La historia de la publicidad de tabaco desde la salud pública : recomendar el cigarrillo a la necesidad de regularla
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Fecha
2021
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Universidad Nacional Arturo Jauretche
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Introducción: el tabaco es la principal causa de muerte evitable en el mundo. En nuestro país provoca cerca de 45.000 muertes anuales (aprox. el 13% del total de las muertes anuales), en su mayoría por Enfermedades No Transmisibles (ENT). Si bien el consumo viene descendiendo de manera constante desde 1999 en el contexto de avances en materia regulatoria a nivel municipal, provincial y nacional como ha sido la Ley Nacional de Control de Tabaco Nº 26.687, continúa siendo uno de los más altos en la región.
Objetivo: estimar el impacto sanitario de la prohibición total de publicidades de productos elaborados con tabaco en términos de eventos cardiovasculares evitados en la población de mayores de 35 años.
Métodos: se utilizó el Cardiovascular Disease Policy Model (CVDPM, por sus siglas en inglés) que es un modelo de simulación utilizado para representar y proyectar la mortalidad y morbilidad por eventos cardiovasculares (ECV) en la población de 35 o más años. La población es estratificada según edad, sexo, y otros 6 factores de riesgo: presión arterial sistólica, consumo de tabaco, colesterol HDL, colesterol LDL, índice de masa corporal, y diabetes mellitus. Constituye un modelo demográfico-epidemiológico, que representa a la población entre 35 y 95 años de edad, y utiliza un modelo de regresión logística basado en la ecuación de Framingham para estimar la incidencia anual de enfermedad cardiovascular. De acuerdo a la revisión de la literatura se asumió que implementar una prohibición completa de publicidad de productos de tabaco conduciría a una reducción en el consumo de tabaco del 9%.
Resultados: la prohibición completa de publicidad podría evitar, en un periodo de 10 años, 15.164 muertes, de las cuales 2610 corresponderían a enfermedad coronaria y 747 a accidentes cerebrovasculares (ACV). Estas reducciones significarían una disminución anual de 0,46% del total de muertes, 0,60% de las muertes por enfermedad coronaria y de 0,33% en las muertes por ACV. Además en ese mismo lapso evitaría 6630 infartos agudos de miocardio y 2851 ACVs (reducciones del 1,35% y 0,40% respectivamente).
Conclusión: Esperamos que estos hallazgos puedan contribuir a fortalecer las políticas sanitarias de control del tabaco en Argentina a partir de los notables beneficios de prohibir integralmente la publicidad de productos de tabaco y en consonancia con las recomendaciones mundiales actuales.
Introduction: tobacco is the leading cause of preventable death in the world. In our country, tobacco causes about 45,000 annual deaths (approximately 13% of total annual deaths), mostly due to Non-communicable Diseases (NCDs). Although tobacco consumption has been declining steadily since 1999 in the context of advances in regulatory matters at the municipal, provincial and national levels, such as the National Tobacco Control Law No. 26,687, it remains one of the highest in the region. Objective: to estimate the health impact of the total ban on advertising of tobacco products in terms of avoided cardiovascular events in the population over 35 years of age. Methods: The Cardiovascular Disease Policy Model (CVDPM) was used, which is a Markov simulation model used to represent and project mortality and morbidity due to cardiovascular disease (CVD) in the population aged 35 or over. The population is stratified according to age, sex, and other 6 risk factors: systolic blood pressure, tobacco use, HDL cholesterol, LDL cholesterol, body mass index, and diabetes mellitus. It constitutes a demographic-epidemiological model, which represents the population between 35 and 95 years of age and uses a logistic regression model based on the Framingham equation to estimate the annual incidence of cardiovascular disease. According to the literature review, it was assumed that implementing a complete ban on advertising of tobacco products would lead to a 9% reduction in tobacco consumption. Results: the complete ban on advertising could prevent 15,164 deaths over a period of 10 years, of which 2610 would correspond to coronary heart disease and 747 to stroke. These reductions would mean an annual decrease of 0.46% of total deaths, 0.60% of deaths from coronary heart disease and 0.33% in deaths from stroke. In addition, during the same period it would avoid 6630 acute myocardial infarctions and 2851 strokes (reductions of 1.35% and 0.40% respectively). Conclusion: We hope that these findings might contribute to strengthening sanitary tobacco control policies in Argentina based on the remarkable benefits of banning the advertising of tobacco products in full and in line with current global recommendations.
Introduction: tobacco is the leading cause of preventable death in the world. In our country, tobacco causes about 45,000 annual deaths (approximately 13% of total annual deaths), mostly due to Non-communicable Diseases (NCDs). Although tobacco consumption has been declining steadily since 1999 in the context of advances in regulatory matters at the municipal, provincial and national levels, such as the National Tobacco Control Law No. 26,687, it remains one of the highest in the region. Objective: to estimate the health impact of the total ban on advertising of tobacco products in terms of avoided cardiovascular events in the population over 35 years of age. Methods: The Cardiovascular Disease Policy Model (CVDPM) was used, which is a Markov simulation model used to represent and project mortality and morbidity due to cardiovascular disease (CVD) in the population aged 35 or over. The population is stratified according to age, sex, and other 6 risk factors: systolic blood pressure, tobacco use, HDL cholesterol, LDL cholesterol, body mass index, and diabetes mellitus. It constitutes a demographic-epidemiological model, which represents the population between 35 and 95 years of age and uses a logistic regression model based on the Framingham equation to estimate the annual incidence of cardiovascular disease. According to the literature review, it was assumed that implementing a complete ban on advertising of tobacco products would lead to a 9% reduction in tobacco consumption. Results: the complete ban on advertising could prevent 15,164 deaths over a period of 10 years, of which 2610 would correspond to coronary heart disease and 747 to stroke. These reductions would mean an annual decrease of 0.46% of total deaths, 0.60% of deaths from coronary heart disease and 0.33% in deaths from stroke. In addition, during the same period it would avoid 6630 acute myocardial infarctions and 2851 strokes (reductions of 1.35% and 0.40% respectively). Conclusion: We hope that these findings might contribute to strengthening sanitary tobacco control policies in Argentina based on the remarkable benefits of banning the advertising of tobacco products in full and in line with current global recommendations.
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Tabaquismo, Enfermedad cardiovascular, Publicidad, Modelo de simulación, Argentina, Smoking, Cardiovascular disease, Advertising, Simulation models