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Resumen OBJETIVO: Describir el nivel de conocimiento de los signos y síntomas de alarma obstétrica en mujeres embarazadas. MATERIALES Y MÉTODOS: Estudio de serie de casos prolectivo y descriptivo efectuado en la Unidad de Medicina Familiar 16, Instituto Mexicano del Seguro Social, Mexicali, Baja California, entre los meses de enero a junio de 2022. Variables de estudio: edad, sexo, escolaridad y nivel de conocimiento de signos y síntomas de alarma a través de una encuesta elaborada conforme a los criterios de la guía de práctica clínica. Se utilizó estadística descriptiva con el programa SPSSv24. RESULTADOS: Se estudiaron 150 pacientes embarazadas. El bajo nivel de conocimiento de los signos y síntomas de alarma se observó en 15 casos, el nivel medio en 47 casos y el nivel alto en 88 casos (58.7%). En cuanto a las características de la población, los límites de edad fueron 20 y 34 años, la escolaridad secundaria ocupó el 47.3% seguido de la preparatoria con el 35.3% y en cuanto a la ocupación el 80.7% refirió ser empleada. El 34% cursaba el primer trimestre del embarazo y el 48.7% el segundo trimestre. CONCLUSIONES: El nivel de conocimiento de las pacientes embarazadas atendidas en la unidad es alto y medio porque pueden reconocer los signos y síntomas de alarma durante el embarazo, sobre todo quienes cursan el segundo embarazo, en coincidencia con estudios nacionales e internacionales. El grupo predominante fue el de 20 a 34 años, con escolaridad media y superior.
Abstract OBJECTIVE: To describe the level of knowledge of obstetric alarm signs and symptoms in pregnant women. MATERIALS AND METHODS: Selective and descriptive case series study carried out in the Family Medicine Unit 16, Mexican Institute of Social Security, Mexicali, Baja California, between January and June 2022. Study variables: age, sex, education and level of knowledge of warning signs and symptoms through a survey prepared according to the criteria of the Clinical Practice Guide. Descriptive statistics were performed using SPSSv24. RESULTS: 150 pregnant patients were screened. A low level of knowledge of warning signs and symptoms was observed in 15 cases, a medium level in 47 cases and a high level in 88 cases (58.7%). Regarding the characteristics of the population, the age range was 20-34 years, 47.3% had secondary education, followed by high school with 35.3%, and 80.7% reported being employed. Thirty-four per cent were in the first trimester of pregnancy and 48.7 per cent in the second trimester. CONCLUSIONS: The level of knowledge of pregnant patients attending the unit is high and medium in terms of being able to recognize the warning signs and symptoms of pregnancy, particularly in the second trimester, in line with national and international studies. The predominant age group was 20-34 years, with secondary and higher education.
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The use of graphic health warnings (GHWs) on tobacco packaging is one of the most widely used public health strategies worldwide, but there is little evidence of the emotional impact of its content and craving they generate. The objective of the present study was to evaluate the emotional and craving responses to GHW content. The study included 300 men and women of different ages (adolescents, young adults, and adults), both smokers and non-smokers. We evaluated the participants' emotional and craving responses to 16 GHWs with different content (i.e., cancer, cardiovascular disease, abortion, and childhood illness). We analyzed the effects of sex, smoking status, and age. GHWs exhibited the capacity to elicit aversive emotional states, with low levels of arousal and high levels of dominance and did not produce craving. GHWs that showed images of cancer and abortion had the greatest emotional impact. Non-smoking adolescent females experienced the greatest emotional impact of GHWs. The results suggest that GHWs effectively reduce the attractiveness of cigarette packages and discourage consumption, and increasing the size of GHWs may favor avoidance of the package. GHWs that depicted explicit threats had a greater emotional impact, especially in women.
