Estimated impact of a tobacco-elimination strategy on lung-cancer mortality in 185 countries: a population-based birth-cohort simulation study.

BACKGROUND: The tobacco-free generation aims to prevent the sale of tobacco to people born after a specific year. We aimed to estimate the impact of eliminating tobacco smoking on lung-cancer mortality in people born during 2006-10 in 185 countries. METHODS: For this population-based birth-cohort simulation study, we proposed a scenario in which tobacco sales were banned for people born between Jan 1, 2006, and Dec 31, 2010, and in which this intervention was perfectly enforced, quantified until Dec 31, 2095. To predict future lung-cancer mortality rates, we extracted lung-cancer mortality data by sex, 5-year age group, and 5-year calendar period for countries with at least 15 years of data from the WHO Mortality Database. For countries for which mortality data were not available, we extracted data on lung-cancer incidence from the Cancer Incidence in Five Continents. To establish the number of lung-cancer deaths that could be prevented in the birth cohort if tobacco smoking was eliminated, we subtracted reported age-specific rate of deaths in people who had never smoked tobacco (hereafter referred to as never smokers) from a previous study from the expected rate of lung-cancer deaths in our birth cohort and applied this difference to the size of the population. We computed population impact fractions (PIFs), the percentage of lung-cancer deaths that could be prevented, by dividing the number of preventable lung-cancer deaths by the expected lung-cancer deaths in the birth cohort. We also aggregated expected and prevented deaths into the four World Bank income groups (ie, high-income, upper-middle-income, lower-middle-income, and low-income). The primary outcome was the impact on lung-cancer mortality of implementing a tobacco-free generation. FINDINGS: Our birth cohort included a total population of 650 525 800 people. Globally, we predicted that 2 951 400 lung-cancer deaths could occur in the population born during 2006-10 if lung-cancer rates continue to follow trends observed during the past 15 years. Of these deaths, 1 842 900 (62·4%) were predicted to occur in male individuals and 1 108 500 (37·6%) were expected to occur in female individuals. We estimated that 1 186 500 (40·2%) of 2 951 400 lung-cancer deaths in people born during 2006-10 could be prevented if tobacco elimination (ie, a tobacco-free generation) was achieved. We estimated that more lung-cancer deaths could be prevented in male individuals (844 200 [45·8%] of 1 842 900 deaths) than in female individuals (342 400 [30·9%] of 1 108 500 deaths). In male individuals, central and eastern Europe had the highest PIF (48 900 [74·3%] of 65 800 deaths) whereas in female individuals, western Europe had the highest PIF (56 200 [77·7%] of 72 300 deaths). Middle Africa was the region with the lowest PIF in both male individuals (180 [2·1%] of 8600 deaths) and female individuals (60 [0·9%] of 6400 deaths). In both sexes combined, PIF was 17 400 (13·5%) of 128 900 deaths in low-income countries, 104 900 (15·8%) of 662 800 deaths in lower-middle-income countries, 650 100 (43·9%) of 1 482 200 deaths in upper-middle-income countries, and 414 100 (61·1%) of 677 600 deaths in high-income countries. INTERPRETATION: The implementation of a tobacco-free generation could substantially reduce global lung-cancer mortality. However, data from low-income countries were scarce and our estimates should be interpreted with caution. FUNDING: Spanish Society of Pneumology and Thoracic Surgery.

Lung cancer screening in Brazil: recommendations from the Brazilian Society of Thoracic Surgery, Brazilian Thoracic Association, and Brazilian College of Radiology and Diagnostic Imaging.

Although lung cancer (LC) is one of the most common and lethal tumors, only 15% of patients are diagnosed at an early stage. Smoking is still responsible for more than 85% of cases. Lung cancer screening (LCS) with low-dose CT (LDCT) reduces LC-related mortality by 20%, and that reduction reaches 38% when LCS by LDCT is combined with smoking cessation. In the last decade, a number of countries have adopted population-based LCS as a public health recommendation. Albeit still incipient, discussion on this topic in Brazil is becoming increasingly broad and necessary. With the aim of increasing knowledge and stimulating debate on LCS, the Brazilian Society of Thoracic Surgery, the Brazilian Thoracic Association, and the Brazilian College of Radiology and Diagnostic Imaging convened a panel of experts to prepare recommendations for LCS in Brazil. The recommendations presented here were based on a narrative review of the literature, with an emphasis on large population-based studies, systematic reviews, and the recommendations of international guidelines, and were developed after extensive discussion by the panel of experts. The following topics were reviewed: reasons for screening; general considerations about smoking; epidemiology of LC; eligibility criteria; incidental findings; granulomatous lesions; probabilistic models; minimum requirements for LDCT; volumetric acquisition; risks of screening; minimum structure and role of the multidisciplinary team; practice according to the Lung CT Screening Reporting and Data System; costs versus benefits of screening; and future perspectives for LCS.

