Tobacco use, cessation, secondhand smoke and exposure to media about tobacco in Brazil: results of the National Health Survey 2013 and 2019

Malta, Deborah Carvalho; Gomes, Crizian Saar; Andrade, Fabiana Martins Dias de; Prates, Elton Junio Sady; Alves, Francielle Thalita Almeida; Oliveira, Patrícia Pereira Vasconcelos de; Freitas, Paula Carvalho de; Pereira, Cimar Azeredo; Caixeta, Roberta de Betânia

doi:10.1590/1980-549720210006.supl.2

person Deborah Carvalho Malta

schoolDepartament of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais – Belo Horizonte (MG), Brazil.

0000-0002-8214-5734

person Crizian Saar Gomes

schoolPost-graduation Program Public Health, School of Medicine, Universidade Federal de Minas Gerais – Belo Horizonte (MG), Brasil.

0000-0001-6586-4561

person Fabiana Martins Dias de Andrade

schoolDepartament of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais – Belo Horizonte (MG), Brazil.

0000-0001-8277-6061

person Elton Junio Sady Prates

schoolDepartament of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais – Belo Horizonte (MG), Brazil.

0000-0002-5049-186X

person Francielle Thalita Almeida Alves

schoolDepartament of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais – Belo Horizonte (MG), Brazil.

0000-0001-8886-8514

person Patrícia Pereira Vasconcelos de Oliveira

schoolSecretary of Health Surveillance, Ministry of Health – Brasília (DF), Brazil.

0000-0003-1539-9272

person Paula Carvalho de Freitas

schoolSecretary of Health Surveillance, Ministry of Health – Brasília (DF), Brazil.

0000-0002-3737-2962

person Cimar Azeredo Pereira

schoolDiretorate of Research, Instituto Brasileiro de Geografia e Estatística – Rio de Janeiro (RJ), Brazil.

0000-0001-6183-1607

person Roberta de Betânia Caixeta

schoolPan-American Health Organization/World Health Organization for the Americas – Washington DC, United States.

0000-0003-3943-8176

Corresponding author: Deborah Carvalho Malta. Avenida Alfredo Balena, 190, Santa Efigênia, CEP: 30130-100, Belo Horizonte (MG), Brazil. E-mail:
dcmalta@uol.com.br

Conflict of interests: None to declare.

Authors’ contribution: DCM: conceptualization, data curation, formal analysis, writing – first draft, writing – revision and editing. CSG: conceptualization, data curation, formal analysis, writing – first draft, writing – revision and editing. FMDA: conceptualization, data curation, formal analysis, writing – first writing, writing – proofreading and editing. EJSP: conceptualization, data curation, formal analysis, writing – first draft, writing – revision and editing. FTAA: conceptualization, data curation, formal analysis, writing – first draft, writing – revision and editing. PPVO: conceptualization, data curation, formal analysis, writing – first draft, writing – revision and editing. PCF: conceptualization, data curation, formal analysis, writing – first draft, writing – revision and editing. CAP: conceptualization, data curation, formal analysis, writing – first draft, writing – revision and editing. RBC: conceptualization, data curation, formal analysis, writing – first draft, writing – revision and editing.

		NHS 2013		NHS 2019		PR (95%CI)
		%	95%CI	%	95%CI	PR (95%CI)
Tobacco use	1. Current tobacco users	14.9	(14.4–15.4)	12.8	(12.4–13.2)	0.86 (0.82–0.90)
	2. Tobacco smokers	14.7	(14.2–15.2)	12.6	(12.1–13.0)	0.86 (0.82–0.90)
	3. Daily tobacco smokers	12.7	(12.2–13.1)	11.4	(11.0–11.8)	0.90 (0.85–0.95)
	4. Cigarette smokers	14.5	(14.0–15.0)	12.3	(11.9–12.7)	0.85 (0.81–.89)
	5. Daily cigarette smokers	13.1	(12.6–13.6)	11.0	(10.7–11.4)	0.84 (0.80–0.89)
Tobacco cessation	6. Ex-smokers	17.5	(16.9–18.1)	26.6	(26.1–27.2)	1.52 (1.46–1.58)
Tobacco cessation	7. Tried to quit smoking	51.1	(49.3–52.8)	46.7	(45.0–48.3)	0.91 (0.87–0.96)
Secondhand smoke	8. Passive smokers at home	10.8	(10.3–11.4)	9.2	(8.8–9.6)	0.85 (0.79–0.90)
Secondhand smoke	9. Passive smokers at work	13.4	(12.6–14.3)	8.4	(7.9–9.0)	0.63 (0.57–0.69)
Media	10. Exposure to pro-tobacco media	28.7	(27.8–29.5)	18.4	(17.6–19.2)	0.64 (0.61–0.68)
	11. Exposure to anti-tobacco media	52.0	(51.0–53.0)	39.2	(38.4–40.0)	0.75 (0.73–0.77)
	12. Smokers exposed to warnings	86.1	(84.7–87.4)	83.2	(81.9–84.4)	0.97 (0.94–0.99)
	13. Smokers who thought about quitting because of warnings	52.1	(50.2–54.0)	44.4	(42.7–46.1)	0.85 (0.81–0.90)

