RESUMEN Objetivo: Examinar las percepciones de las mujeres sobre la implementación y el cumplimiento de la legislación nacional colombiana sobre el tabaco en Antioquia, Colombia, a través del lente de los indicadores MPOWER, que es la guía del Convenio Marco para el Control del Tabaco de la Organización Mundial de la Salud. Métodos: Se trata de un estudio transversal con una muestra representativa de mujeres mayores de 18 años de las nueve subregiones de Antioquia mediante un muestreo probabilístico polietápico. Resultados: De 4.383 mujeres que participaron en el estudio, solo el 35% conocía la Ley 1335, siendo el conocimiento más alto entre las participantes blancas y casadas con títulos universitarios, que tienen seguro de salud privado o residentes de nivel socioeconómico medio y alto. El grado de implementación varió entre las subregiones y los participantes percibieron que el monitoreo del consumo de tabaco (M) y la protección de la población contra el humo del tabaco (P) tienen altos niveles de implementación en Antioquia, mientras que las advertencias sobre los peligros del consumo de tabaco (W) y el cumplimiento de las prohibiciones sobre publicidad, promoción y patrocinio (E) son débiles. En cuanto a la oferta de ayuda para dejar de fumar (O), solo el 8,5% de los fumadores o exfumadores buscó alguna vez asistencia de profesionales de la salud para dejar de fumar y, entre ellos, solo el 2% recibió tratamiento cubierto por su seguro de salud. Conclusiones: Aunque la legislación para el control del tabaco se establece a nivel nacional, su aplicación depende en gran medida de las estrategias locales. En Antioquia, se deben poner esfuerzos en estrategias educativas sobre advertencias de los daños asociados con el consumo de tabaco, cumplimiento de la publicidad y promoción de productos de tabaco y provisión de tratamientos para dejar de fumar basados en evidencia.

ABSTRACT Objective: To examine women's perceptions of the implementation and enforcement of the Colombian national tobacco legislation in Antioquia, Colombia, through the lens of the MPOWER indicators, which is the World Health Organization Framework Convention on Tobacco Control guide. Methods: This was a cross-sectional study with a representative sample of women over 18 years of age in the nine subregions of Antioquia, using a multi-stage probabilistic sampling. Results: Out of 4,383 women who participated in the study, only 35% were aware of Law 1335, with awareness being the highest among white and married participants with college degrees, who have private health insurance, or residents in middle and high socioeconomic status. The degree of implementation varied across subregions, and participants perceived that monitoring tobacco consumption (M) and protecting the population from tobacco smoke (P) have high levels of implementation in Antioquia, while warnings about the dangers of tobacco use (W) and enforcing the prohibitions on advertising, promotion, and sponsorship (E) are weak. In terms of offering help for quitting (O), only 8.5% of smokers or former smokers ever sought assistance from health professionals to quit smoking and, among those, only 2% received treatment covered by their health insurance plan. Conclusions: Even though tobacco control legislation is established at the national level, its enforcement relies heavily on local strategies. In Antioquia, efforts should be placed on educational strategies regarding warnings of the harms associated with tobacco use, enforcement of advertising and promotion of tobacco products, and provision of evidence-based tobacco cessation treatments.

Resumen Introducción: El uso del tabaco en mujeres está aumentando significativamente a pesar de los alarmantes peligros para la salud. Objetivo: Determinar la prevalencia y factores asociados al consumo de tabaco en mujeres del departamento de Antioquia, Colombia. Materiales y métodos: Estudio descriptivo transversal, con una muestra representativa de mujeres mayores de 18 años en las nueve subregiones del departamento, se utilizó un muestreo probabilístico multietápico, estratificado por región. Resultados: De 4377 mujeres, 10,8% eran fumadoras, 13,1% exfumadoras, y 75,9% nunca habían fumado. Variables relacionadas con mayor reporte de tabaquismo: tener más de 45 años (OR=3,2, IC 2,6-3,9); no tener educación o primaria incompleta (OR=2,2, IC 1,5-3,1), secundaria incompleta (OR=1,5, IC 1,1-2,2), consumir licor (OR=2,3, IC 1,9-2,7), no consumir verduras (OR=1,4, IC 1,02,0), no consumir frutas (OR=1,6, IC 1,2-2,1). Variables relacionadas con menor reporte de tabaquismo: estar casada (OR=0,6, IC 0,5-0,8), y vivir en algunas de las subregiones. Conclusiones: Se evidencia la importancia de programas enfocados a prevenir el consumo de productos nuevos como el cigarrillo electrónico, especialmente en población joven.