Lung cancer screening in Brazil: recommendations from the Brazilian Society of Thoracic Surgery, Brazilian Thoracic Association, and Brazilian College of Radiology and Diagnostic Imaging / Recomendações da Sociedade Brasileira de Cirurgia Torácica, Sociedade Brasileira de Pneumologia e Tisiologia e Colégio Brasileiro de Radiologia e Diagnóstico por Imagem para o rastreamento do câncer de pulmão no Brasil

ABSTRACT Although lung cancer (LC) is one of the most common and lethal tumors, only 15% of patients are diagnosed at an early stage. Smoking is still responsible for more than 85% of cases. Lung cancer screening (LCS) with low-dose CT (LDCT) reduces LC-related mortality by 20%, and that reduction reaches 38% when LCS by LDCT is combined with smoking cessation. In the last decade, a number of countries have adopted population-based LCS as a public health recommendation. Albeit still incipient, discussion on this topic in Brazil is becoming increasingly broad and necessary. With the aim of increasing knowledge and stimulating debate on LCS, the Brazilian Society of Thoracic Surgery, the Brazilian Thoracic Association, and the Brazilian College of Radiology and Diagnostic Imaging convened a panel of experts to prepare recommendations for LCS in Brazil. The recommendations presented here were based on a narrative review of the literature, with an emphasis on large population-based studies, systematic reviews, and the recommendations of international guidelines, and were developed after extensive discussion by the panel of experts. The following topics were reviewed: reasons for screening; general considerations about smoking; epidemiology of LC; eligibility criteria; incidental findings; granulomatous lesions; probabilistic models; minimum requirements for LDCT; volumetric acquisition; risks of screening; minimum structure and role of the multidisciplinary team; practice according to the Lung CT Screening Reporting and Data System; costs versus benefits of screening; and future perspectives for LCS.

RESUMO O câncer de pulmão (CP) é uma das neoplasias mais comuns e letais no Brasil, e apenas 15% dos pacientes são diagnosticados nos estágios iniciais. O tabagismo persiste como o responsável por mais de 85% de todos os casos. O rastreamento do CP (RCP) por meio da TC de baixa dosagem de radiação (TCBD) reduz a mortalidade do CP em 20%, e, quando combinado com a cessação do tabagismo, essa redução chega a 38%. Na última década, diversos países adotaram o RCP como recomendação de saúde populacional. No Brasil, embora ainda incipiente, a discussão sobre o tema é cada vez mais ampla e necessária. Com o intuito de aumentar o conhecimento e estimular o debate sobre o RCP, a Sociedade Brasileira de Cirurgia Torácica, a Sociedade Brasileira de Pneumologia e Tisiologia e o Colégio Brasileiro de Radiologia e Diagnóstico por Imagem constituíram um painel de especialistas para elaborar as recomendações para o RCP. As recomendações aqui apresentadas foram baseadas em revisão narrativa da literatura, com ênfase em grandes estudos populacionais, em revisões sistemáticas e em recomendações de diretrizes internacionais, sendo construídas após ampla discussão pelo grupo de especialistas. Os temas revisados foram os seguintes: porque rastrear, considerações gerais sobre tabagismo, epidemiologia do CP, critérios de elegibilidade, achados incidentais, lesões granulomatosas, modelos probabilísticos, requisitos mínimos da TCBD, aquisições volumétricas, riscos do rastreamento, estrutura mínima e papel da equipe multidisciplinar, conduta segundo o Lung CT Screening Reporting and Data System (Lung-RADS), custos vs. benefícios e perspectivas do rastreamento.