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AIMS: To measure how cigarette packaging (standardised packaging and branded packaging) and health warning size affect visual attention and pack preferences among Colombian smokers and non-smokers. DESIGN: To explore visual attention, we used an eye-tracking experiment where non-smokers, weekly smokers and daily smokers were shown cigarette packs varying in warning size (30%-pictorial on top of the text, 30%-pictorial and text side-by-side, 50%, 70%) and packaging (standardised packaging, branded packaging). We used a discrete choice experiment (DCE) to examine the impact of warning size, packaging and brand name on preferences to try, taste perceptions and perceptions of harm. SETTING: Eye-tracking laboratory, Universidad Nacional de Colombia, Bogotá, Colombia. PARTICIPANTS: Participants (n = 175) were 18 to 40 years old. MEASUREMENTS: For the eye-tracking experiment, our primary outcome measure was the number of fixations toward the health warning compared with the branding. For the DCE, outcome measures were preferences to try, taste perceptions and harm perceptions. FINDINGS: We observed greater visual attention to warning labels on standardised versus branded packages (F[3,167] = 22.87, P < 0.001) and when warnings were larger (F[9,161] = 147.17, P < 0.001); as warning size increased, the difference in visual attention to warnings between standardised and branded packaging decreased (F[9,161] = 4.44, P < 0.001). Non-smokers visually attended toward the warnings more than smokers, but as warning size increased these differences decreased (F[6,334] = 2.92, P = 0.009). For the DCE, conditional trials showed that increasing the warning size from 30% to 70% reduced preferences to try (odds ratio [OR] = 0.48, 95% CI = [0.42,0.54], P < 0.001), taste perceptions (OR = 0.61, 95% CI = [0.54,0.68], P < 0.001); and increased harm perceptions (OR = 0.78, 95% CI = [0.76,0.80], P < 0.001). Compared with branded packaging, standardised packaging reduced our DCE outcome measures with ORs ranging from OR = 0.25 (95% CI = [0.17,0.38], P < 0.001) to OR = 0.79 (95% CI = [0.67,0.93], P < 0.001) across two brands. These effects were more pronounced among non-smokers, males and younger participants. Unconditional trials showed similar results. CONCLUSIONS: Standardised cigarette packaging and larger health warnings appear to decrease positive pack perceptions and have the potential to reduce the demand for cigarette products in Colombia.
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Fumantes , Produtos do Tabaco , Adolescente , Adulto , Colômbia , Humanos , Masculino , não Fumantes , Rotulagem de Produtos/métodos , Embalagem de Produtos , Fumar , Adulto JovemRESUMO
Pictorial health warnings (PHW) were introduced in Mexico by the end of 2010. Different studies have assessed how PHW influence attitude or desire to renounce smoking, but they have not studied the actual effect on the demand of tobacco products. Our objective in this paper is to analyze the effect of duration of pictorial health warnings on consumption of tobacco in Mexico. We assess the influence of different consecutive rounds of pictorial warnings, taking into account their length and the use of repeated images. We use a Dynamic Least Squares model (DOLS) with quarterly data (1994-2015), to estimate the long run demand of cigarettes in Mexico, as a function of per-capita income, the relative price of tobacco, different regulatory measures and the different rounds of pictograms, its duration, and the use of repeated images. We find evidence indicating that the pictorial health warnings have reduced consumption of cigarettes, that the effect has decreased in the last rounds, and that the most effective duration of the rounds is six months. PHW regulation deters consumption; however, its effectiveness decreases over time, suggesting that consumers tend to adapt to images.
