Population-based evidence of a strong decline in the prevalence of smokers in Brazil (1989-2003)

TLDR: In this paper, the authors evaluated the evolution in smoking indicators in the adult Brazilian population between 1989 and 2003 and found that there was a substantial decrease in the prevalence of smoking (from 34.8% to 22.4% and a modest reduction in the mean number of cigarettes consumed per day (from 13.3 to 11.6).

Abstract: Objective To evaluate the evolution in smoking indicators in the adult Brazilian population between 1989 and 2003. Methods We compared age-adjusted prevalence ratios and means for smoking indicators, stratified by age, sex and sociodemographic variables, obtained from two comparable household surveys that used probabilistic sampling of the Brazilian population aged > 18 years (n = 34 808 in 1989 and n = 5000 in 2003). Findings Between 1989 and 2003, there was a substantial decrease in the prevalence of smoking (from 34.8% to 22.4%; ageadjusted prevalence ratio, 0.65; 95% confidence interval, CI, 0.60–0.70) and a modest reduction in the mean number of cigarettes smoked per day (from 13.3 to 11.6; age-adjusted difference, –1.8; 95% CI, –2.6 – –1.0). Reductions in the prevalence and intensity of smoking were greater among males, younger age groups and higher socioeconomic strata. Conclusion The prevalence of smoking in the adult Brazilian population declined by 35% between 1989 and 2003, or an average of 2.5% per year. This exceptional reduction surpasses those seen in other countries that implemented wide-ranging and rigorous policies for controlling smoking during the same period. The more intense decline in smoking in younger age groups was consistent with the concentration of efforts of the Brazilian tobacco control programme to prevent the onset of smoking among youths and the total prohibition of cigarette advertising. We recommend the intensification of programme initiatives targeting women and less economically favoured population strata.