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Summary
Background
In 2005, Uruguay initiated a series of comprehensive anti-smoking measures. We aimed to assess the effect of Uruguay's anti-tobacco campaign.
Methods
We did a population-based trend analysis, using neighbouring Argentina, which has not instituted such extensive anti-tobacco measures, as a control. We assessed three key endpoints in both countries: per-person consumption of cigarettes, as measured by tax records; the prevalence of tobacco use in adolescents, as measured by school-based surveys; and the prevalence of tobacco use in adults, as measured by nationwide household-based surveys.
Findings
During 2005-11, per-person consumption of cigarettes in Uruguay decreased by 4¡¤3 % per year (95 % CI 2¡¤4 to 6¡¤2), whereas per-person consumption in Argentina increased by 0¡¤6 % per year (-1¡¤2 to 2¡¤5; p=0¡¤002 for difference in trends). During 2003-09, the 30-day prevalence of tobacco use in Uruguayan students aged 13 years, 15 years, and 17 years decreased by an estimated 8¡¤0 % per year (4¡¤5 to 11¡¤6), compared with a decrease of 2¡¤5 % annually (0¡¤5 to 4¡¤5) in Argentinian students during 2001-09 (p=0¡¤02 for difference in trends). From 2005 to 2011, the prevalence of current tobacco use in Uruguay decreased annually by an estimated 3¡¤3 % (2¡¤4 to 4¡¤1), compared with an annual decrease in Argentina of 1¡¤7 % (0¡¤8 to 2¡¤6; p=0¡¤02 for difference in trends).
Interpretation
Uruguay's comprehensive tobacco-control campaign has been associated with a substantial, unprecedented decrease in tobacco use. Decreases in tobacco use in other low-income and middle-income countries of the magnitude seen in Uruguay would have a substantial effect on the future global burden of tobacco-related diseases.
Funding
J William Fulbright Foreign Scholarship Board and the US Department of State.