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Rotulagem de Produtos , Produtos do Tabaco , Humanos , México/epidemiologia , Prevenção do Hábito de Fumar , Uso de TabacoRESUMO
Introducción: La prevención de infecciones intrahospitalarias es uno de los aspectos más inquietantes en enfermería en los últimos años. Para esto, se han establecido diversas estrategias, entre ellas, los aislamientos hospitalarios. Sin embargo, se encuentra gran diAcultad para el cumplimiento de las medidas de aislamiento. Objetivo: Determinar los factores sociodemográAcos y de la atención en salud relacionados con el cumplimiento de las precauciones de contacto por parte de los visitantes en un hospital de alta complejidad de la ciudad de Medellín. Método: Se realizó un estudio descriptivo de corte trasversal a un total de 126 visitantes de pacientes aislados por contacto. Se identiAcaron factores asociados al cumplimiento del aislamiento mediante una encuesta, se analizó la información en el programa SPSS mediante una regresión logística y se asumió signiAcancia estadística si valor P menor a 0,05. Resultados: La adherencia total al aislamiento fue de un 40,5% y está asociada principalmente con dos factores: disponibilidad de los elementos de protección y estar de acuerdo con el uso de estos. Conclusiones: Los factores mejor asociados con el cumplimiento del aislamiento hacen necesario que las instituciones garanticen suAcientes insumos para los visitantes y que tanto el personal de salud como los visitantes reciban una mayor sensibilización en este tema.
Introduction: Preventing the intra-hospital infections is one of the major concerns in the last year. To that end, different strategies have been set such as hospital isolation. However, there is a grate default in order to comply with the isolation measures Objective: To determine the sociodemographic and healthcare factors related to how to comply with the contact warnings by the visitors coming into a high complexity hospital in Medellín. Methods: It is a cross-sectional descriptive study including in total 126 visitors who were isolated aÆer a contact. Factors associated with the isolation compliance were identiAed based on a survey. Information was analyzed with SPSS soÆware by doing a logistic regression and statistical signiAcance was assumed as P<0.05. Results: Total adherence to isolation was 40.5%, which is mainly associated with two factors: availability of protective garments and to agree with their use. Conclusions: Ǽe factors deemed as best associated with the isolation compliance required that the institutions provided enough protective garments to the visitors and that both the visitors and the hospital staff can receive a better awareness-rising communication on this topic.
Introdução: A prevenção de infeções intrahospitalares é um dos aspectos mais preocupantes nos últimos anos. Para isso, tem se estabelecido várias estratégias, entre elas, o isolamento hospitalar. No entanto, há grande diAculdade para a adesão as medidas de isolamento. Objetivo: Determinar os fatores sociodemográAcos e da atenção em saúde relacionados com o cumprimento das precauções de contato por parte dos visitantes em um hospital de alta complexidade na cidade de Medellín. Método: Foi realizado um estudo descritivo transversal com um total de 126 visitantes de pacientes isolados por contato. IdentiAcaram-se fatores associado ao cumprimento do isolamento mediante inquérito, analisou-se a informação no programa SPSS mediante regressão logística e foi assumida signiAcância estatística se o valor P fosse menor a 0,05. Resultados: A adesão total ao isolamento foi de 40,5% e está associada principalmente com dois fatores: disponibilidade dos elementos de proteção e concordância com seu uso. Conclusões: Os fatores mais bem associados ao cumprimento do isolamento tornam necessário que as instituições garantam suprimentos suAcientes para os visitantes e que tanto o pessoal de saúde quanto os visitantes recebam maior conscientização sobre essa questão.
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Humanos , Isolamento de Pacientes , Precauções Universais , Cooperação e Adesão ao TratamentoRESUMO
OBJECTIVE: The health warnings printed on cigarette packs are a strategy to control cigarette smoking and induce changes in the behavior of the smoker with regard to habit. The objective was to evaluate the educational material of cigarette packs of anti-smoking campaigns in a group of smokers in a city in Colombia. METHODS: Descriptive cross-sectional study; 189 smokers rated 21 images of cigarette packs used in Colombia, through an instrument of the Pan American Health Organization - PAHO. Univariate analysis of variables was performed; In the analytical phase, Pearson's Chi Square parametric test was used; statistical significance was accepted with a value of p <0.05. RESULTS: The images need reforms, which indicate that the material partially meets its objective. The 21 images are evaluated as unattractive (77,5%), accepted (9,1%), understood (14,7%) and do not induce to stop smoking (80,2%). There is a statistical association between the understanding / identification of images and the education of smokers (p = 0.004); induction to the action of the images and socioeconomic level of the smokers (p = 0.01); attraction of the smoker's images and sex (p = 0.02), as well as acceptance and socioeconomic status (p = 0.02). CONCLUSIONS: The images used in cigarette packages require reforms and adjustments to international guidelines, so that they respond as a means of transmitting public health messages, as a perception of risk and real behavioral changes in relation to cigarette consumption.
