Real price and affordability as challenges for effective tobacco control policies: an analysis for Argentina.

OBJECTIVE: To describe the evolution of cigarettes' real price and affordability during the last decade in Argentina. METHODS: To analyze the real price of cigarettes, the weighted average monthly price of a pack of 20 cigarettes was divided by the consumer price index (CPI) from 2004 to 2014. The relative income price (RIP) was evaluated for the same period, defining RIP as the percentage of the income required to buy 100 packs of 20-per-pack cigarettes. The RIP was calculated for first-quartile, median, and third-quartile income groups. The lower the RIP, the higher the affordability. RESULTS: The nominal price of a pack of 20 cigarettes sold in Argentina increased from AR$ 2.24 in March 2004 to AR$ 14.36 in June 2014 (nominal price increase of about 19.7% per year). The real price fell from AR$ 2.24 in March 2004 to AR$ 2.11 in June 2014 (real price drop of about 0.6% per year). Between June 2004 and June 2014, the RIP decreased about 39% for the 3rd quartile income group (from 31.3% to 19.2%), about 42% for the median (from 55.7% to 32.0%), and about 50% for the 1st quartile (from 104.4% to 51.8%). CONCLUSIONS: In Argentina, inflation and rising income were greater than growth in cigarette prices. Cigarette affordability increased for each income group, with the highest shifts occurring among the poorest and most vulnerable income earners. The increased affordability of cigarettes might reduce the impact of implemented tobacco control policies.

Real price and affordability as challenges for effective tobacco control policies: an analysis for Argentina / El precio real y la asequibilidad como obstáculos para las políticas de control del tabaquismo: análisis de la situación en la Argentina

Objective. To describe the evolution of cigarettes' real price and affordability during the last decade in Argentina. Methods. To analyze the real price of cigarettes, the weighted average monthly price of a pack of 20 cigarettes was divided by the consumer price index (CPI) from 2004 to 2014. The relative income price (RIP) was evaluated for the same period, defining RIP as the percentage of the income required to buy 100 packs of 20-per-pack cigarettes. The RIP was calculated for first-quartile, median, and third-quartile income groups. The lower the RIP, the higher the affordability. Results. The nominal price of a pack of 20 cigarettes sold in Argentina increased from AR$ 2.24 in March 2004 to AR$ 14.36 in June 2014 (nominal price increase of about 19.7% per year). The real price fell from AR$ 2.24 in March 2004 to AR$ 2.11 in June 2014 (real price drop of about 0.6% per year). Between June 2004 and June 2014, the RIP decreased about 39% for the 3rd quartile income group (from 31.3% to 19.2%), about 42% for the median (from 55.7% to 32.0%), and about 50% for the 1st quartile (from 104.4% to 51.8%). Conclusions. In Argentina, inflation and rising income were greater than growth in cigarette prices. Cigarette affordability increased for each income group, with the highest shifts occurring among the poorest and most vulnerable income earners. The increased affordability of cigarettes might reduce the impact of implemented tobacco control policies.

Objetivo. Describir la evolución del precio real y la asequibilidad de los cigarrillos durante la última década en la Argentina. Métodos. Para analizar el precio real de los cigarrillos, se dividió todos los meses el promedio ponderado del precio de un paquete de 20 cigarrillos por el índice de precios al consumidor entre el 2004 y el 2014. Se calculó durante el mismo período el precio relativo a los ingresos, definido como el porcentaje de los ingresos necesario para adquirir 100 paquetes de 20 cigarrillos. Se calculó el precio relativo a los ingresos en los cuartiles primero, segundo y tercero de los grupos de ingresos. Cuanto más bajo es el precio relativo a los ingresos, mayor es la asequibilidad. Resultados. El precio nominal en la Argentina de un paquete de 20 cigarrillos pasó de los 2,24 pesos de marzo del 2004 a los 14,36 pesos de junio del 2014 (un aumento próximo a 19,7% por año). El precio real pasó de 2,24 pesos en marzo del 2004 a 2,11 pesos en junio del 2014 (reducción real de cerca de 0,6% por año). Entre junio del 2004 y junio del 2014, el precio relativo a los ingresos se redujo cerca de 39% en el tercer cuartil de ingresos (de 31,3% a 19,2%), 42% en la mediana (de 55,7% a 32,0%) y cerca de 50% en el primer cuartil (de 104,4% a 51,8%). Conclusiones. En la Argentina, la inflación y el aumento de los ingresos fueron mayores que el crecimiento de los precios de los cigarrillos. La asequibilidad de los cigarrillos aumentó en todos los grupos de ingresos y las variaciones más acusadas se produjeron en los grupos más pobres y más vulnerables. La mayor asequibilidad de los cigarrillos puede reducir la repercusión de las políticas de control del tabaquismo llevadas a cabo.

[Diabetes in Mexico. CARMELA study].

