Tobacco smoking and cancer in Brazil: Evidence and prospects

Abstract

In this paper, the prevalence of smoking in Brazil is examined according to time trend and regions of the country, as well as considering the asymmetries of the prevalence of tobacco smoking by age, sex and socio-economic level of the population. Since the establishment of the relationship between smoking and lung cancer 60 years ago, the number of malignant tumors with evidence of a causal association with tobacco smoking has amounted to twenty. From the late 80's, the decline of the prevalence of smoking in the Brazilian population has been continuous. Until 2003, the decrease was more significant among men, when an inversion occurred and the decline became more pronounced in women. The highest prevalence of smoking is detected in the Southeast and South, and these two regions present the highest incidence of tumors closely related to tobacco (oral cavity, esophagus and lung). Environmental exposure to tobacco smoke was also examined considering the effect in nonsmoking adults, with a higher risk of lung, larynx and pharynx tumors, as well as among children of smoking parents more susceptible to the risk of hepatoblastoma and acute lymphocytic leukemia. Despite the undeniable success of the policy to control tobacco smoking in the country, health professionals should be attentive to populations with low socioeconomic status and lower educational levels who show the highest prevalence rates of smoking. Adolescents represent a priority in these populations.