OBJETIVO: Las advertencias sanitarias impresas en los paquetes de cigarrillos, se constituyen en una estrategia para controlar el consumo de cigarrillos e inducir cambios de comportamiento del fumador frente al hábito tabáquico. El objetivo de este trabajo fue evaluar el material educativo de las cajetillas de cigarrillos de las campañas de control de tabaco, en un grupo de fumadores de una ciudad de Colombia. METODOS: Estudio descriptivo de corte transversal; 189 fumadores valoraron 21 imágenes de cajetillas de cigarrillos, utilizadas en Colombia, a través de instrumento de la Organización Panamericana de la Salud OPS. Se realizó análisis univariado de variables; en la fase analítica se utilizó la prueba paramétrica de Chi Cuadrado de Pearson; se aceptó significación estadística con un valor de p<0,05. RESULTADOS: Las 21 imágenes fueron evaluadas como poco atractivas (77,5%), aceptadas (9,1%), entendidas (14,7%) y no inducen a dejar de fumar (80,2%). Existe asociación estadística entre el entendimiento/identificación de las imágenes y la escolaridad de los fumadores (p=0.004); inducción a la acción de las imágenes y nivel socioeconómico de los fumadores (p=0.01); atracción de las imágenes y el sexo del fumador (p=0.02), al igual que la aceptación y nivel socioeconómico (p=0.02). CONCLUSIONES: Las imágenes utilizadas en las cajetillas de cigarrillos, requieren de reformas y ajustes a alineamientos internacionales, para que respondan como medio en la trasmisión de mensajes de salud pública, en cuanto a la percepción del riesgo y los cambios de comportamiento reales frente al consumo de cigarrillo.
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Educação de Pacientes como Assunto/métodos , Rotulagem de Produtos , Prevenção do Hábito de Fumar , Adolescente , Adulto , Colômbia , Estudos Transversais , Feminino , Guias como Assunto , Hábitos , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Produtos do Tabaco , Uso de TabacoRESUMO
OBJECTIVE: To investigate the relative influence of nutritional warnings and 2 marketing strategies commonly used in food labels, nutrient claims, and fruit images on consumers' healthfulness judgments. DESIGN: Labels of cereal bars were designed according to a full factorial design with 3 2-level variables: images of fruit (with vs without), nutrient claims about the fiber content (with vs without), and nutritional warnings about excessive content of sugar and saturated fat (with vs without). SETTING: Experiment conducted in Montevideo, Uruguay. PARTICIPANTS: One hundred Uruguayan people, 75% female, aged 18-56 years. MAIN OUTCOME MEASURES: Healthfulness perception and eye-tracking variables. ANALYSIS: The researchers used ANOVA to evaluate the influence of the experimental design's variables on perceived healthfulness and eye-tracking measures. RESULTS: Nutritional warnings caught participants' attention and reduced the amount of visual attention needed to evaluate healthfulness. Participants mainly relied on nutritional warnings to make healthfulness judgments. CONCLUSIONS AND IMPLICATIONS: Findings of the current work confirm the potential of nutritional warnings to influence consumers' healthfulness perception, overriding the effect of other label cues used by the food industry to convey the concept of healthfulness.
