The ITC Uruguay Survey found that the country's world-leading, comprehensive tobacco control strategy has had positive effects on raising awareness of the true harms of smoking, reducing misperceptions about "light/mild" cigarettes, reducing exposure to secondhand smoke, and reducing the demand for tobacco products through tax increases.
The strategy has been accompanied by increased support for tobacco control and smoke-free policies, with two-thirds of smokers in 2011 supporting even stronger government action to protect the public from the harms of smoking, up from about half of smokers in 2006.
The findings are based upon three waves of the ITC Uruguay Survey, conducted between 2006 and 2011. The Survey polled representative samples of smokers in Montevideo, the capital city, and (since 2008) in an additional four cities throughout the country — Durazno, Maldonado, Rivera, and Salto. During this period, Uruguay implemented several important tobacco control policies in line with the WHO Framework Convention on Tobacco Control (FCTC), the first-ever health treaty, which the country ratified in 2004.
These policies were: a comprehensive ban on indoor smoking in public places, a ban on tobacco advertising and promotion, and several tobacco tax increases. In addition, Uruguay's Government increased the size of pictorial warning labels from 50 percent to 80 percent of the front and back of cigarette packs, implemented highly graphic warnings on the health effects of smoking, and introduced a ban on multiple brand presentations. By comparing data from each wave of the Survey in the context of policy changes during the preceding period, researchers were able to measure the impact of those policies on key attitudes and behaviors.
Uruguay introduced graphic health warnings in 2006, but in 2009-10 (in between Waves 2 and 3 of the Survey) the health warnings were enhanced with stronger graphic images and in size, increasing to 80 percent of the front and back of the pack, becoming the largest in the world. This enhancement led to significant increases in several indicators of warning effectiveness included in the ITC Uruguay Survey. Smokers were significantly more likely to report noticing the warnings often or very often (from 65.1 percent at Wave 2 before the enhanced warnings to 70.9 percent at Wave 3, after the enhanced warnings were introduced); they were also more likely to report that the warnings made them think about the health risks of smoking (increasing from 33.1 percent to 43.1 percent), and more likely to report that the warnings made them more likely to think about quitting (from 15.6 percent to 30.3 percent).
MEDICA.de; Source: University of Waterloo