10.1590/1413-812320141911.07732014] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 08/08/2014] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste artigo é analisar a Política Nacional de Promoção da Saúde (PNPS) quanto à implementação de eixos prioritários de gestão. Foram consultadas informações contidas em portarias, documentos institucionais, sites, livros e artigos publicados visando analisar as ações implementadas. Houve avanços na gestão como a criação de linha orçamentária específica, a inserção da promoção no Plano Plurianual, monitoramento de indicadores da Promoção da Saúde nos pactos federativos, o financiamento de projetos de Promoção da Saúde em municípios e a criação de programas de Promoção da Saúde. Foram realizadas avaliações de programas de atividade física que apontaram a efetividade dos programas. Ações intersetoriais implementadas foram relevantes, em especial a articulação com os setores de Educação, Justiça, Cidades, Direitos Humanos, Desenvolvimento Social, Esporte e Lazer, dentre outros. Ações regulatórias foram implementadas, como a Lei "Seca" e a lei de ambientes livres de tabaco. Foram observados avanços e pontuamos o fortalecimento da Promoção da Saúde na agenda do setor saúde, aprofundamento nas parcerias e nas ações intersetoriais, a identificação das iniquidades no território visando sua redução, bem como a sustentabilidade das ações de Promoção da Saúde.
Collapse
|
9
|
Volchan E, David IA, Tavares G, Nascimento BM, Oliveira JM, Gleiser S, Szklo A, Perez C, Cavalcante T, Pereira MG, Oliveira L. Implicit motivational impact of pictorial health warning on cigarette packs. PLoS One 2013; 8:e72117. [PMID: 23977223 PMCID: PMC3744501 DOI: 10.1371/journal.pone.0072117] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 07/06/2013] [Indexed: 11/22/2022] Open
Abstract
Objective The use of pictorial warning labels on cigarette packages is one of the provisions included in the first ever global health treaty by the World Health Organization against the tobacco epidemic. There is substantial evidence demonstrating the effectiveness of graphic health warning labels on intention to quit, thoughts about health risks and engaging in cessation behaviors. However, studies that address the implicit emotional drives evoked by such warnings are still underexplored. Here, we provide experimental data for the use of pictorial health warnings as a reliable strategy for tobacco control. Methods Experiment 1 pre-tested nineteen prototypes of pictorial warnings to screen for their emotional impact. Participants (n = 338) were young adults balanced in gender, smoking status and education. Experiment 2 (n = 63) tested pictorial warnings (ten) that were stamped on packs. We employed an innovative set-up to investigate the impact of the warnings on the ordinary attitude of packs’ manipulation, and quantified judgments of warnings’ emotional strength and efficacy against smoking. Findings Experiment 1 revealed that women judged the warning prototypes as more aversive than men, and smokers judged them more aversive than non-smokers. Participants with lower education judged the prototypes more aversive than participants with higher education. Experiment 2 showed that stamped warnings antagonized the appeal of the brands by imposing a cost to manipulate the cigarette packs, especially for smokers. Additionally, participants’ judgments revealed that the more aversive a warning, the more it is perceived as effective against smoking. Conclusions Health warning labels are one of the key components of the integrated approach to control the global tobacco epidemic. The evidence presented in this study adds to the understanding of how implicit responses to pictorial warnings may contribute to behavioral change.
Collapse
Affiliation(s)
- Eliane Volchan
- Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
| | - Isabel A. David
- Biomedical Institute, Universidade Federal Fluminense, Niteroi, Brazil
| | - Gisella Tavares
- Biomedical Institute, Universidade Federal Fluminense, Niteroi, Brazil
| | - Billy M. Nascimento
- Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jose M. Oliveira
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sonia Gleiser
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andre Szklo
- Coordination for Prevention and Surveillance, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
| | - Cristina Perez
- Executive Secretariat of the National Commission for FCTC Implementation in Brazil, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
| | - Tania Cavalcante
- Executive Secretariat of the National Commission for FCTC Implementation in Brazil, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
| | - Mirtes G. Pereira
- Biomedical Institute, Universidade Federal Fluminense, Niteroi, Brazil
| | - Leticia Oliveira
- Biomedical Institute, Universidade Federal Fluminense, Niteroi, Brazil
| |
Collapse
|
10
|
Nascimento BEM, Oliveira L, Vieira AS, Joffily M, Gleiser S, Pereira MG, Cavalcante T, Volchan E. Avoidance of smoking: the impact of warning labels in Brazil. Tob Control 2008; 17:405-9. [PMID: 18849316 DOI: 10.1136/tc.2008.025643] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Research on human emotion shows that pictures drive the activity of specialised brain networks affecting attitude and behaviour. Pictorial warnings on cigarette packages are considered one of the most effective ways to convey information on the health consequences of smoking. However, few studies have evaluated the effectiveness of warning labels to elicit avoidance of smoking. OBJECTIVES To investigate the impact of pictorial health warnings conveyed by the Brazilian tobacco control programme through a well-established psychometric tool designed for studies on emotion and behaviour. METHODS Graphic Brazilian cigarette warnings labels were evaluated. They consisted of the two sets of warning pictures displayed in 2002-4 (n = 9) and 2004-8 (n = 10). Pleasant, unpleasant and neutral pictures selected from a standard catalogue were used as controls. Undergraduate students (n = 212, 18% smokers) evaluated the emotional content of each picture in two affective dimensions: hedonic valence and arousal. Participants were not provided with the sources of distinction between control and warning pictures. RESULTS The judgements of hedonic content of the warning pictures ranged from neutral to very unpleasant. None was classified as highly arousing. Smokers judged warning pictures representing people smoking significantly more pleasant than pictures without smoking scenes, and significantly more so than non-smokers. No significant differences between smokers and non-smokers were found for warning pictures without these smoking scenes. CONCLUSION Previous studies have shown that the most threatening and arousing pictures prompt the greatest evidence of defensive activation. Emotional ratings of Brazilian warning pictures described them as unpleasant but moderately arousing. To intensify avoidance of the packages, future graphic warnings should therefore generate more arousal. The ratings for the Brazilian warning pictures indicated that, except for those depicting people smoking, judgements by smokers and non-smokers were similar, suggesting a potential applicability in both prevention and cessation. Smoking cues, however, should be avoided.
Collapse
|
11
|
Affiliation(s)
- Tania Cavalcante
- Programa Nacional de Control de Tabaco, División de Control del Tabaco y Otros Factores de Riesgo de Cáncer, Instituto Nacional de Cáncer, Coordinación de Prevención y Vigilancia, Ministerio de Salud, Brasil.
| |
Collapse
|