BACKGROUND: Diabetes has demonstrated an epidemic behavior in Mexico, which is among the top countries with the highest number of patients with diabetes. The objective of this study was to estimate the prevalence of type 2 diabetes in Mexico City and its relation with some cardiovascular risk factors. METHODS: A cross-sectional study was conducted. A total of 1,772 adults of both genders, aged 25 to 64 years, were randomly selected. Type 2 diabetes and impaired fasting glucose prevalence were estimated as well as its relation with some cardiovascular risk factors such as hypertension, dyslipidemia, obesity, abdominal obesity and the common carotid artery intima-media thickness. RESULTS: The prevalence of type 2 diabetes was 9.7% in women and 8.0% in men. An age effect was evident. The proportion of patients who were unaware of having diabetes was 26%. The main risk factors related to diabetes were age, abdominal obesity, hypertension, low high-density cholesterol lipoproteins (HDL-c) and hypertriglyceridemia. Metabolic control was low. CONCLUSIONS: Prevalence of type 2 diabetes in Mexico is high and is a major health problem. Its close relation with cardiovascular risk factors demand health policies aimed to diminish risk factors related to its occurrence.

The role of organized civil society in tobacco control in Latin America and the Caribbean.

Civil society has been the engine that has permitted many of the accomplishments seen in tobacco control in Latin America and the Caribbean. However, the role of civil society is not clearly understood. Civil society plays five main roles: advocate, coalition builder, provider of evidence-based information, watchdog and service provider. Some of these roles are played weakly by civil society in the region and should be encouraged to support beneficial societal change. Civil society working in tobacco control has evolved over the years to now become more professionalized. The WHO Framework Convention on Tobacco Control and the Bloomberg Initiative to Reduce Tobacco Use have brought about significant change with positive and negative consequences. Strengthening civil society not only supports the tobacco control movement but it provides competencies that may be used in many ways to promote change in democratic societies.

The role of organized civil society in tobacco control in Latin America and the Caribbean / El papel de la sociedad civil organizada en el control del tabaco en Latinoamérica y el Caribe

Civil society has been the engine that has permitted many of the accomplishments seen in tobacco control in Latin America and the Caribbean. However, the role of civil society is not clearly understood. Civil society plays five main roles: advocate, coalition builder, provider of evidence-based information, watchdog and service provider. Some of these roles are played weakly by civil society in the region and should be encouraged to support beneficial societal change. Civil society working in tobacco control has evolved over the years to now become more professionalized. The WHO Framework Convention on Tobacco Control and the Bloomberg Initiative to Reduce Tobacco Use have brought about significant change with positive and negative consequences. Strengthening civil society not only supports the tobacco control movement but it provides competencies that may be used in many ways to promote change in democratic societies.

La sociedad civil ha sido el motor que ha permitido muchos logros en el control del tabaco en Latinoamérica y el Caribe. Sin embargo, no se comprende bien el papel que juega. La sociedad civil tiene cinco roles principales: abogar, construir coaliciones, proveer información basada en evidencia, ser perro guardián y proveer servicios. Algunos de estos roles se juegan débilmente y deben ser promovidos para apoyar cambios benéficos en la sociedad. La sociedad civil ha evolucionado a través de los años en el control del tabaco y ahora se ha profesionalizado más. El Convenio Marco para el Control del Tabaco (CMCT) de la OMS y la iniciativa Bloomberg para Reducir el Uso del Tabaco han traído consigo cambios significativos con consecuencias positivas y negativas. El fortalecimiento de la sociedad civil no sólo significa un beneficio para el movimiento del control del tabaco sino que también provee las competencias que sirven de muchas formas para promover el cambio en las sociedades democráticas.

CARMELA: assessment of cardiovascular risk in seven Latin American cities.

OBJECTIVE: This cross-sectional, population-based observational study using stratified multistage sampling assessed the prevalence of cardiovascular risk factors and carotid plaques and measured carotid intima-media thickness in individuals living in major cities in 7 Latin American countries. PATIENTS AND METHODS: The study comprised individuals (n=11,550) aged 25 to 64 years, living in Barquisimeto, Bogota, Buenos Aires, Lima, Mexico City, Quito, and Santiago. Data on anthropometric parameters, blood pressure, fasting glucose, total and high-density lipoprotein cholesterol, triglycerides, carotid intima-media thickness, carotid plaque, and smoking status were collected through household interviews and clinical, biochemical, and sonographic measurements. RESULTS: The overall prevalence rates (ranges across cities) were as follows: hypertension (> or = 140/90 mm Hg or pharmacologic treatment), 18% (9%-29%); hypercholesterolemia (total cholesterol > or = 240 mg/dL), 14% (6%-20%); diabetes (glycemia > or = 126 mg/dL or self-reported diabetes), 7% (4%-9%); metabolic syndrome, 20% (14%-27%); obesity (body mass index > or = 30 kg/m2), 23% (18%-27%); smoking, 30% (22%-45%); and plaque, 8% (5%-14%). The mean intima-media thickness was 0.65 mm (0.60-0.74 mm). CONCLUSION: The prevalence of hypertension mirrored the world average in 3 cities but was lower in the rest. Hypercholesterolemia was highly prevalent even in countries of different socioeconomic levels. The prevalence of diabetes was similar to that in the developed countries. Tobacco use in women living in Santiago and Buenos Aires was among the world's highest. Intima-media thickness and carotid plaque prevalences varied widely.