Physical properties of beans of the BRSMG majestoso cultivar during drying / Propriedades físicas de grãos de feijão cultivar BRSMG majestoso durante a secagem

Beans are the main source of protein of plant origin in the Brazilian diet, they also contain phenolic compounds, antioxidants, iron, fibers and vitamins. The BRSMG Majestoso cultivar belongs to the commercial group of carioca beans, displays high productivity, excellent health and a 90-day cycle, has high yield and is resistant to disease. The study of physical properties enables the prediction of agricultural products behavior relative to responses of physical and chemical treatments, in order to allow the maintenance of quality and safety of processed foods. The aim of the present study was to evaluate the effect of drying on the physical characteristics of beans of the BRSMG Majestoso cultivar. Beans with an initial moisture content of approximately 0.2660 d.b. (dry basis) were used, and dried at 40ºC. The following physical characteristics were determined: bulk density, unit density, intergranular porosity, 1000-grain weight, sphericity, circularity, geometric diameter, unit volume, projected area, surface area and the surface to volume ratio. Based on the results, a reduction in the moisture content of the beans promotes an increase in bulk density, unit density, porosity, sphericity, circularity and the surface to volume ratio. Conversely, the 1000-grain weight, geometric diameter, unit volume, projected area and surface area decreased as the moisture content of the beans was reduced.

Objetivou-se com o presente trabalho, avaliar o efeito da secagem sobre as características físicas de grãos de feijão cultivar BRSMG Majestoso. Foram utilizados grãos com teor de água inicial de aproximadamente 0,2660 b.s. (base seca), e submetidos à secagem com temperatura de 40 ºC. Foram determinadas as propriedades físicas: massa específica aparente, massa específica unitária, porosidade intergranular, massa de mil grãos, esfericidade, circularidade, diâmetro geométrico, volume unitário, área projetada, área superficial e a relação superfície/volume. Com base nos resultados obtidos conclui-se que a redução do teor de água dos grãos de feijão proporcionou aumento da massa específica aparente e unitária, porosidade, esfericidade, circularidade e relação superfície/volume. Em contrapartida, a massa de mil grãos, o diâmetro geométrico, o volume unitário, a área projetada e a área superficial diminuíram com a redução do teor de água dos grãos de feijão.

On the case report of Platypnea-orthodeoxia after SARSCoV-2 pneumonia plus historical notes.

A new cause of POS hás been recently described: SARS-CoV-2 pneumonia. Important aspects regarding the case are presented and clarifications requested from the authors. Dr Howard B. Burchell described platypnea-orthodeoxia syndrome (POS) in 1949. Burchell´s contributions to Medicine are briefly presented as well as his career.

Update on the approach to smoking in patients with respiratory diseases.

Smoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with "healthy" smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success.

EAT-Brazil Award for Tobacco Control: a brief description of its first edition.

Smoking is a major global risk factor for preventable death and disability. EAT is an acronym for Education Against Tobacco, a multinational network of physicians and medical students that aims to improve tobacco control by means of school-based prevention targeted at adolescents through counseling, use of software and support materials. The first EAT-Brazil Award, launched in March 2018, was a competition designed to encourage the proposal of objective solutions for tobacco control in Brasil, and identify new talents in the area. Brazilian undergraduate students from any field of study could submit a one-page essay on the subject, competing for the amount of R$ 1000.00 (one thousand reais). There were a total of 39 applicants (20 women and 19 men) from 9 Brazilian states and 18 undergraduate programs, with a mean age of 22.5 years (SD = 3.7). Data from an online anonymous questionnaire answered after the submission of their essays revealed that most applicants were students of institutions from in the state of Minas Gerais (n = 26/39; 66.6%), studied medicine (n = 20/39, 51.3%), and had no prior knowledge of the EAT-Brazil Network (n = 27/39, 69.2%). The winner of the award was Lucas Guimarães de Azevedo, a fourth-year medical student at Federal University of Western Bahia. The next editions of the award should focus on increasing the number of applicants and diversifying their geographical distribution.