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Comportamento do Consumidor/estatística & dados numéricos , Grão Comestível , Rotulagem de Alimentos/métodos , Marketing/métodos , Valor Nutritivo , Lanches , Adolescente , Adulto , Açúcares da Dieta , Ácidos Graxos , Feminino , Fixação Ocular , Preferências Alimentares , Frutas , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Julgamento , Masculino , Pessoa de Meia-Idade , Uruguai , Adulto JovemRESUMO
OBJECTIVE: To evaluate how information about low nutrient content included in the traffic light labeling system influences consumers' perception of the healthfulness of products with high content of 1 key nutrient, and to compare the traffic light system with warnings in terms of the perception of healthfulness. DESIGN: Images of front-of-pack (FOP) nutrition labels (the traffic light labeling system with different numbers of nutrients with low content, and warnings) were evaluated in study 1, whereas product labels featuring the different FOP nutrition labels were evaluated in study 2. SETTING: Online studies conducted in Montevideo, Uruguay. PARTICIPANTS: A total of 1,228 Uruguayan Facebook users. MAIN OUTCOME MEASURES: Perception of healthfulness. ANALYSIS: The researchers used ANOVA to evaluate the influence of FOP nutrition labels on perceived healthfulness. RESULTS: The inclusion of information about low nutrient content in the traffic light system statistically significantly increased the perception of the healthfulness of products with high nutrient content. Nutritional warnings showed healthfulness ratings similar to those of the simplified version of the traffic light system. CONCLUSIONS AND IMPLICATIONS: Information about low nutrient content in the traffic light system might be used to infer health, and thus could raise the perception of healthfulness and decrease the traffic light system's efficacy in discouraging the consumption of unhealthful products. A simplified version of the traffic light highlighting only high-nutrient content or nutritional warnings seems to overcome this problem.
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Comportamento do Consumidor/estatística & dados numéricos , Rotulagem de Alimentos , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Comportamento de Escolha , Feminino , Rotulagem de Alimentos/métodos , Rotulagem de Alimentos/estatística & dados numéricos , Preferências Alimentares , Humanos , Masculino , Pessoa de Meia-Idade , Política Nutricional , Valor Nutritivo , Uruguai , Adulto JovemRESUMO
Time orientation can influence health-related behaviors, including food consumption. The aim of the present work was to study the influence of time orientation on food choice, using cookie labels as case study. A choice-conjoint task was designed using labels differing in type of cookie (chocolate chips vs. granola), front-of-pack nutrition information (nutritional warnings vs. Facts Up Front system) and nutritional claim (no claim vs. "0% cholesterol. 0% trans fat"). An online study was conducted, in which 155 participants evaluated 8 pairs of cookie labels and selected the one they would buy if they were in the supermarket. Then, they were asked to complete a consideration of future consequences scale (CFC) adapted to eating habits, as well as a questionnaire about socio-demographic characteristics. Time orientation influenced participants' choices of cookies labels; particularly the importance attached to type of cookie. Participants with greater consideration of future consequences preferred the granola cookies, associated with health, while those who prioritized immediate consequences preferred chocolate chip cookies. In addition, nutritional warnings discouraged choice regardless of participants' time orientation. Results from the present work provide additional evidence of the influence of time preferences on food choices and suggest that strategies to stimulate and generate a more future-oriented perspective on eating habits could contribute to more healthful food choices.
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Comportamento de Escolha , Comportamento do Consumidor , Comportamento Alimentar , Rotulagem de Alimentos , Valor Nutritivo , Lanches , Adolescente , Adulto , Qualidade de Produtos para o Consumidor , Dieta Saudável , Feminino , Preferências Alimentares , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Inquéritos e Questionários , Fatores de Tempo , Uruguai , Adulto JovemRESUMO
BACKGROUND: Uruguay, a South American country of 3.4 million inhabitants that has already banned tobacco advertising, prohibited such terms as light, mild and low-tar and required graphic warnings covering 80% of cigarette packs, is considering the imposition of plain, standardised packaging. METHODS: We conducted an experimental choice-based conjoint analysis of the impact of alternative cigarette package designs on the risk perceptions of 180 adult current Uruguayan smokers. We compared plain packaging, with a standardised brand description and the dark brown background colour required on Australian cigarette packages, to two controls: the current package design with distinctive brand elements and colours; and a modified package design, with distinctive brand elements and the dark brown background colour. Graphic warnings were also varied. RESULTS: Plain packaging significantly reduced the probability of perceiving the stimulus cigarettes as less harmful in comparison to the current package design (OR 0.398, 95% CI 0.333 to 0.476, p<0.001) and the modified package design (OR 0.729, 95% CI 0.626 to 0.849, p<0.001). CONCLUSIONS: Plain packaging enhanced the perceived risk of cigarette products even in a highly regulated setting such as Uruguay. Both the elimination of distinctive brand elements and the use of Australia's dark brown background colour contributed to the observed effect.
