Observatory of the National Policy on Tobacco Control

The National Commission for FCTC Implementation in Brazil (Conicq)


Last updated: 04/03/2019 | 11h36

Aligned with Article 5.2 of the treaty, the National Commission for Implementation of the Framework Convention on Tobacco Control (Conicq), created by the Decree of August 1st of 2003, is chaired by the Minister of Health and composed of representatives from each of the government sectors listed below, as Decree S / No. of March 16, 2012. The National Cancer Institute (INCA) act as its Executive Secretariat.

I – Ministry of Health; II - Ministry of Foreign Affairs; III - Ministry of Finance; IV - Ministry of Planning, Budget and Management; V – Civil House of Presidency of the Republic; VI - Ministry da Agriculture, Food and Rural Affairs; VII - Ministry of Justice; VIII - Ministry of Education; IX - Ministry of Labor and Employment; X - Ministry of Development, Industry and Foreign Trade; XI - Ministry of Agrarian Development; XII - Ministry of Communications; XIII - Ministry of Environment; XIV - Ministry of Science and Technology; XV - Secretariat of Policies for Women of the Presidency; XVI – National Secretariat for Drug Policies of the Ministry of Justice; XVII – Attorney General’s Office (AGU); e XVIII – National Health Surveillance Agency (Anvisa).

The Conicq holds quarterly ordinary meetings, restricted to its members, to discuss, develop and evaluate actions and policies that address the various obligations of the Framework Convention. The Conicq also conducts opened seminars to civil society during the process of preparing for the sessions of the Conference of the Parties in order to collect subsidies that contribute to defining the position of the Brazilian delegation representing the country in these sessions.

The Procedure Rules of the National Commission to implement the Framework- Convention for Tobacco control (Conicq) can be accessed here.

Main measures adopted

Graphic health warnings

One of the most cost-effective measures available, because communication costs fall on the manufacturer. The industry pays for the packaging, so they pay for the printing.

Warnings are scientifically demonstrated to be effective in informing the society about the tobacco use risks.

Many years before Brazil ratified the FCTC/WHO, the government started to adopt the warning labels on the cigarette packaging. It started in the 80´s and it passed by four important phases.

First Phase: In August 1988 the Ministry of Health required the tobacco companies to print the following sentence on all packages: “The Ministry of Health Warns: smoking is harmful to health”.

Second Phase: In 1996, with the advent of Federal Law, health warnings began to be required by law and not by a voluntary agreement.

Also in 1999, the Ministry of Health created the National Sanitary Surveillance Agency – Anvisa (Federal Law number 9.782), mandating, among other things, to regulate control and inspect tobacco products, with the technical cooperation of the National Cancer Institute – INCA.

Third Phase: 2001 -Based on World Health Assembly recommendations and on the positive experience of Canada, which was the pioneer in the inclusion of pictorial health warnings in 2000, the National Commission for Tobacco Control (known today as Conicq), recommended in August 2000 that the Brazilian government adopt a similar strategy. Thus, Brazil was the second country to adopt it.

Forth Phase: In 2003 the Ministry of Health launched the second group of health warnings with stronger messages and pictures, published in Anvisa's Resolution Number 335, which also required their inclusion on tobacco product advertising. The objective of this initiative was to ensure the renewal of the content of the messages and pictures, which had become ineffective after a long period of use. The concept was based on a phone poll conducted by quit line  “Disque Saúde – Pare de Fumar”, which found that 90% of 89 thousand people interviewed stated that the images launched in 2001 needed to be more shocking. It is worth emphasizing that 80% of them were smokers.

2008 - Given that images must be replaced regularly, the Ministry of Health began efforts to be innovative in the design of new warnings.

With this goal, INCA created a Study Group formed by INCA itself, the National Health Surveillance Agency (Anvisa), the Neurobiology Laboratory at the Federal University of Rio de Janeiro (UFRJ), the Behavior Neurophysiology Laboratory at the Fluminense Federal University (UFF) and the Department of Arts & Design at the Catholic University of Rio de Janeiro (PUC-Rio).

The objective of this group was to produce and select pictures and messages for health warning labels, based on their emotional impact on young people aged 18 to 24. The project was conducted in six stages.

2015 - Anivsa published a new regulation to include health warning in, at least, 30% of the front face, printed in white letters on a black background. The warning should print the messages:
"This product causes cancer”
“Stop Smoking”
“Dial-Health: 136"

2017- In December , 2017, Anvisa published the new normative which included:
New phrases correlating the toxic substances present in the product with people's daily items as well as illnesses caused by their use on a bright yellow background (more contrasting);  The forbidden sale message for people under 18 will be in a red background, so that there is also a greater visibility of the message. 

The new GHW Should be on the packaging after May 25th, 2018. (RDC Nº 195, de 14 de dezembro de 2017)

The Brazil 2008 Health Warnings on Tobacco Products Report can be accessed here

Bans on tobacco advertising, promotion and sponsorship

The advertising, promotion and sponsorship were banned on the media since 2000. In December, 14, 2011, the law nr. 12.546, banned the advertising in the places of sale too.  Today, in these places are only permitted the products exposure, as long as accompanied by health warning about the dangers of consumption and its price list.

