Health of workers wins wide support to go smoke-free

Aliançade Controle do Tabagismo/Rio de Janeiro

Brazil was early in passing a law to bring about smoke-free places with its Federal Law of 1996. However, there was little compliance with or enforcement of the law. At national level, the Tobacco Control Co-ordination Office has started to develop new and more protective legislation for smoke-free places. Recife’s smoke-free agenda has been developed and implemented within the framework of the 1996 Federal Law and State laws.

Fact file: Recife, Brazil

Population: 1.4m

Smokers (total): 28% in 2001, estimated to have dropped to 10%

Under these laws, smoking is forbidden in all enclosed public places except in designated smoking areas that have “good ventilation”. Smoking is allowed in open areas and public ways. However, Recife has adopted a more protective approach. Efforts were made to bring about comprehensive smoke-free environments and to extend them to open or partially-open areas such as porches and pavements.

Key actions

In 2005, a strong focus on smoke-free places began. Key actions included:

  • Launching the “Smoke Free Recife City Hall” programme to protect the local government workforce from exposure to secondhand smoke.
  • Building on this experience, the Smoke Free Places Programme, with the backing of the Mayor, the Secretary of Health and the Secretary of Finances, began to be rolled out - initially to shopping malls then to the hospitality sector. It included widespread training of workers in implementing the smoke-free agenda.
  • Public hearings with hospitality sector representatives to sensitise hospitality sector business owners and workers.
  • Employers’ responsibilities regarding workers’ health that is contained in other Worker Law statutes was cited to justify the extension of smoke-free measures that went beyond the Federal Law.
  • An intensive promotional campaign at all stages of the programme.
  • A survey of air quality measurement in leisure establishments to involve workers and raise awareness amongst the population about the importance of adopting 100% smoke-free places.

Impact

  • The programme led to over 7800 smoke free institutions in Recife, including 7400 leisure sector premises such as bars, restaurants and night clubs - benefiting more than 156 000 workers.
  • There is evidence that smoking prevalence has fallen significantly in Recife between 2007 and 2008.
  • Between 2002 and 2008, the number of hospital admissions due to respiratory problems fell from 11% to 8%, the number of deaths due hypertension problems fell by 19% and vascular brain diseases declined by 7%.
  • An opinion poll showed that the policy is widely accepted by hospitality sector workers - 96% oppose smoking in closed indoor areas.

Lessons learnt

  • Political leadership and a committed partnership of stakeholders were crucial to initiating and implementing, over several years, a proactive smoke-free agenda.
  • In the context of a Federal Law that had smoke-free provisions that were less protective than Recife’s policy, the Prosecutor’s Office role was vital to sustain the credibility and enforceability of the city’s smoke-free programme - especially for upholding the policy with the hospitality sector.
  • The training and active participation of workers and key personnel was a vital factor in the effective implementation of the smoke-free programme.
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