Smoking is still one of the leading causes of death in both developed and developing countries, even thought the daily prevalence among men fell from 41% in 1980 to 31% in 2012 and from 11% to 6% in women in the same time period. However it remains a Public Health issue in young people of developing countries who have limited funding for its consequences.

Prof. Bo Xi et al. studied the “data from the Global School-based student Health survey (2006-13) and the China Global Tobacco Youth Survey (2013), which are school-based surveys of young adolescents aged 112-15 years that assess health behaviors using a standardized anonymous, self-reported questionnaire. We calculated the prevalence of current tobacco use and exposure to second-hand smoke in young adolescents from 68 low-income and middle-income countries that collected these data in surveys.”

They created a multilevel model to study the association between parental tobacco use, second-hand smoke, and adolescent tobacco use, adjusting for sex, age, school, school class, country’s purchasing power parity, smoking initiation age, national prevalence of tobacco use, year of the WHO-FCTC ratification, a measurement of socioeconomic status and survey year.

The general prevalence of actual tobacco use was 13.6%, ranging from 2.8% in Tajikistan to 44.7% in Samoa. In the majority of countries the prevalence was higher for boys than girls, and higher for adolescents aged 14-15 years than for those aged 12-13 years. The prevalence of second-hand smoke exposure was 55.9% and parental tobacco use (especially maternal use) was a risk factor for adolescents’ tobacco use, unlike the socio-economic status.

For almost a decade, the “República Oriental del Uruguay”, my birthplace, has enacted some of the toughest anti-smoking laws anywhere in the planet. Smoking is banned in all indoor public spaces and in outdoor areas adjacent to education and healthcare facilities. Tobacco taxes are high and the graphic warnings about risks must cover a least 80% of the pack’s front and back.

Using its humongous legal and lobbying resources, the Philip Morris Co. and Abal Hermanos, its local subsidiary, sued the Uruguayan government in an international trade court over its supposedly unfair labelling practices. In 2015 the litigation finally arrived in ICSID’s docket after arbitration failed.

The unthinkable, the unimaginable, the unfathomable did materialize.

The court sided with Uruguay and ruled against the multinational company. The court ruled that Philip Morris had to pay Uruguay’s government U$ 7 million in damages, together with all the legal fees and related expenses. Humbled by the clear ruling, the multinational did not contest it and paid up.

With Reason standing by, any David can defy any Goliath goofing around.Hailed as the “Switzerland of the Americas”, Uruguay is showing the way for all the world to watch.

Congratulations to Tabaré Vazquez, its president, and the “Frente Amplio”, the political coalition in power.

What do you think? Please tell us.

Don’t leave me alone.

2 thoughts on “Adolescent smoking in developing countries

  1. Durante algunos años, en mi casi lejana juventud, fumé fundamentalmente en forma social. Aquella compulsión que los jóvenes solían y suelen tener, acerca de lo prohibido y políticamente incorrecto. Crecí entre no fumadores – nadie en mi familia lo hacía -. Con los años, abandoné totalmente aquella errónea “forma social” y la reemplacé por una ocasional pipa. Mis hijos no fuman y mi nieta – 16 años – tampoco lo hace. Por lo expuesto me coloco en una posición privilegiada para poder emitir una humilde opinión al respecto, no viciada en absoluto de una posición política que es muy crítica hacia el gobierno que nos rige desde 2005 a la fecha. Creo en la libertad en todas sus formas de expresión tanto como en el libre pensamiento; creo firmemente en el deber del Estado – a través del gobierno de turno – de salvaguardar a sus ciudadanos, en los múltiples aspectos que hacen a la vida, en una República, como lo son educación,trabajo,vivienda y SALUD, entre otros. Pero no creo en las normas que se imponen verticalmente por parte de un gobierno en aras de la salvaguarda de sus ciudadanos. Creo en la educación y en el uso de los medios de comunicación para informar y alertar a los ciudadanos acerca de los múltiples riesgos del tabaquismo. No creo en la cohersión ni en las normas que se dictan y cercenan la libertad en cualquiera de sus formas. Eduquemos para el cambio. No impongamos el cambio.

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    1. Querido Carlitos: buenas noches y muchas gracias por tu comentario ponderado y casi acertado. Si bien el gobierno uruguayo impuso una normativa un poco draconiana en la publicidad y marketing de los cigarrillos, no prohibio en absoluto su consumo. Como dice el articulo de “The Lancet” las tabaqueras multinacionales estan fogoneando el consumo de menores en paises sub-desarrollados que no pueden financiar las consecuencias nefastas desde el punto de vista economico, laboral y sanitario. En una nota un poco mas liviana, te estoy viendo en una de esas tardes terriblemente grisaceas de nuestro querido Montevideo, de pantuflas y bata, al lado de la estufa con quebracho, saboreando tu pipa, mientas corregis las pruebas de tus alumnos o lees un buen libro. Bien British che !!!

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