Protection from exposure to tobacco smoke

Since 2014 is forbidden the use of Products Tobacco in all collective places, public or private in the country. This ban applies to restaurants, pubs, night clubs, universities, hotels, guesthouses, concert halls, workplaces, government offices, health institutions, public and private vehicles to public transportation and others, even the environment partially enclosed by a wall, partition, roof or awning.

In addition to the outdoor areas (such as parks and squares), the smoking ban does not apply: the establishments specifically intended for the marketing of tobacco products (tobacco); the studios and filming or recording of audiovisual productions, when necessary for the production of the work; places  for research and development of tobacco products or tobacco not derivatives ; religious services (if part of the ritual) and the health care institutions that have patients allowed to smoke by the doctor who assists them. These locations can be installed designated smoking areas, which should present isolation conditions, ventilation and exhaust air and worker protection measures, according to the Ministerial Ordinance MTE / MS Nr. 2.647, of December 4, 2014.

Taxation

In December 2011, the national pricing policy and tax achieved a major breakthrough with the sanction of Law 12,546 amending the system of Industrialized Product Tax and establishing a policy of minimum prices for cigarettes.

In January 2016, another decree established the new ad valorem rate for packets of 20 cigarettes from May 1st, 2016 (63.3%), and further increase after December 1st, 2016 (66.7%). The decree also raised the minimum price of the package of 20 cigarettes to R $ 5.00 (USD 1.40) after May 1st , 2016.

National Program for Diversification in Areas of Tobacco Cultivation

By the ratification of the Framework Convention on Tobacco Control, the Ministry of Agrarian Development (MDA) assumed an important commitment to the implementation of the National Program for Diversification in Areas of Tobacco Cultivation. Based on the principles of sustainable development, food security, diversification of production and social participation, the program operates in the qualification of the production and development process in the areas of tobacco farming, as well as from the perspective of ecological production, by reducing the use of pesticides.

Brazil is one of the key facilitators of the International GT Articles 17 and 18 of the FCTC. This group was created in 2006 during the 1st Conference of the Parties (COP 1), as a study group status and at COP3 it acquired the status of Working Group.

The Brazilian government has held two meetings (2013 and 2016) in the Southern region to receive FCTC Parties who have come to know the experiences of Brazil over the past 15 years on the livelihoods methodology adopted at COP 6 in Russia. This methodology is being implemented in the Technical Assistance and Rural Extension (ATER) public call for diversification,  currently coordinated by the Special Secretariat for Family Agriculture and Agrarian Development/Civil House of the Presidency of the Republic.

You can find the visit´s reports below and the Ministry of Agrarian Development actions in Brazil:

Brazil - Actions of the ministry of Agrarian development in Brazil

Report of WG 17 e 18-Pelotas_Brazil_2013

Report of International Cooperation on Art17_Brazil_2016

A  Network to enhance the National Program for Diversification in Areas of Tobacco Cultivation

More than 20 organizations, including civil society representatives, are committed to the implementation of Articles 17 and 18 of the FCTC/WHO working in partnership with the Government on Technical Assistance and Rural Extension (Ater) to tobacco growers who choose to diversify their production in order to reduce economic dependence on tobacco.

There is also a community radio network with spots of 30 seconds to publicize actions for the implementation of articles 17&18.

Impacts of tobacco growing on health, life and family economy

The prevalence of smoking is higher than the national average, child labor in agriculture, green leaf disease, depression, suicide rates higher than the Brazilian average, poisoning by pesticides, contamination of soil, food, fauna and rivers, and deforestation are some of the direct documented damage associated with tobacco production.

The Ministry of Health, with support of Oswaldo Cruz Foundation, INCA and other institutions, is developing a Protocol to prevent, diagnose and treat occupational risks for tobacco growers and their families.

Sale to underage

In Brazil, since 1990 the Statute of Children and Adolescents (Law No. 8.069/1990) prohibits sell or deliver the child or adolescent products whose components may cause physical or psychological dependence, as is the case of tobacco products. In 2003 this ban became more expressed in Law No. 10,702 / 2003, which prohibits the sale of any tobacco products to persons under 18 years.

Cessation treatment

The National Cancer Institute (INCA), as the Ministry of Health body responsible for coordination of the National Program for Tobacco Control and considering the complexity that involves dependence and smoking cessation, met in 2000, different scientific societies and professional advice of health in Brazil to develop the "Consensus Approach and Smoker Treatment" containing general guidelines on methods to quit smoking.

The approach of network and smoking treatment follows the logic of the Brazilian Health System, and is found in many cities, thus contributing to achieving the important goal of controlling the tobacco epidemic in Brazil.

Challenges

Plain Package

Since the ban on tobacco product advertising in the media, the packaging of cigarettes and other tobacco products have been used as a strategy to attract new smokers. To counter this strategy and inform smokers about the dangers of smoking, since 2001 the government requires that tobacco manufacturers and importers of products include health warnings on their packages, accompanied by photos that take up 100% of the principal surfaces and the number of the Health Hotline - Stop Smoking, but the adoption of standardized packaging is still in the legislative process for consideration.

Fundraising

The establishment of a mechanism to finance the government and Brazilian society for the burden and social costs caused by tobacco related diseases would be a way to compensate the Health System and Social Security.

The goal is to get resources to make possible to implement alternatives to tobacco production programs, intersectoral actions for the prevention and control of smoking, as well as reduce the burden that smoking has imposed the health system due to tobacco disease treatment costs related.

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