EAT-Brazil Award for Tobacco Control: a brief description of its first edition

SUMMARY Smoking is a major global risk factor for preventable death and disability. EAT is an acronym for Education Against Tobacco, a multinational network of physicians and medical students that aims to improve tobacco control by means of school-based prevention targeted at adolescents through counseling, use of software and support materials. The first EAT-Brazil Award, launched in March 2018, was a competition designed to encourage the proposal of objective solutions for tobacco control in Brasil, and identify new talents in the area. Brazilian undergraduate students from any field of study could submit a one-page essay on the subject, competing for the amount of R$ 1000.00 (one thousand reais). There were a total of 39 applicants (20 women and 19 men) from 9 Brazilian states and 18 undergraduate programs, with a mean age of 22.5 years (SD = 3.7). Data from an online anonymous questionnaire answered after the submission of their essays revealed that most applicants were students of institutions from in the state of Minas Gerais (n = 26/39; 66.6%), studied medicine (n = 20/39, 51.3%), and had no prior knowledge of the EAT-Brazil Network (n = 27/39, 69.2%). The winner of the award was Lucas Guimarães de Azevedo, a fourth-year medical student at Federal University of Western Bahia. The next editions of the award should focus on increasing the number of applicants and diversifying their geographical distribution.

RESUMO O tabagismo é um dos principais fatores de risco globais para morte e incapacidade evitáveis. EAT é a sigla em inglês para Educação contra o Tabaco (Education Against Tobacco), uma rede mundial formada por médicos e estudantes de medicina cuja missão é atuar no combate ao tabagismo por meio da prevenção da iniciação ao tabagismo em adolescentes escolares mediante aconselhamento, uso de aplicativos móveis e de materiais de apoio. O primeiro Prêmio EAT-Brazil, lançado em março de 2018, foi um concurso destinado a encorajar a proposição de soluções objetivas para o avanço do controle do tabagismo no país e a identificação de novos talentos para a área. Estudantes de graduação brasileiros de qualquer curso submeteram um texto de uma página sobre o tema, concorrendo à quantia de R$ 1.000. Houve um total de 39 trabalhos inscritos (20 por mulheres e 19 por homens) de nove estados brasileiros e 18 cursos de graduação, com idade média de 22,5 anos (DP=3,7). Dados de um questionário anônimo on-line respondido pelos inscritos revelou que a maioria era composta por graduandos de alguma instituição do estado de Minas Gerais (n=26/39; 66,6%), que estudavam medicina (n=20/39; 51,3%) e não tinham conhecimento prévio sobre a Rede EAT-Brazil (n=27/39; 69,2%). O ganhador do prêmio foi Lucas Guimarães de Azevedo, aluno do oitavo período de medicina da Universidade Federal do Oeste da Bahia. As próximas edições do Prêmio devem focar o aumento do número de inscritos e a diversificação de sua distribuição geográfica.

A Smoking Prevention Program Delivered by Medical Students to Secondary Schools in Brazil Called "Education Against Tobacco": Randomized Controlled Trial.

BACKGROUND: Smoking is the largest preventable cause of mortality in Brazil. Education Against Tobacco (EAT) is a network of more than 3500 medical students and physicians across 14 countries who volunteer for school-based smoking prevention programs. EAT educates 50,000 adolescents per year in the classroom setting. A recent quasi-experimental study conducted in Germany showed that EAT had significant short-term smoking cessation effects among adolescents aged 11 to 15 years. OBJECTIVE: The aim is to measure the long-term effectiveness of the most recent version of the EAT curriculum in Brazil. METHODS: A randomized controlled trial was conducted among 2348 adolescents aged 12 to 21 years (grades 7-11) at public secondary schools in Brazil. The prospective experimental design included measurements at baseline and at 6 and 12 months postintervention. The study groups comprised randomized classes receiving the standardized EAT intervention (90 minutes of mentoring in a classroom setting) and control classes in the same schools (no intervention). Data were collected on smoking status, gender, social aspects, and predictors of smoking. The primary endpoint was the difference in the change in smoking prevalence between the intervention group and the control group at 12-month follow-up. RESULTS: From baseline to 12 months, the smoking prevalence increased from 11.0% to 20.9% in the control group and from 14.1% to 15.6% in the intervention group. This difference was statistically significant (P<.01). The effects were smaller for females (control 12.4% to 18.8% vs intervention 13.1% to 14.6%) than for males (control 9.1% to 23.6% vs intervention 15.3% to 16.8%). Increased quitting rates and prevented onset were responsible for the intervention effects. The differences in change in smoking prevalence from baseline to 12 months between the intervention and control groups were increased in students with low school performance. CONCLUSIONS: To our knowledge, this is the first randomized trial on school-based tobacco prevention in Brazil that shows significant long-term favorable effects. The EAT program encourages quitting and prevents smoking onset, especially among males and students with low educational background. TRIAL REGISTRATION: ClinicalTrials.gov NCT02725021; https://clinicaltrials.gov/ct2/show/NCT02725021. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/resprot.7134.

