How smokers may react to cigarette taxes and price increases in Brazil: data from a national survey.

BACKGROUND: Despite being the third largest tobacco producer in the world, Brazil has developed a comprehensive tobacco control policy that includes a broad restriction on both advertising and smoking in indoor public places, compulsory pictorial warning labels, and a menthol cigarette ban. However, tax and pricing policies have been developed slowly and only very recently were stronger measures implemented. This study investigated the expected responses of smokers to hypothetical price increases in Brazil. METHODS: We analyzed smokers' responses to hypothetical future price increases according to sociodemographic characteristics and smoking conditions in a multistage sample of Brazilian current cigarette smokers aged≥14 years (n=500). Logistic regression analysis was used to examine the relationship between possible responses and different predictors. RESULTS: In most subgroups investigated, smokers most frequently said they would react to a hypothetical price increase by taking up alternatives that might have a positive impact on health, i.e., they would "try to stop smoking" (52.3%) or "smoke fewer cigarettes" (46.8%). However, a considerable percentage responded that they would use alternatives that would reduce the effect of price increases, such as the same brand with lower cost (48.1%). After controlling for sex age group (14-19, 20-39, 40-59, and ≥60 years), schooling level (≥9 versus ≤9 years), number of cigarettes per day (>20 versus ≤20), and stage of change for smoking cessation (precontemplation, contemplation, and preparation), lower levels of dependence were positively associated with the response "I would try to stop smoking" (odds ratio [OR], 2.19). Young age was associated with "I would decrease the number of cigarettes" (OR, 3.44). A low schooling level was strongly associated with all responses. CONCLUSIONS: Taxes and prices increases have great potential to stimulate cessation or reduction of cigarette consumption further among two important vulnerable populations of smokers in Brazil: young smokers and those of low educational level. The results from the present study also suggest that seeking illegal products may reduce the impact of increased taxes, but does not eliminate it.

Case studies of tobacco dependence treatment in Brazil, England, India, South Africa and Uruguay.

AIMS: The aims of this study are to describe the tobacco dependence treatment systems in five countries at different stages of development of their systems, and from different income levels and regions of the world, and to draw some lessons from their experiences that might be useful to other countries. METHODS AND DATA SOURSES: Data were drawn from an earlier survey of treatment services led by M.R. and A.M., from Party reports to the Secretariat of the Framework Convention on Tobacco Control, and from correspondents in the five countries. These data were entered onto a standard template by the authors, discussed with the correspondents to ensure they were accurate and to help us interpret them, and then the templates were used as a basis to write prose descriptions of the countries' treatment systems, with additional summary data presented in tables. RESULTS: Two of the middle-income countries have based their treatment on specialist support and both consequently have very low population coverage for treatment. Two countries have integrated broad-reach approaches, such as brief advice with intensive specialist support; these countries are focusing currently upon monitoring performance and guaranteeing quality. Cost is a significant barrier to improving treatment coverage and highlights the importance of using existing infrastucture as much as possible. CONCLUSIONS: Perhaps not surprisingly the greatest challenges appear to be faced by large, lower-income countries that have prioritized more intensive but low-reach approaches to treatment, rather than developing basic infrastructure, including brief advice in primary care and quitlines.

The effect of restricting opening hours on alcohol-related violence.

OBJECTIVE: We investigated whether limiting the hours of alcoholic beverage sales in bars had an effect on homicides and violence against women in the Brazilian city of Diadema. The policy to restrict alcohol sales was introduced in July 2002 and prohibited on-premises alcohol sales after 11 pm. METHODS: We analyzed data on homicides (1995 to 2005) and violence against women (2000 to 2005) from the Diadema (population 360,000) police archives using log-linear regression analyses. RESULTS: The new restriction on drinking hours led to a decrease of almost 9 murders a month. Assaults against women also decreased, but this effect was not significant in models in which we controlled for underlying trends. CONCLUSIONS: Introducing restrictions on opening hours resulted in a significant decrease in murders, which confirmed what we know from the literature: restricting access to alcohol can reduce alcohol-related problems. Our results give no support to the converse view, that increasing availability will somehow reduce problems.