Protecting Children and Families from Tobacco: Leadership Training. Peru

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1 Click here for the Table of Contents! Protecting Children and Families from Tobacco: Leadership Training Peru XVI Congreso Latinoamericano de Pediatría November 14, 2012 La Asociación Latinoamericana de Pediatría-ALAPE

2 Table of Contents Click on the links below to access the reports included in this document. WHO Country Profile WHO NCD GYTS Lima 2007 GYTS Huancayo 2007 GYTS Ica City 2007 GYTS Rest of Urban 2007 GYTS Tarapoto 2007 GYTS Trujillo 2007 GSHS 2010 Fact Sheet GSHS 2010 Full Report CTFK Advertising, Promotion & Sponsorship CTFK Packaging & Labeling CTFK Smoke Free Places Informe sobre Control del Tabaco 2011 Additional Resources

3 WHO Report on the Global Tobacco Epidemic, 2011 Country profile Peru Note: Where no data were available, " " shows in the table. Where data were not required, " " shows in the table. WHO Framework Convention on Tobacco Control (WHO FCTC) status Date of signature 21 April 2004 Date of ratification (or legal equivalent) 30 November 2004 Socioeconomic context Population (thousands) Income group Middle income Prevalence of tobacco use Tobacco use data as provided by the country from the latest survey result available to WHO as at 1 November 2010 Any smoked tobacco Cigarettes Adult prevalence, smoking (%)* Current Daily Current Daily Male Female Total Adult prevalence, smokeless tobacco use (%)*... Male... Female... Total... * Ages 15-49, Demographic and Health Survey, 2008 " " Data not reported/not available. WHO age-standardized estimated prevalence of smoking among those aged 15 years or more: Year 2009 Adult prevalence, smoking (%) Any smoked tobacco Cigarettes Current Daily Current Daily Male Female Total " " Estimate not available.

4 Country Profile: Peru Tobacco control measures and programmes as at 31 December 2010 Smoke-free environments 2010 Public places with smoke-free legislation: Health-care facilities Educational facilities except universities Universities Government facilities Indoor offices Restaurants Pubs and bars Public transport All other public places Compliance score... National law requires fines for smoking Fines levied on the establishment Fines levied on the smoker No Dedicated funds for enforcement No Citizen complaints and investigations No A score of 0 10, where 0 is low compliance. Subnational laws on smoke-free environments Subnational jurisdictions do not have the authority to adopt and implement smoke-free laws. 2

5 Country Profile: Peru Treatment of tobacco dependence Is there a toll-free telephone quit line/help line with a live person available to discuss cessation with callers in your country? No 2010 Nicotine replacement therapy (e.g., patch, gum, lozenge, spray or inhaler) Bupropion (e.g., Zyban, Wellbutrin) Varenicline Is this product legally sold in the country? Where and how can this product be legally purchased in your country? Does the national/federal health insurance or the national health service cover the cost of this product? Is any NRT on the country's essential drugs list? Is this product legally sold in your country? Where and how can this product be legally purchased in your country? Does the national/federal health insurance or the national health service cover the cost of this product? Is this product legally sold in your country? In a general store without a prescription No No In a pharmacy with a prescription No Is smoking cessation support available in the following places in your country? Does the national/federal health insurance or the national health service cover the cost of this support? Where and how can this product be legally purchased in your country? In a pharmacy with a prescription Does the national/federal health insurance or the No national health service cover the cost of this product? Health clinics or other primary care facilities No Hospitals in some Office of a health professional in some In the community No Other in some Health clinics or other primary care facilities Hospitals... Office of a health professional No In the community Other... 3

6 Country Profile: Peru Health warnings on tobacco packages Cigarettes 2010 Smokeless tobacco Does the law mandate that health warnings appear on tobacco packages? What percentage of the principal display areas of the package is legally mandated to be 50* 50* covered by health warnings? FRONT AND REAR COMBINED What percentage of the principal display areas of the FRONT of the package is legally 50* 50* mandated to be covered by health warnings? What percentage of the principal display areas of the REAR of the package is legally 50* 50* mandated to be covered by health warnings? Does the law mandate that the warning be placed at the top of the principle display areas No No of the package? Does the law mandate font style, font size and colour for package warnings? Are the health warnings rotating on packages? Are the health warnings on packages written in the principal language(s) of the country? Does the law require that health warnings on packages are not obscured in any way, No No including by required markings such as tax stamps? Do the health warnings on packages include a photograph or graphic? Do health warnings appear on each package and any outside packaging and labelling used in the retail sale? Does the law on health warnings apply to products whether manufactured domestically, No No imported, AND for duty-free sale? Does the law state that warnings on packages do not remove or diminish the liability of the No No tobacco industry? Do health warnings on packages describe the harmful effects of tobacco use on health? Does the law mandate specific health warnings on cigarette packages? How many specific health warnings are approved by the law? Does the law require or establish fines for violations regarding health warnings on packages? Are there any laws requiring that cigarette packaging and labelling do not use misleading terms which imply the product is less harmful than other similar products, such as low tar, light, ultra-light, or mild? Are there any laws requiring that cigarette packaging and labelling do not use figurative or No No other signs, including colours or numbers, as substitutes for prohibited misleading terms and descriptors? Are there any laws requiring that cigarette packaging and labelling do not use descriptors No No depicting flavours? Does the law ban the display of quantitative information on emission yields (such as tar, No No nicotine and carbon monoxide) on cigarette packaging, including when used as part of a brand name or trademark? Does the law mandate the display of qualitative information on relevant constituents and emissions of tobacco products on cigarette packaging? Does the law mandate that this information is displayed on one or more of the principal display areas (front, rear) of the package? Does the law prevent the display of expiry dates on cigarette packaging? No No Is it mandatory for the quit line number to appear on packaging or labelling? No No Does the law mandate plain packaging (ie. prohibit the use of logos, colours, brand images No No or promotional information on packaging other than brand names and product names displayed in a standard colour and font style)? * Policy adopted but not implemented by 31 December

