Law compliance, why do we need it? Comparative data from the Brazilian National Survey of School Health (PeNSE) on adolescents' access to cigarettes

The cigarette market in Brazil: new evidence on illicit practices from the 2019 National Health Survey

OBJECTIVE

To explore new evidence on illicit practices, such as selling legal brands below the minimum legal price (MLP), and smugglers selling illicit brands at or above the MLP.

METHODS

For the first time in Brazil, self-reported information on cigarette brand name and price paid per pack in smokers' last purchase from a nationally representative survey conducted in 2019 was used to distinguish the illicit and the legal markets. We estimated the proportion of illicit cigarette consumption, using the combination of brand and price.

RESULTS

The proportion of smuggled illicit cigarette consumption based on brands not approved on the Brazilian market was estimated at 38.6% (95% CI: 35.8% to 41.5%). When we added legal brands not paying taxes, it increased to 47.1% (95% CI: 44.2% to 49.9%). Around 25% of illicit brand cigarettes were sold at or above MLP.

CONCLUSIONS

In Brazil, since 2017 there is a lack of adjustment in tobacco taxes and the MLP for inflation and income growth. The increase in cigarette affordability and the presence on the market of a segment of 'higher-priced' illicit brands suggest patterns of illicit brand loyalty and/or perceived 'brand quality' among smokers of illicit cigarettes. The evidence also shows that a sizeable proportion of legal brand cigarettes were sold below the MLP. This study offers insight into what happened in circumstances in which a government failed to keep current with tax policies and the monitoring of domestic manufacturing. Brazil has been a world leader in the monitoring of the tobacco epidemic, and this study also offers an innovative use of data that an increasing number of countries are collecting.

[Bullying victimization and associated factors among schoolchildren in a city in the south of Brazil]

The objective was to assess the prevalence of bullying victimization and associated factors among adolescents in the city of Pelotas, Rio Grande do Sul. A cross-sectional school-based study was conducted with 795 ninth grade students from 25 urban municipal schools linked to the School Health Program. Bullying was assessed using questions that addressed the occurrence, frequency, location, type of violence suffered and how much it bothers the victims. Gross and adjusted analyses were performed by Poisson regression. Approximately 71% of the students reported having suffered bullying, and school was the location of greatest occurrence (86.7%). Among the types of aggression suffered, "nicknames" was the most recurrent complaint (88.4%), followed by exclusion or isolation (26.6%). Victimization was more frequent among girls (PR 1.13; 95%CI 1.02-1.27), students with non-white skin color/race (PR 1.16; 95%CI 1.05-1.29), who have already tried tobacco (PR 1.14; 95%CI 1.03-1.27), dissatisfied (PR 1.42; 95%CI 1.27-1.58) or indifferent (PR 1.21; 95%CI 1.02-1.43) about their bodies, and who were overweight (PR 1.15; 95%CI 1.04-1.27). The results show that bullying is a frequent practice in the school environment, pointing to the need for educational practices aimed at reducing and preventing this type of violence.