Tobacco Consumption Interventions and Smoke-Free Policy in Ecuador Intervenciones Gubernamentales Sobre El Consumo De Tabaco
Total Page:16
File Type:pdf, Size:1020Kb
Revista científica digital INSPILIP Código ISSN 2588-0551 DOI: 10.31790/inspilip.v3i1.82.g151 Acceso abierto Artículo de Revisión Citación Tobacco Consumption Interventions and Smoke-Free Policy in Carrillo J. et. al. Tobacco Consumption Interventions and Ecuador Smoke-Free Policy in Ecuador Revista científica INSPILIP V. (3), Intervenciones gubernamentales sobre el consumo de tabaco y Número 2, Guayaquil, Ecuador. políticas libres de tabaco en Ecuador Joffre Carrillo-Pincay1a; A.P. Fan1b*; G.A. Mandell2a; R.O. Kosik2b; Chiu-Yen Lu3a; Correspondencia D.T. Tran3b Dr. Joffre Carrillo – Pincay 1a Universidad de Guayaquil. Universidad Tecnológica Empresarial de Guayaquil, Ecuador. 1b mail:[email protected] Faculty of Medicine at National Yang-Ming University, Taiwan. 2a Senior Foundation Relations Advisor, National and International Programs, American Heart Association, NY, USA. 2b Santa Clara Valley Medical Center, San José, CA, USA. Fecha de ingreso: 17/11/2018 3a Department of Long-Term Care, Ministry of Health and Welfare in Taiwan. Fecha de aprobación: 30/07/2019 3b Department of Nephrology and Endocrinology, Children's Hospital, HoChiMinh City, Fecha de publicación: 31/07/2019 Vietnam. Contributors Conception and design of the study: JCP, APF; acquisition of data: JCP. Analysis and interpretation of data: JCP, ROK, GAM, CYL. Drafting the article or revising: JCP, ROK, GAM, DTT, APF. Final approval of the version: APF Ethical approval: not required Abstract El autor declara estar libre de cualquier Objectives: The World Health Organization Framework Convention on asociación personal o comercial que pueda suponer un conflicto de intereses en Tobacco Control Conference of the Parties (WHO-FCTC COP) recognized conexión con el artículo, así como el haber respetado los principios éticos de Ecuador as a leader in the Latin American region for having increased tobacco investigación, como por ejemplo haber solicitado las autorizaciones de la taxation, which is widely considered one of the best government tools for institución donde se realizó el estudio, permiso para utilizar los datos, consentimientos informados y en caso de decreasing tobacco consumption. Despite such efforts, the nation has a tratarse de estudio observacionales y ensayos clínicos, autorización de un persistent need for high quality tobacco prevention programs, especially with CEISH, ARCSA, DIS, Medio Ambiente, entre otros. Además la licencia para regards to adolescent smoking and second-hand smoke. In this study, we publicar imágenes de la o las personas que aparecen en el manuscrito. Por ello la identify and describe the tobacco consumption interventions and policies in revista no se responsabiliza por cualquier afectación a terceros. Ecuador Revista científica INSPILIP. Disponible en: http://www.inspilip.gob.ec/ 1/15 Julio del 2019 Revista científica digital INSPILIP Código ISSN 2588-0551 DOI: 10.31790/inspilip.v3i1.82.g151 Data Sources: secondary data survey and maintenance of smoke-free areas in and analyzed literature. Ecuador are needed. Methods: Through an extensive search Keywords: Smoke, tobacco of the academic literature and of the consumption, secondhand smoke, active current tobacco laws in Ecuador, in this surveillance, Ecuador study we identify and describe the important interventions regarding tobacco consumption in Ecuador that the Resumen current administration has instituted. Objetivos: la Conferencia de las Partes Results: Rates of lung cancer (5.0%) and del Convenio Marco de la Organización heart disease (19.5%) have been steadily Mundial de la Salud para el Control del increasing. Government interventions Tabaco (CMCT- OMS) reconoció a have led to a mandatory 150% SCT Ecuador como líder en la región de (Special Consumption Tax) and a 12% América Latina por haber incrementado VAT (Value-Added Tax) being added to abrumadoramente los impuestos al the purchase price of all tobacco tabaco, la cual es considerada como una products. Following these interventions, de las mejores estrategias Ecuador has achieved a tobacco gubernamentales para disminución del consumption rate of less than 20% consumo de tabaco. A pesar de estos among adolescents aged 11 to 15 years esfuerzos, el país tiene una necesidad old. persistente de programas de alta calidad Conclusions: The institution of certain sobre prevención del tabaco, governmental policies, particularly especialmente con temas relacionados al tobacco taxation, has dramatically tabaquismo en los adolescentes y la reduced the rate of tobacco consumption exposición al humo del tabaco. En este in Ecuador. However, additional estudio, identificamos y describimos las interventions, such as a national tobacco