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Embalagem de Produtos/normas , Medição de Risco , Fumantes/psicologia , Produtos do Tabaco , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rotulagem de Produtos , Uruguai , Adulto JovemRESUMO
OBJECTIVE: Warnings are a new directive front-of-pack (FOP) nutrition labelling scheme that highlights products with high content of key nutrients. The design of warnings influences their ability to catch consumers' attention and to clearly communicate their intended meaning, which are key determinants of their effectiveness. The aim of the present work was to evaluate the influence of design features of warnings as a FOP nutrition labelling scheme on perceived healthfulness and attentional capture. DESIGN: Five studies with a total of 496 people were carried out. In the first study, the association of colour and perceived healthfulness was evaluated in an online survey in which participants had to rate their perceived healthfulness of eight colours. In the second study, the influence of colour, shape and textual information on perceived healthfulness was evaluated using choice-conjoint analysis. The third study focused on implicit associations between two design features (shape and colour) on perceived healthfulness. The fourth and fifth studies used visual search to evaluate the influence of colour, size and position of the warnings on attentional capture. RESULTS: Perceived healthfulness was significantly influenced by shape, colour and textual information. Colour was the variable with the largest contribution to perceived healthfulness. Colour, size and position of the warnings on the labels affected attentional capture. CONCLUSIONS: Results from the experiments provide recommendations for the design of warnings to identify products with unfavourable nutrient profile.
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Atenção , Comportamento do Consumidor , Rotulagem de Alimentos , Preferências Alimentares/psicologia , Adolescente , Adulto , Comportamento de Escolha , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Nutritivo , Adulto JovemRESUMO
Research on the relative influence of package features on children's perception of food products is still necessary to aid policy design and development. The aim of the present work was to evaluate the relative influence of two front-of-pack (FOP) nutrition labelling schemes, the traffic light system and Chilean warning system, and label design on children's choice of two popular snack foods in Uruguay, wafer cookies and orange juice. A total of 442 children in grades 4 to 6 from 12 primary schools in Montevideo (Uruguay) participated in the study. They were asked to complete a choice-conjoint task with wafer cookies and orange juice labels, varying in label design and the inclusion of FOP nutrition information. Half of the children completed the task with labels featuring the traffic-light system (n = 217) and the other half with labels featuring the Chilean warning system (n = 225). Children's choices of wafer cookies and juice labels was significantly influenced by both label design and FOP nutritional labels. The relative impact of FOP nutritional labelling on children's choices was higher for the warning system compared to the traffic-light system. Results from the present work stress the need to regulate the design of packages and the inclusion of nutrient claims, and provide preliminary evidence of the potential of warnings to discourage children's choice of unhealthful products.