Mechanical properties of bean grains (BRSMG Majestic) coated with carnauba wax / Propriedades mecânicas de grãos de feijão cultivar BRSMG Majestoso revestidos com cera de carnaúba

ABSTRACT: The objective of this research was to determine the mechanical properties of beans (BRSMG Majestuoso) coated with carnauba wax solution. Grains with 0.1481 (d.b.) moisture content was used. Treatments 0, 1 and 2 were respectively defined as the control sample, application of the wax diluted 1/1 (carnauba wax solution/water) and application of carnauba wax without dilution. Uniaxial compression tests were performed in the universal test apparatus, TA HD Texture Analyzer with 500 N load cell. Compression tests were carried out during the storage period of in-nature grains, in those that underwent the hydration process at 40 and 50 °C of temperature and in grains during the cooking process. Only the storage time had a significant effect (P<0.05) on the rupture force and the proportional deformity module. Hydration and cooking of the grains provided a reduction in the values of the studied variables.

RESUMO: Objetivou-se com este trabalho determinar as propriedades mecânicas de grãos de feijão cultivar BRSMG Majestoso revestidos com cera de carnaúba. Foram utilizados grãos com teor de água de aproximadamente 0,1481 decimal b.s. (base seca), tratados com solução de cera de carnaúba. Parte destes destinou-se à amostra testemunha, uma a aplicação de cera diluída na proporção de 1/1 (solução de cera de carnaúba/água) e outra a aplicação apenas de solução de cera de carnaúba, tratamentos 0, 1 e 2, respectivamente. Foram realizados ensaios de compressão uniaxiais no aparelho universal de testes, TA. HD Texture Analyser, com célula de carga de 500 N. Os testes de compressão foram realizados ao longo do período de armazenamento nos grãos in natura, naqueles que passaram pelo processo de hidratação nas temperaturas de 40 e 50 °C e em grãos ao longo do processo de cocção. Apenas o tempo de armazenamento teve um efeito significativo (P<0,05) sobre a força de ruptura e o módulo proporcional de deformidade. A hidratação e a cocção dos grãos proporcionaram redução nos valores das variáveis estudadas.

Update on the approach to smoking in patients with respiratory diseases / Atualização na abordagem do tabagismo em pacientes com doenças respiratórias

ABSTRACT Smoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with "healthy" smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success.

RESUMO O tabagismo é o maior responsável pelas doenças respiratórias (DR). Os efeitos nocivos do tabaco sobre o aparelho respiratório se iniciam ainda intraútero e influenciam as respostas imunológicas ao longo da infância e vida adulta. Os tabagistas com DR possuem peculiaridades que podem dificultar a cessação tabágica, tais como maior grau de dependência e de abstinência de nicotina; níveis mais elevados de monóxido de carbono exalado; motivação e autoeficácia baixas; maior preocupação com ganho ponderal; e elevada prevalência de ansiedade e depressão. Além disso, requerem tratamento mais intensivo e prolongado. É necessário esclarecer sempre o paciente sobre o fato de que parar de fumar será a única medida que irá reduzir a progressão das DR e melhorar sua qualidade de vida, independentemente do tempo e da gravidade da doença. Os médicos devem sempre oferecer o tratamento de cessação tabágica. O tratamento ambulatorial ou hospitalar deve ser multidisciplinar, baseado em intervenções comportamentais e farmacoterapia, sendo eficaz e custo-efetivo, dobrando as chances de sucesso.