intervenciones y políticas education program overseen by family gubernamentales sobre el consumo de and community-based physicians, would tabaco en Ecuador. likely further reduce tobacco consumption. Finally, the enforcement Revista científica INSPILIP. Disponible en: http://www.inspilip.gob.ec/ 2/15 Julio del 2019 Revista científica digital INSPILIP Código ISSN 2588-0551 DOI: 10.31790/inspilip.v3i1.82.g151 Fuentes de datos: Datos secundarios, revisión literaria. Métodos: a través de una búsqueda 20% entre los adolescentes de 11 a 15 extensa de la literatura académica y de años de edad. las leyes de tabaco vigentes en Ecuador, Conclusiones: La institución de ciertas en este estudio identificamos y políticas gubernamentales, en particular describimos las intervenciones los impuestos al tabaco, ha reducido importantes con respecto al consumo de drásticamente la tasa de consumo de tabaco que la administración actual en tabaco en el Ecuador. Sin embargo, las Ecuador ha sido constituida. intervenciones adicionales, como un Resultados: las tasas de cáncer de programa nacional de educación sobre el pulmón (5,0%) y enfermedad cardíaca consumo de tabaco direccionado por (19,5%) han aumentado constantemente. médicos especialistas en medicina Las intervenciones gubernamentales han familiar y comunitaria, probablemente dado lugar a un impuesto del 100% reducirían aún más el consumo de (impuesto especial sobre el consumo) tabaco. Finalmente, se requiere de la obligatorio y un IVA del 12% (impuesto aplicación y el mantenimiento de áreas al valor agregado) que se agrega al libres de humo de tabaco en el Ecuador. precio de compra de todos los productos Palabras clave: consumo de tabaco, de tabaco. Después de estas exposición al humo del tabaco, intervenciones, Ecuador ha logrado una vigilancia activa, Ecuador. tasa de consumo de tabaco de menos del Introduction The percentage of Ecuadorian adults Ecuador is a middle-income country1 who smoke has increased from 18.4% in with a population of 14,483,499 people2 2007 to 22% in 2010. Meanwhile, in With a 46.6% smoking rate, it is the adolescents aged 13 to 15 years old, fourth highest tobacco-consuming nation smoking rates have dropped from 27.9% in Latin America. In addition, exposure to 26.0% (Table 1).3 to second-hand smoke is one of the In terms of gender, approximately leading causes of morbidity and 22% of males and 9% of females in 2010 mortality in the nation. 3, 4 were cigarette smokers5. Males smoked Revista científica INSPILIP. Disponible en: http://www.inspilip.gob.ec/ 3/15 Julio del 2019 Revista científica digital INSPILIP Código ISSN 2588-0551 DOI: 10.31790/inspilip.v3i1.82.g151 60% more cigarettes per day than Control Conference of the Parties females6. Tobacco consumption related (WHO-FCTC COP) recognized to cardiovascular and respiratory disorders Ecuador as a leader in the Latin were the principal causes of death, American region for having increased accounting for about 4000 per year. tobacco taxation, which is widely Increasing rates of lung cancer (5.0%) considered one of the best government and heart disease (19.5%) were reported tools for decreasing tobacco in 2010, while other respiratory diseases consumption. Despite such efforts, the have slightly decreased over the past five nation has a persistent need for high years (Table 1). In addition, the national quality tobacco prevention programs, tumor registries, provided by the especially with regards to adolescent Sociedad de Lucha contra el Cancer smoking and second-hand smoke. (SOLCA), show that cancer rates have increased from approximately 6% in This study shows how tobacco- 1980 to 14% in 2010.5 free policies stablished by local government in Ecuador has made WHO/NCD-2008 estimated that males important changes in controlling tobacco are more likely than females to develop consumption and increasing tobacco both cancer and chronic respiratory taxation as leading tobacco control diseases.7 Moreover, in 2011 the WHO country in Latin America (LA). reported that the most common cancers Cigarette packages pictorial warnings in among Ecuadorian cigarette smokers Ecuador have challenged strong were breast cancer (<14%) and psychological impact on potential gastric/colorectal cancer (<7%). customers; such a strategy not only is Further, both breast and printed on at least 70% both side of the gastric/colorectal cancer rank in the top package, but also is a pioneer strategy in thirteen causes of death.8 decreasing young people tobacco use in the LA region, which is considered as the major public health problem even in The World Health Organization developed countries. Framework Convention on Tobacco Revista científica INSPILIP. Disponible en: http://www.inspilip.gob.ec/ 4/15 Julio del 2019 Revista científica digital INSPILIP Código ISSN 2588-0551 DOI: 10.31790/inspilip.v3i1.82.g151 Table