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Comportamento Infantil , Comportamento de Escolha , Dieta Saudável , Embalagem de Alimentos , Preferências Alimentares , Qualidade dos Alimentos , Cooperação do Paciente , Adolescente , Comportamento do Adolescente , Criança , Comportamento Infantil/etnologia , Citrus sinensis/química , Dieta Saudável/etnologia , Fast Foods/efeitos adversos , Fast Foods/análise , Feminino , Preferências Alimentares/etnologia , Sucos de Frutas e Vegetais/efeitos adversos , Sucos de Frutas e Vegetais/análise , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Masculino , Valor Nutritivo , Cooperação do Paciente/etnologia , Lanches/etnologia , UruguaiRESUMO
Between 2008 and 2013, Brazil experienced a large decline in smoking prevalence, with an innovative round of aversive pictorial health warnings implemented on cigarette packs and at points of sale in 2009. The objective of this study was to examine changes over time in the distribution of quitting attempts and self-reported thoughts about quitting due to health warnings among current smokers. We conducted a pre-post study to evaluate data from two nationally-representative surveys conducted in 2008 and 2013. Responses to questions on smokers' quitting attempts in the last year (yes vs. no) and whether health warnings led them to think about quitting in the last month (yes vs. no) were combined into four categories, for which the distribution of the Brazilian smoking population by year was estimated. A multinomial model was used to obtain proportions for each category, adjusted by socio-demographic variables and nicotine dependence. The proportion of smokers who reported making a quitting attempt in the last year and stated that health warnings led them think about quitting smoking statistically increased over time (from 30.0% to 33.1%; p-value=0.010). The percentage of those who answered "no" to these two questions also increased over time (from 23.5% to 32.9%; p-value≤0.001). These findings suggest that innovative warnings introduced in Brazil likely served as a "reminder" for continuing to think about cessation among those who attempted to quit in the last year. These warnings may have also triggered more avoidance of thinking about their contents than the previous warnings, which some studies have found to promote subsequent quitting activity.
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Fumar Cigarros/epidemiologia , Rotulagem de Produtos/métodos , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos , Adolescente , Adulto , Brasil/epidemiologia , Fumar Cigarros/terapia , Estudos Transversais , Feminino , Humanos , Masculino , Adulto JovemRESUMO
We analyzed a nationwide registry of all pregnancies in Uruguay during 2007-2013 to assess the impact of three types of tobacco control policies: (1) provider-level interventions aimed at the treatment of nicotine dependence, (2) national-level increases in cigarette taxes, and (3) national-level non-price regulation of cigarette packaging and marketing. We estimated models of smoking cessation during pregnancy at the individual, provider and national levels. The rate of smoking cessation during pregnancy increased from 15.4% in 2007 to 42.7% in 2013. National-level non-price policies had the largest estimated impact on cessation. The price response of the tobacco industry attenuated the effects of tax increases. While provider-level interventions had a significant effect, they were adopted by relatively few health centers. Quitting during pregnancy increased birth weight by an estimated 188 g. Tobacco control measures had no effect on the birth weight of newborns of non-smoking women.
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Publicidade/legislação & jurisprudência , Peso ao Nascer/fisiologia , Regulamentação Governamental , Embalagem de Produtos/legislação & jurisprudência , Abandono do Hábito de Fumar , Produtos do Tabaco/legislação & jurisprudência , Adolescente , Feminino , Promoção da Saúde/métodos , Humanos , Gravidez , Sistema de Registros , Impostos , Produtos do Tabaco/economia , UruguaiRESUMO
O propósito desta dissertação de mestrado é entender a relação que se estabelece entre a adoção de uma medida reguladora pelo governo, com forte impacto na população, e a reação por ela gerada em grupos de interesse.O embasamento teórico do estudo proposto se fundamenta na teoria de políticas sociais, que estuda a ação de grupos de interesse contra a implantação de medidas reguladoras, neste caso específico, a influência da indústria fumageira e seus aliados, na implementação das advertências sanitárias em produtos de tabaco no Brasil.Esta dissertação é dividida em quatro partes, incluindo introdução, percurso teórico metodológico, resultados e discussão e conclusão e recomendações.A metodologia utilizada envolve o estudo de documentos relacionados à implementação e avaliação das advertências sanitárias nos produtos de tabaco comercializados no Brasil, assim como do arcabouço legislativo que amparou a introdução dessas advertências. Em paralelo, foi realizada uma busca dos documentos internos da indústria do tabaco, liberados em 1999 durante ações de litígio nos Estados Unidos, com o objetivo de identificar as reações do setor, no processo de introdução e adoção das advertências sanitárias no mundo e no Brasil. Este trabalho também apresenta a evolução histórica desta medida no Brasil, com o foco na reação da indústria do tabaco.Os resultados deste estudo sugerem que várias ações do governo foram permeadas pela interferência da indústria do tabaco. Em alguns casos as intervenções eram explícitas e em outros momentos eram indiretas ou obscuras.À luz do marco referencial adotado, concluiu-se que houve a interferência da indústria fumageira como um grupo de interesse, de pressão e de lobby nas políticas de advertências sanitárias adotadas. Esta dissertação trouxe informações inovadoras e originais no cenário nacional que poderão ser úteis aos gestores da saúde pública e tomadores de decisão, na promoção de políticas de controle do tabaco, com foco nas advertências sanitárias. Recomendações para a melhoria da condução estratégica da Política Nacional de Controle do Tabaco foram também desenvolvidas.