Physical-chemical characterization of powder soursop obtained by foam-mat drying / Caracterização físico-química de pó de graviola obtido por secagem em leito de espuma

The development and improvement of fruit processing technologies in powder form is a alternative to add value to the product and increase the income of the producers, being required the knowledge of physicalchemical properties of the product. The aim of this study was to determine the physical-chemical properties of soursop powder obtained by foam-mat drying. To the foam formation, albumin was added to the pulp at concentration of 7.43% in mass and subjected in mixer for 15 min; then, it was spread onto trays forming a thin layer about 5.0 mm thick, and the drying conditions were: 40, 50, 60, 70 and 80 °C, 5.6 m s-1 and 60%. Moisture content, water activity, titratable total acidity and hydrogenic potential of soursop powder indicate good stability of the product obtained by foam-mat drying, without the need of addition of preservatives for its conservation. Reducing sugars increased with increasing drying temperature due to the concentration of the compounds caused by moisture content reduction. In addition, the color was the physical-chemical property that presented greater sensitivity to drying, mainly by darkening index. Temperatures lower than 60 °C indicate higher preservation of initial characteristics for soursop powder. Besides that, bulk density, true density, porosity and repose angle increased subtly with drying temperature.

O desenvolvimento e aperfeiçoamento de tecnologias de processamentos de frutos na forma de pó é uma alternativa para agregar valor ao produto e aumentar a renda dos produtores, sendo necessário para isso o conhecimento das propriedades físico-químicas do produto. Assim objetivou-se determinar as propriedades físicoquímicas do pó de graviola obtido pelo método de secagem em leito de espuma. Para a formação da espuma foi adicionada, à polpa, albumina, na concentração de 7,43% em massa e submetida à agitação em batedeira doméstica, durante 15 min; em seguida, esta foi espalhada sobre bandejas formando uma camada fina de cerca de 5,0 mm de espessura cujas condições de secagem foram: de 40, 50, 60, 70 e 80 °C, 5,6 m s-1 e 60%. O teor de água, atividade de água, acidez total titulável e o potencial hidrogeniônico do pó de graviola indicam boa estabilidade do produto obtido pelo método de secagem em leito de espuma, não necessitando portanto, da adição de conservantes para sua conservação. Os açúcares aumentaram com o incremento da temperatura de secagem devido a concentração dos compostos provocada pela redução do teor de água. Adicionalmente, a cor foi a propriedade físico-química que apresentou maior sensibilidade à secagem, principalmente pelo índice de escurecimento. Temperaturas menores que 60 °C indicam maior preservação das características iniciais para o pó de graviola. Além disso, a massa específica aparente e unitária, a porosidade e o ângulo de repouso aumentaram sutilmente com a temperatura de secagem.

Facial-Aging Mobile Apps for Smoking Prevention in Secondary Schools in Brazil: Appearance-Focused Interventional Study.

BACKGROUND: Most smokers start smoking during their early adolescence, often with the idea that smoking is glamorous. Interventions that harness the broad availability of mobile phones as well as adolescents' interest in their appearance may be a novel way to improve school-based prevention. A recent study conducted in Germany showed promising results. However, the transfer to other cultural contexts, effects on different genders, and implementability remains unknown. OBJECTIVE: In this observational study, we aimed to test the perception and implementability of facial-aging apps to prevent smoking in secondary schools in Brazil in accordance with the theory of planned behavior and with respect to different genders. METHODS: We used a free facial-aging mobile phone app ("Smokerface") in three Brazilian secondary schools via a novel method called mirroring. The students' altered three-dimensional selfies on mobile phones or tablets and images were "mirrored" via a projector in front of their whole grade. Using an anonymous questionnaire, we then measured on a 5-point Likert scale the perceptions of the intervention among 306 Brazilian secondary school students of both genders in the seventh grade (average age 12.97 years). A second questionnaire captured perceptions of medical students who conducted the intervention and its conduction per protocol. RESULTS: The majority of students perceived the intervention as fun (304/306, 99.3%), claimed the intervention motivated them not to smoke (289/306, 94.4%), and stated that they learned new benefits of not smoking (300/306, 98.0%). Only a minority of students disagreed or fully disagreed that they learned new benefits of nonsmoking (4/306, 1.3%) or that they themselves were motivated not to smoke (5/306, 1.6%). All of the protocol was delivered by volunteer medical students. CONCLUSIONS: Our data indicate the potential for facial-aging interventions to reduce smoking prevalence in Brazilian secondary schools in accordance with the theory of planned behavior. Volunteer medical students enjoyed the intervention and are capable of complete implementation per protocol.