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A lo largo de las últimas décadas, la prevalencia del tabaquismo ha seguido en la Unión Europea tendencias diferentes según el sexo. Mientras que entre los varones la prevalencia ha disminuido notablemente, entre las mujeres se ha incrementado o se ha estancado. En algunos países en que estos cambios se iniciaron más precozmente, la prevalencia del tabaquismo es hoy mayor entre las mujeres que entre los varones. Este documento cuantifica estas tendencias, con referencia a la situación española. En 1995, fumaban 60 millones de hombres y 42 millones de mujeres en la Unión Europea. El 48% de las fumadoras consumían cigarrillos light, lo que supone veinte millones de mujeres que los utilizan. Hay documentos de la industria del tabaco que indican que la promoción de cigarrillos light tiene como intención tranquilizar a sus clientes y frenar a quienes se preocupan por el mantenimiento de su salud y se plantean dejar de fumar. Hay datos que confirman que esta política consigue sus objetivos y que las concepciones erróneas de los fumadores sobre los cigarrillos light puede hacerles persistir en el consumo. Existen datos que indican que el tabaco puede jugar un papel en el control del peso. Las mujeres están más preocupadas por su peso que los hombres, y para las mujeres jóvenes la imagen corporal es muy importante. Éstas tienen a menudo la percepción de tener exceso de peso. Aunque es más común el miedo al sobrepeso que el exceso de peso real, la evidencia sugiere que el temor a ganar peso puede mantener a las mujeres en el hábito de fumar, y que las consideraciones sobre cómo mantener el control del peso influyen en las mujeres jóvenes al comenzar a fumar. El consejo sobre cómo controlar el peso debería formar parte de los programas de tratamiento del tabaquismo dirigidos a las mujeres. Además, cualquier intervención preventiva sobre mujeres adolescentes fumadoras debería abordar la cuestión del aumento de peso.

Abstract Background Because of the magnitude of the global tobacco epidemic, the World Health Organisation developed the Framework Convention on Tobacco Control (FCTC), an international legally binding treaty to control tobacco use. Adoption and implementation of specific tobacco control measures within FCTC is an outcome of a political process, where social norms and public opinion play important roles. The objective of our study was to examine how a country’s level of tobacco control is associated with smoking prevalence, two markers of denormalisation of smoking (social disapproval of smoking and concern about passive smoking), and societal support for tobacco control. Methods An ecological study was conducted, using data from two sources. The first source was the Tobacco Control Scale (TCS) from 2011, which quantifies the implementation of tobacco control policies in European Union (EU) countries. Data on smoking prevalence, societal disapproval of smoking, concern about passive smoking, and societal support for policy measures were taken from the Eurobarometer survey of 2009. Data from Eurobarometer surveys were aggregated to country level. Data from the 27 European Union member states were used. Results Smoking prevalence rates in 2009 were negatively associated with a country’s TCS 2011 score, although not statistically significant (r = −.25; p = .21). Experience of societal disapproval was positively associated with higher TCS scores, though not significantly (r = .14; p = .48). The same was true for societal support for tobacco control (r = .27; p = .18). The TCS score in 2011 was significantly correlated with concern about passive smoking (r = .42; p =.03). Support for tobacco control measures was also strongly correlated with concern about passive smoking (r = .52, p = .006). Conclusions Smokers in countries with a higher TCS score were more concerned about whether their smoke harms others. Further, support for tobacco control measures is higher in countries that have more of these concerned smokers. Concerns about passive smoking seem central in the implementation of tobacco control measures, stressing the importance of continuing to educate the public about the harm from passive smoking.

Faced with a difficult business environment in the United States and the falling demand for cigarettes in industrialized countries, multinational tobacco companies have been competing fiercely to expand their sales in developing countries. Because of the worldwide threat posed by smoking to health and the emphasis being placed by international tobacco companies on marketing in developing countries, an international regulatory strategy, such as the WHO proposed Framework Convention on Tobacco Control, is needed. This review describes from a public health perspective the possible scope and key considerations of protocols that should be included in the convention. The key international areas that should be considered in tobacco control are: prices, smuggling; tax-free tobacco products; advertising and sponsorship; the Internet; testing methods; package design and labelling; agriculture; and information sharing. Keywords: tobacco industry, legislation; tobacco, adverse effects; treaties; taxes; advertising, legislation; product packaging, legislation; World Health Organization., Voir page 935 le resume en francais. En la pagina 936 figura un resumen en espanol Introduction A feature of the global cigarette market during the present decade has been [...]