The purpose of this monograph is to understand the relationship between the adoption of a regulatory measure by the government, with strong impact over the population, and the reaction of interest groups. The theoretical framework of this study is the theory of social policies, which addresses the influence of interest groups against the adoption of regulatory measures, in this specific case, the interference of the tobacco industry and its allies in the regulatory framework of health warnings used on tobacco products in Brazil. The methodology involves the study of documents related to the implementation and evaluation of health warnings on tobacco products sold in Brazil, as well as on the legislative framework that based the introduction of these warnings in the country. In parallel, we conducted a search on tobacco industrys internal documents, released in 1999 during a litigation process in the United States, aiming to identify the reactions of this sector in the process of introduction and implementation of health warnings globally and specifically in Brazil. This paper presents the historical evolution of this measure, with focus on tobacco industrys reaction. The text of this monograph has four parts, comprising the introduction, theoretical and methodological aspects, results and discussion and conclusion and recommendations. The results of this study suggest that several governmental actions were targeted by tobacco industrys interference. In some cases the influence was explicit and in other situations their presence was indirect and obscure. The study concludes that, following the theoretical referential, there is evidence that the industry has interfered on the health warnings regulatory and implementation framework in Brazil acting as an interest/pressure/lobby group. The results of this monograph shadow a new light on this area with useful and innovative information that might be relevant to decision makers and public health managers when 9 furthering tobacco control policies targeting health warnings measures. Recommendations for improvement in the strategic guidance of the Tobacco Control National Policy were made in this regard.
Assuntos
Humanos , Comunicação , Promoção da Saúde , Nicotiana , Publicidade de Produtos Derivados do Tabaco , BrasilRESUMO
A exposição a produtos derivados do tabaco é considerada a mais importante causa de morte evitável no mundo. Ações de controle do tabagismo envolvem uma gama de intervenções para ajudar pessoas a parar de fumar e prevenir que jovens não se tornem dependentes. Advertências sanitárias com imagens mostradas em embalagens de cigarro são uma das formas mais efetivas de informar acerca das consequências do tabagismo. Pesquisas em neurobiologia da emoção demonstram que estímulos visuais afetam atitudes e comportamentos; estímulos agradáveis promovem predisposições para aproximação e os aversivos, afastamento. Os apelos positivos que o marketing da indústria tabagista induz em suas embalagens devem ser neutralizados por advertências que mostrem os riscos de fumar, desconstruindo o apelo prazeroso e induzindo predisposições de afastamento em relação ao produto.
Exposure to tobacco products is considered the leading cause of avoidable death in the world. Tobacco control initiatives encompass a gamut of ways of helping people to quit smoking and keeping young people from ever becoming addicted. Pictorial health warnings on cigarette packaging constitute one of the most effective means of conveying information about the consequences of smoking. Research on the neurobiology of emotions shows that visual stimuli affect attitudes and behavior: pleasant stimuli prompt a tendency to approach while unpleasant stimuli prompt a tendency to avoid. The positive appeals placed on packaging by the tobacco industry's marketing departments should be neutralized by warnings that indicate the risks of smoking, thereby deconstructing any pleasurable appeal and prompting a tendency to avoid the product.