|Fact sheet No 196: The Tobacco Epidemic in Latin America - May 1998 (WHO, 1998, 3 p.)|
|THE TOBACCO EPIDEMIC IN LATIN AMERICA|
More Than 400 Latin Americans Are Killed Every Day
At present, there are an estimated 150,000 deaths per year from tobacco in Latin America. The numbers are rising steadily, and in the next quarter-century this toll will almost triple. By 2020, tobacco will be killing around 400,000 people every year. Of particular concern is the projected escalation in the proportion of tobacco-caused deaths occurring among women in the region.
The pace of epidemiological transition in Latin America is among the highest of any developing region. In Latin America, more people already die of non-communicable diseases, many of which are caused by tobacco, than of communicable diseases, maternal and perinatal conditions and nutritional deficiencies.
In Latin America, the predominance of non-communicable diseases, already apparent in 1990, will become even more evident over the next few decades. From 1990 to 2020, deaths from chronic diseases are expected to double, by which time they might well account for about three-fourths of all deaths in the region. By 2020, there will be seven times more deaths from non-communicable diseases than infectious diseases, compared to twice as many at present.
Consumption: In the early 1990s, per capita consumption of cigarettes for adults aged 15 and above averaged about 1300 annually. This ranged from around 350 to 450 in countries such as Peru and Guatemala to around 2000 and above in Venezuela and Cuba. Today, an estimated average of 12 cigarettes are smoked per smoker per day in the region
· After rapid growth in per capita tobacco consumption in Latin America during the 1960s and 1970s, a severe economic downturn in the 1980s led to a decline in tobacco consumption, which for many countries continued into the 1990s. However, there are strong indications that by the end of the decade, an increase in cigarette consumption will be experienced in many countries of the region.
· Predicted increases in consumption are attributed to such factors as improved economic conditions, a rise in disposable income, population growth, and an increase in smoking among women.
· According to WHO estimates, approximately 40% of men and 21% of women in Latin America and the Caribbean smoke. In general, smoking prevalence is highest in urban populations.
· The prevalence of smoking in Latin America is variable, but reaches 50% or more among young people in some urban areas. Significant numbers of women in the region have taken up smoking in recent years.
· Studies conducted in a number of Latin American countries indicate that three-fourths of smokers start smoking between the ages of 14 and 17. There appears to have been an increase in smoking prevalence among teenagers, mostly in urban areas. In contrast, rural populations, particularly indigenous or native populations record relatively low smoking prevalence.
· In Latin America, public awareness of the health risks of tobacco use is generally low, so are the levels of motivation to quit smoking.
Tobacco economics: Tobacco is grown in a number of countries in Latin America
The number of hectares devoted to tobacco cultivation ranges from 25,000 hectares in countries such as Peru and Columbia to more than 50,000 hectares in large producing countries such as Brazil, Argentina, and Cuba.
· Only a few countries of Latin America presently have economies that are largely dependent on tobacco production. The economic impact of the tobacco industry ranges from negative, due to a negative balance of trade for tobacco products and goods used in tobacco production and manufacture, to substantial, for countries such as Brazil. Brazil is the largest producer of tobacco in Latin America, and the third largest producer of tobacco in the world, with over 700,000 hectares under cultivation.
· In the countries where tobacco production and marketing represent an important part of the national economies, this has often lead to a conflict of interest concerning the implementation of effective tobacco control policies and programmes.
· The tobacco industry in Latin America is dominated by multinational companies. In recent years, multinational tobacco companies have been expanding rapidly in Latin America and their investments in the region appear to be rewarding. According to a trade journal, in 1996 a British multinational tobacco company sold 174 billion of its cigarettes in Latin America, earning it $390 million in profits.
· Cigarette smuggling remains a problem for many countries of the region.
Tobacco control measures: They are badly needed in order to reverse the tobacco epidemic in Latin America.
· Tobacco advertising and promotions by multinational tobacco companies are prolific throughout the region. Multinational tobacco companies are frequent sponsors of sports and cultural events, many of which are popular with young people.
· In some countries children work selling single cigarettes, and are also employed in tobacco cultivation.
· In general, medical professionals are not widely informed about the risks of tobacco. There is also a lack of health promotion programmes. This results in a lack of public knowledge which serves to reinforce a culture where tobacco use is socially acceptable. This makes it difficult for tobacco control programmes to advance.
· Although many countries in Latin America have passed tobacco control legislation, the legislation tends to be weak and contain loopholes which serve to the advantage of tobacco companies. In recent years, there are some Latin American countries which have passed fairly strong tobacco control legislation. Yet, few countries have adopted comprehensive tobacco control programmes and policies as recommended by WHO.
· The Tobacco Control Coordinating Committee for Latin America (CLACCTA) has been actively involved in moving countries towards the adoption of comprehensive tobacco control polices and programmes.
· An Interagency Action Plan has been developed for Latin America to provide assistance and technical support to the various countries involved in the development and/or strengthening of tobacco control groups at the country level. One goal is to facilitate the establishment of strategic alliances or coalitions which are multisectoral and involve both government and nongovernmental organizations. The plan provides an important framework for implementing and monitoring progress on tobacco control in Latin America.
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