		Sex
		Male (A)		Female (B)		PR B/A (95%CI)
		%	95%CI	%	95%CI	PR B/A (95%CI)
Tobacco use	1. Current tobacco users	16.2	15.6–16.9	9.8	9.3–10.3	0.60 (0.57–0.64)
	2. Tobacco smokers	15.9	15.3–16.6	9.6	9.2–10.1	0.61 (0.57–0.64)
	3. Daily tobacco smokers	14.3	13.7–15.0	8.8	8.4–9.2	0.61 (0.58–0.65)
	4. Cigarette smokers	15.5	14.9–16.2	9.4	9.0–9.9	0.61 (0.57–0.64)
	5. Daily cigarette smokers	13.9	13.3–14.5	8.4	8.0–8.8	0.61 (0.57–0.65)
Tobacco cessation	6. Ex-smokers	26.8	26.1–27.5	26.5	25.7–27.2	0.99 (0.95–1.03)
Tobacco cessation	7. Tried quitting	43.8	41.6–46.0	50.8	48.5–53.2	1.16 (1.08–1.24)
Secondhand smoke	8. Passive smokers at home	7.9	7.3–8.5	10.2	9.7–10.8	1.30 (1.18–1.42)
Secondhand smoke	9. Passive smokers at work	10.4	9.4–11.3	6.7	6.1–7.4	0.65 (0.57–0.74)
Media	10. Exposure to pro-tobacco media	21.3	20.3–22.3	15.8	15.1–16.6	0.74 (0.70–0.78)
	11. Exposure to anti-tobacco media	40.4	39.3–41.6	38.1	37.2–39.0	0.94 (0.91–0.97)
	12. Smokers exposed to warnings	82.0	80.5–83.6	84.8	83.1–86.6	1.03 (1.01–1.06)
	13. Smokers who thought about quitting because of warnings	42.0	39.8–44.1	48.0	45.3–50.6	1.14 (1.06–1.23)

