The Lancet, Volume 380, Issue 9853, Pages 1575 - 1582, 3 November 2012

Tobacco control campaign in Uruguay: a population-based trend analysis

Winston Abascal MD, Elba Esteves MD, Beatriz Goja MD, Franco González Mora Soc, Ana Lorenzo MDa, Amanda Sica Ps Soc, Patricia Triunfo PhD, Dr Jeffrey E Harris MD

Summary
Background

In 2005, Uruguay initiated a series of comprehensive anti-smoking measures. We aimed to assess the effect of Uruguay's anti-tobacco campaign.

Methods

We did a population-based trend analysis, using neighbouring Argentina, which has not instituted such extensive anti-tobacco measures, as a control. We assessed three key endpoints in both countries: per-person consumption of cigarettes, as measured by tax records; the prevalence of tobacco use in adolescents, as measured by school-based surveys; and the prevalence of tobacco use in adults, as measured by nationwide household-based surveys.

Findings

During 2005—11, per-person consumption of cigarettes in Uruguay decreased by 4·3% per year (95% CI 2·4 to 6·2), whereas per-person consumption in Argentina increased by 0·6% per year (—1·2 to 2·5; p=0·002 for difference in trends). During 2003—09, the 30-day prevalence of tobacco use in Uruguayan students aged 13 years, 15 years, and 17 years decreased by an estimated 8·0% per year (4·5 to 11·6), compared with a decrease of 2·5% annually (0·5 to 4·5) in Argentinian students during 2001—09 (p=0·02 for difference in trends). From 2005 to 2011, the prevalence of current tobacco use in Uruguay decreased annually by an estimated 3·3% (2·4 to 4·1), compared with an annual decrease in Argentina of 1·7% (0·8 to 2·6; p=0·02 for difference in trends).

Interpretation

Uruguay's comprehensive tobacco-control campaign has been associated with a substantial, unprecedented decrease in tobacco use. Decreases in tobacco use in other low-income and middle-income countries of the magnitude seen in Uruguay would have a substantial effect on the future global burden of tobacco-related diseases.