Abstract Introduction: Tobacco use among women is increasing significantly despite alarming health hazards. Objective: To determine the prevalence and factors associated with tobacco consumption in women from the department of Antioquia, Colombia. Material and methods: Cross-sectional descriptive study, with a representative sample of women over 18 years of age in the nine subregions of the department, using multistage probabilistic sampling, stratified by region. Results: Of the 4,377 women, 10.8% were smokers, 13.1% were ex-smokers, and 75.9% were women who had never smoked. Variables related to the highest reported smokers: having more than 45 years of age (OR=3.2, CI 2.6-3.9); not having an education or an incomplete primary education (OR=2.2, IC 1.5-3.1), incomplete secondary education (OR=1.5, CI 1.1-2.2), consuming liquor (OR=2.3, CI 1.9-2.7), not consuming vegetables (OR=1.4, IC 1.0-2.0), not consuming fruit (OR=1,6, CI 1,2-2,1). Variables related to less reported smoking: being married (OR=0.6, CI 0.5-0.8) and living in some of the subregions. Conclusions: The importance of programs focused on preventing the consumption of new products such as e-cigarettes is evident, especially in young people.

O objetivo deste estudo foi avaliar a prevalência do uso de produtos derivados do tabaco e o perfil demográfico de mulheres fumantes no Paraná, Brasil. Foi um estudo transversal de base populacional com amostragem por cluster envolvendo 2.153 mulheres com 18 anos de idade ou mais em sete cidades. A prevalência do uso do tabaco fumado foi de 13,4% variando de 10% (Cascavel) a 19% (Irati). Na análise multivariada, cidade, estado civil e escolaridade foram significativamente associados ao uso do tabaco. Mulheres em Irati (OR = 2,08; IC95%: 1,22-3,54) foram mais propensas a serem fumantes que mulheres em Cambé. As casadas ou viúvas foram menos propensas a serem fumantes (OR = 0,47; IC95%: 0,30-0,73 e OR = 0,43; IC95%: 0,22-0,87) que as solteiras. Mulheres em união estável foram mais propensas a serem fumantes que as solteiras (OR = 2,49; IC95%: 1,12-5,53) e mulheres com curso superior foram menos propensas a serem fumantes que as com primeiro grau ou menos (OR = 0,41; IC95%: 0,22-0,87). Estes resultados confirmam a necessidade de programas de controle do tabaco que levem em consideração as questões de gênero e regiões.

This study aimed to estimate the prevalence of tobacco use and to describe the demographic profile of female smokers in Paraná State, Brazil. The study used a cross-sectional population-based design with cluster sampling (n = 2,153) of women 18 years or older in seven cities. Prevalence of smoking was 13.4%, ranging from 10% in Cascavel to 19% in Irati. According to multivariate analysis, city of residence, marital status, and schooling were significantly associated with tobacco use. Women in Irati (OR = 2.08; 95%CI: 1.22-3.54) were more likely to smoke than those in Cambé. Married women and widows were less likely to smoke (OR = 0.47; 95%CI: 0.30-0.73 and OR = 0.43; 95%CI: 0.22-0.87) than single women. Women living with a partner (but not married) were more likely to smoke than single women (OR = 2.49; 95%CI: 1.12-5.53), and women with university degrees were less likely to smoke than those with eight years of school or less (OR = 0.41; 95%CI: 0.22-0.87). The results confirm the need for tobacco control programs that take gender and regional differences into account.

O objetivo deste estudo foi avaliar a prevalência do uso de produtos derivados do tabaco e o perfil demográfico de mulheres fumantes no Paraná, Brasil. Foi um estudo transversal de base populacional com amostragem por cluster envolvendo 2.153 mulheres com 18 anos de idade ou mais em sete cidades. A prevalência do uso do tabaco fumado foi de 13,4% variando de 10% (Cascavel) a 19% (Irati). Na análise multivariada, cidade, estado civil e escolaridade foram significativamente associados ao uso do tabaco. Mulheres em Irati (OR = 2,08; IC95%: 1,22-3,54) foram mais propensas a serem fumantes que mulheres em Cambé. As casadas ou viúvas foram menos propensas a serem fumantes (OR = 0,47; IC95%: 0,30-0,73 e OR = 0,43; IC95%: 0,22-0,87) que as solteiras. Mulheres em união estável foram mais propensas a serem fumantes que as solteiras (OR = 2,49; IC95%: 1,12-5,53) e mulheres com curso superior foram menos propensas a serem fumantes que as com primeiro grau ou menos (OR = 0,41; IC95%: 0,22-0,87). Estes resultados confirmam a necessidade de programas de controle do tabaco que levem em consideração as questões de gênero e regiões.

This study aimed to estimate the prevalence of tobacco use and to describe the demographic profile of female smokers in Paraná State, Brazil. The study used a cross-sectional population-based design with cluster sampling (n = 2,153) of women 18 years or older in seven cities. Prevalence of smoking was 13.4%, ranging from 10% in Cascavel to 19% in Irati. According to multivariate analysis, city of residence, marital status, and schooling were significantly associated with tobacco use. Women in Irati (OR = 2.08; 95%CI: 1.22-3.54) were more likely to smoke than those in Cambé. Married women and widows were less likely to smoke (OR = 0.47; 95%CI: 0.30-0.73 and OR = 0.43; 95%CI: 0.22-0.87) than single women. Women living with a partner (but not married) were more likely to smoke than single women (OR = 2.49; 95%CI: 1.12-5.53), and women with university degrees were less likely to smoke than those with eight years of school or less (OR = 0.41; 95%CI: 0.22-0.87). The results confirm the need for tobacco control programs that take gender and regional differences into account.