		Age group (years)
		18–24 (A)		25–39 (B)		40–59 (C)		60 or older (D)		PR (95%CI) B/A	PR (95%CI) C/A	PR (95%CI) D/A
		%	95%CI	%	95%CI	%	95%CI	%	95%CI	PR (95%CI) B/A	PR (95%CI) C/A	PR (95%CI) D/A
Tobacco use	1.	10.8	9.6–12.0	12.0	11.2–12.7	14.9	14.2–15.6	11.9	11.2–12.6	1.11 (0.98–1.26)	1.38 (1.23–1.56)	1.10 (0.97–1.25)
	2.	10.6	9.5–11.8	11.8	11.1–12.5	14.7	14.0–15.4	11.4	10.7–12.1	1.11 (0.98–1.26)	1.38 (1.22–1.56)	1.07 (0.95–1.22)
	3.	8.6	7.5–9.6	10.2	9.6–10.9	13.8	13.1–14.5	10.8	10.1–11.5	1.19 (1.04–1.37)	1.61 (1.41–1.84)	1.26 (1.10–1.45)
	4.	9.6	8.5–10.7	11.6	10.9–12.3	14.6	13.9–15.3	11.1	10.4–11.8	1.20 (1.06–1.35)	1.50 (1.33–1.70)	1.15 (1.01–1.31)
	5.	7.6	6.7–8.6	9.9	9.2–10.6	13.5	12.9–14.2	10.4	9.7–11.1	1.29 (1.12–1.49)	1.76 (1.53–2.02)	1.35 (1.17–1.56)
Tobacco cessation	6.	18.6	17.0–20.2	18.7	17.8–19.6	26.8	25.9–27.7	42.2	41.1–43.3	1.00 (0.91–1.10)	1.44 (1.31–1.57)	2.27 (2.07–2.48)
Tobacco cessation	7.	51.5	45.8–57.2	48.0	45.0–51.1	44.9	42.4–47.5	45.1	42.1–48.1	0.93 (0.82–1.06)	0.87 (0.77–0.98)	0.88 (0.77–0.99)
Secondhand smoke	8.	15.7	14.0–17.3	8.2	7.5–8.9	7.8	7.2–8.4	8.4	7.7–9.1	0.52 (0.46–0.60)	0.50 (0.44–0.57)	0.54 (0.47–0.61)
Secondhand smoke	9.	9.5	7.4–11.7	8.0	7.1–8.9	8.5	7.7–9.3	7.8	6.3–9.4	0.84 (0.65–1.08)	0.90 (0.70–1.15)	0.82 (0.61–1.11)
Media	10.	20.2	18.5–21.9	21.1	20.0–22.2	19.0	17.8–20.2	12.6	11.7–13.4	1.04 (0.95–1.15)	0.94 (0.85–1.04)	0.62 (0.56–0.69)
	11.	37.7	35.7–39.7	38.6	37.4–39.8	40.5	39.3–41.8	38.7	37.5–39.9	1.02 (0.97–1.08)	1.07 (1.01–1.14)	1.03 (0.97–1.09)
	12.	84.4	80.5–88.4	84.2	82.1–86.3	85.9	84.3–87.5	75.3	72.7–77.8	1.00 (0.95–1.05)	1.02 (0.97–1.07)	0.89 (0.84–0.94)
	13.	35.7	30.1–41.4	46.8	43.8–49.8	47.5	44.8–50.2	39.8	36.7–43.0	1.31 (1.11–1.54)	1.33 (1.12–1.58)	1.11 (0.93–1.33)

		No schooling and incomplete primary (A)		Complete primary and incomplete secondary (B)		Complete secondary and incomplete higher (C)		Complete higher (D)		PR (95%CI) B/A	PR (95%CI) C/A	PR (95%CI) D/A
		%	95%CI	%	95%CI	%	95%CI	%	95%CI	PR (95%CI) B/A	PR (95%CI) C/A	PR (95%CI) D/A
Tobacco use	1.	17.6	16.8–18.4	15.5	14.3–16.6	9.6	8.9–10.2	7.1	6.3–7.8	0.88 (0.81–0.96)	0.54 (0.50–0.58)	0.40 (0.36–0.45)
	2.	17.2	16.4–18.0	15.3	14.2–16.5	9.4	8.8–10.0	7.0	6.3–7.7	0.89 (0.82–0.97)	0.55 (0.51–0.59)	0.41 (0.36–0.45)
	3.	16.0	15.3–16.8	14.1	12.9–15.2	8.1	7.6–8.7	5.9	5.3–6.6	0.88 (0.80–0.96)	0.51 (0.47–0.55)	0.37 (0.33–0.41)
	4.	9.6	8.5–10.7	11.6	10.9–12.3	14.6	13.9–15.3	11.1	10.4–11.8	0.87 (0.80–0.95)	0.53 (0.50–0.58)	0.39 (0.35–0.43)
	5.	15.5	14.8–16.3	13.5	12.4–14.6	7.8	7.3–8.4	5.7	5.0–6.3	0.87 (0.80–0.95)	0.50 (0.46–0.54)	0.36 (0.32–0.41)
Quitting	6.	33.9	33.0 -34.8	26.1	24.7–27.5	22.3	21.4–23.3	20.7	19.6–21.8	0.77 (0.73–0.82)	0.66 (0.63–0.69)	0.61 (0.58–0.65)
Quitting	7.	47.4	45.1–49.6	51.1	47.0–55.1	44.5	41.3–47.8	40.5	35.3–45.7	1.08 (0.98–1.18)	0.94 (0.86–1.02)	0.85 (0.75–0.98)
Secondhand smoke	8.	11.1	10.4–11.8	11.0	9.7–12.2	8.6	7.8–9.3	5.1	4.4–5.9	0.98 (0.87–1.12)	0.77 (0.69–0.86)	0.46 (0.40–0.54)
Secondhand smoke	9.	14.1	12.6–15.7	10.6	9.0–12.3	8.2	7.3–9.1	4.2	3.5–4.8	0.75 (0.63–0.90)	0.58 (0.50–0.68)	0.30 (0.24–0.36)
Media	10.	14.9	13.9–15.8	19.8	18.4–21.2	20.7	19.6–21.8	19.7	18.3–21.2	1.33 (1.23–1.44)	1.39 (1.31–1.48)	1.33 (1.21–1.46)
	11.	39.7	38.6–40.9	40.7	39.0–42.4	39.9	38.7–41.2	34.9	33.4–36.3	1.02 (0.98–1.07)	1.00 (0.97–1.04)	0.88 (0.83–0.92)
	12.	77.6	75.7–79.4	86.8	84.1–89.5	88.0	86.0–90.0	92.0	89.0–94.9	1.12 (1.08–1.16)	1.13 (1.10–1.17)	1.19 (1.14–1.23)
	13.	45.1	42.8–47.4	47.2	43.0–51.5	43.3	40.0–46.6	38.1	33.2–43.1	1.05 (0.94–1.16)	0.96 (0.88–1.05)	0.85 (0.74–0.97)

