Tobacco control in Uruguay: achievements and challenges since FTCT ra9fica9on
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1 Tobacco control in Uruguay: achievements and challenges since FTCT ra9fica9on Dr Laura Roballo CIET Advocacy and Capacity Building Coordinator Director of Tobacco Cessa;on Program. HCFFAA
2 BRASIL Paraguay ARGENTINA URUGUAY
3 Topics The tobacco epidemic in Uruguay. FCTC implementa9on. First outcomes. Obstacles: PMI interna9onal legal claim. Challenges ahead.
4 Smoking was a serious problem in adults Ministry of Health Survey 2006
5 Smoking was a serious problem in youngsters GYTS 2002
6 Smoking was a serious problem in doctors SMU 2001
7 Health Impact? Approximately 4500 people died yearly due to tobacco- related diseases. Lung cancer (90% related to tobacco): main cause of cancer deaths in Uruguayan men. Per 2006 World Cancer Atlas, Uruguay had the highest lung cancer mortality in men in La9n America. The Pla9no study, on Chronic Obstruc9ve Pulmonary Disease (COPD) (85% a]ributable to tobacco) showed that 19% of the Uruguayan popula9on is affected, and set Uruguay as the La9n American country with the highest prevalence. Na9onal data from CHSCV es9mates that around 50% of cardiovascular deaths first cause of death in Uruguay were related to tobacco consump9on or second hand smoke.
8 Tobacco Control Policy Evolu9on in Uruguay SMU lobbied for FCTC Signature Uruguay signed and ra9fied FCTC First Smoke- Free Country in the Americas Region Ciet`s founda9on PMI law suit intoduced and Held WHO- FCTC COP President Batlle NRF gives free treatments for smokers tobacco products taxa9on: 71% NATIONAL LAW 50% warning labels Banned Misleading terms Banned Adver9sing Offered Smoking Cessa9on for free 80% warning labels Banned brand extension President Vazquez President Mujica
9 FIRST FCTC IMPLEMENTATION: OUTCOMES IN URUGUAY
10 Smoking prevalence in adults Año
11 Tobacco Consump9on in Youth* 24.8% 18.6% *13 to 17 years old, high school JND, Na9onal Drug Commission
12 Tobacco Consump9on in Medical Doctors 1 27% 1 17% 2 9.8% 1. SMU, Sindicato Médico del Uruguay 2. CIET; SMU; FEMI, Federa9on of Medical Doctors of Inland Ci9es
13 Evolu9on of tax collec9on
14 Economic impact of food places
15 Indoor Air Contamina9on Levels PM 2.5 par9cles Before 210 ug/m3 Aqer 18 ug/m3 March 1, 2006 Tobacco Control 2008; 17:
16 8 µg/m 3 18 µg/m 3 22 µg/m 3
17 Health Impact: AMI Admissions to Hospital Decreased 7949 pa9ents with AMI: 4346 before 24 months 24 months 3603 aqer 22% Protected 500 people each year from an AMI AMI, acute myocardial infarc9on
![0 Current situa9on 1990 1995 2000 2005 2010 Ramos A, Cur9s D Actual cigare]e sales (per capita packs)](/docs-images/82/85301162/images/18-3.jpg "Simulated cigare]e sales without price increases Simulated cigare]e sales without price increases and")
18 Es9ma9on of Tobacco Sales Evolu9on With and Without Tobacco Control Measures CIGARETTES SALES WOULD BE 28% HIGHER 15.0 Without TC measures 12.5 Just tobacco prices increasing + 28% 10.0 Current situa9on Ramos A, Cur9s D Actual cigare]e sales (per capita packs) Simulated cigare]e sales without price increases Simulated cigare]e sales without price increases and other control tobacco measures
19 OBSTACLES AND CHALLENGES
20 PMI vs Uruguay PMI CLAIM: URUGUAY VIOLATES INVESTMENT BILATERAL SWITZERLAND- URUGUAY TRADE AGREEMENT ICSID- Interna9onal Centre for Se]lement of Investments Disputes. 1. Pictorial warning images. 2. Single presentation per brand % packaging health warnings.
21 Vazquez and NGOs vs Mujica
22 Current status of Arbitration Process The risk: it is not an open process we depend on arbitration judgment objectivity The government is closely following the process and committed to defend Uruguay`s right to implement FCTC; Health over profits!
23 Tobacco Industry Interfence: Viola9on of POS Adver9sing Ban Gral. Paz y Caramurú Av. Italia y Bolivia Arocena y
24 Learned lessons Even in hos9le/problema9c environments, poli9cal will and civil society involvement working together in FCTC implementa9on can make a big change. The more implemented strategies, the more posi9ve outcomes Tobacco industry interference remain the most important obstacle. Interna9onal experience and collabora9on is a key element to achieve future objec9ves
25 Endgame! Thank you!
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