Tobacco control campaign in Uruguay: a population-based trend analysis

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.