		Race/skin color
		White (A)		Black (B)		Brown (C)		PR (95%CI) B/A	PR (95%CI) C/A
		%	95%CI	%	95%CI	%	95%CI	PR (95%CI) B/A	PR (95%CI) C/A
Tobacco use	1.	11.8	11.2–12.4	13.7	12.5–15.0	13.5	12.9–14.2	1.16 (1.05–1.28)	1.14 (1.07–1.22)
	2.	11.6	11.0–12.2	13.5	12.3–14.7	13.3	12.7–13.9	1.16 (1.05–1.28)	1.14 (1.07–1.22)
	3.	10.6	10.0–11.2	12.4	11.2–13.5	11.9	11.3–12.5	1.17 (1.05–1.30)	1.12 (1.05–1.21)
	4.	11.2	10.6–11.8	13.3	12.1–14.5	13.0	12.4–13.6	1.18 (1.07–1.31)	1.15 (1.08–1.24)
	5.	10.2	9.7–10.8	11.8	10.7–12.9	11.5	10.9–12.0	1.15 (1.04–1.28)	1.12 (1.04–1.21)
Tobacco cessation	6.	26.4	25.5–27.3	28.8	27.2–30.5	26.2	25.5–27.0	1.09 (1.02–1.17)	0.99 (0.95–1.04)
Tobacco cessation	7.	42.8	40.1–45.4	54.1	49.9–58.2	48.2	45.9–50.5	1.26 (1.15–1.39)	1.13 (1.05–1.21)
Secondhard smoke	8.	7.9	7.3–8.5	10.4	9.1–11.7	10.1	9.5–10.6	1.32 (1.14–1.53)	1.27 (1.16–1.40)
Secondhard smoke	9.	6.8	6.0–7.5	10.7	9.0–12.3	9.8	8.8–10.7	1.58 (1.30–1.92)	1.45 (1.25–1.68)
Media	10.	19.2	18.2–20.2	19.1	17.6–20.6	17.3	16.4–18.2	0.99 (0.91–1.08)	0.90 (0.85–0.96)
	11.	38.1	37.0–39.2	41.8	40.0–43.7	39.7	38.7–40.7	1.10 (1.04–1.15)	1.04 (1.01–1.08)
	12.	87.0	85.2–88.8	82.2	79.1–85.2	80.2	78.4–81.9	0.94 (0.91–0.98)	0.92 (0.89–0.95)
	13.	42.8	40.1–45.6	45.4	40.9–49.9	45.7	43.2–48.3	1.06 (0.94–1.19)	1.07 (0.98–1.16)

[TFN1] NHS: National Health Survey; PR: prevalence ratio; 95%CI: 95% confidence interval

Tobacco use, cessation, secondhand smoke and exposure to media about tobacco in Brazil: results of the National Health Survey 2013 and 2019

ABSTRACT