A snapshot of the striking decrease in cigarette smoking prevalence in Brazil between 1989 and 2008

Abstract

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

Methodology: We calculated absolute and relative differences in smoking prevalences, overall and stratified by gender, age, place of residence, educational level and birth cohort. Data were obtained from random samples from two National Household Surveys (1989,n=39,969; 2008,n=38,461). GLM models were specified to obtain estimates and assess whether differences in proportions of smokers differed by categories of the stratification variables.

Results: Adjusted absolute and relative differences in smoking prevalence rates between 1989 and 2008 were, respectively, -12.4% and -41.0%. Individuals aged 15-34 years and those with 9 or more years of education presented larger relative declines than their counterparts (p(s)≤0.001). After stratification by birth cohort, men presented larger reductions than women, only in the absolute scale (p(s)≤0.001), with the exception of the youngest birth cohort (i.e.,1965-1974).

Conclusions: In Brazil, several tobacco control measures have been adopted since 1986, in particular increasing taxation of tobacco products and strong health warnings, which may have contributed to the marked decline in smoking prevalence. It is important to understand the evolution of the tobacco epidemic to propose new actions to prevent initiation and encourage cessation among those who started/continued smoking.