7 Country Profile: Peru Bans on tobacco advertising, promotion and sponsorship 2010 Direct bans National TV and radio International TV and radio No Local magazines and newspapers No International magazines and newspapers No Billboards and outdoor advertising No Point of sale No Internet Other direct bans No Compliance score of direct bans 3 Indirect bans Free distribution No Promotional discounts No Non-tobacco goods and services identified with tobacco brand names No Brand name of non-tobacco products used for tobacco product No Appearance of tobacco brands in TV and/or films (product No placement) Appearance of tobacco products in TV and/or films No Sponsored events No Other indirect bans No Compliance score of indirect bans Are there subnational laws or regulations banning some or all types No of tobacco advertising, promotion and sponsorship mentioned in the above questions? A score of 0 10, where 0 is low compliance. 5

8 Country Profile: Peru Tobacco taxation policy as at 31 July 2010 Price of lowest-cost brand of cigarettes (Pall Mall) A Tax inclusive retail sales price (TIRSP) for a pack of 20 cigarettes PEN PEN Price of Marlboro or similar brand of cigarettes (Marlboro) A Tax inclusive retail sales price (TIRSP) for a pack of 20 cigarettes PEN PEN Taxes on the most popular brand of cigarettes (Hamilton) ᄌ Price of most sold brand, pack of 20 cigarettes In currency reported by country In US$ at official exchange rate Taxes on this brand (% of retail price) 6 WHO's comparable estimate for 2008 WHO's comparable estimate for 2010 PEN PEN USD USD Total ᄌ taxes Specific excise 0 31 Ad valorem excise 25 0 Value added tax (VAT) Import duty 2 3 Other taxes Individual categories of tax may not add to total due to rounding. National tobacco control programme 2010 Specific national government objectives in tobacco control No National agency or technical unit for tobacco control No Number of full-time equivalent staff Government expenditure on tobacco control: In currency reported by country... Year of expenditure... In US$ at official exchange rate US$... *****

9 NCDs IN PERU Sociodemographic indicators Men Women Total population (thousands): 29,399.8 Average annual deaths (thousands): Life expectancy at birth (years): Total: 74.1 Male: 71.5 Female: 76.7 Adult literacy rate (%): 89.6 Gross National Income US$ per capita: 4,200.0 % of population covered by any type health insurance: 23.5 Burden of disease PREMATURE DEATHS (2007) RISK FACTORS Prevalence (%) of: Total Males Females 48.0 % Cancer 33,721 premature deaths (<70 yrs) 5.4 % Diabetes Mellitus 12.6 % Chronic Respiratory Disease 33.9 % Cardiovascular Disease Premature deaths from NCDs (<70 yrs) account for 20.9 % of all deaths Current adult tobacco smokers Adolescent tobacco smokers Fruit and vegetable intake in adults a Fruit and vegetable intake in adolescents a Binge drinking among adults Low physical activity in adults b Low physical activity in adolescents c Overweight among adults (BMI ) Obesity among adults (BMI 30) Overweight among adolescents (BMI>+1SD) Obesity among adolescents (BMI>+2SD) Children <5 overweight Adults with diabetes mellitus Adults with raised BP and/or taking medication Notes: a: % who eat 5 servings of fruit and vegetables per day; b: physically active for <600 met minutes; c: physically active less than 60 min per day in 5-7 of the last 7 days; BP: Blood pressure. Country capacity POLICIES & ACTION PLANS SURVEILLANCE Is there an integrated NCD policy? Is there a budget? Is there an operational multisectoral mechanism to coordinate the NCD policies? Is there an integrated NCD action plan? If the answer is yes, does it have: Budget? Measurable outcomes? Monitoring and evaluation component? Communications component? Is there dedicated staff? Does the information system include specific data on? Specific cause of mortality Hospital based morbidity Risk factors surveys Are there disease specific registries? Is there a unique personal identifier? Use of data for policy making and planning? Are there plans for specific diseases? Established mechanisms for data dissemination? 47

10 Country capacity PREVENTIVE HEALTH SERVICES AT THE PRIMARY LEVEL OF CARE CVD RISK ASSESSMENT BMI Blood pressure Blood glucose Blood lipids Individual risk management with a validated CV risk score DM AND CVD MANAGEMENT Blood pressure monitoring Blood glucose monitoring Blood lipids monitoring Available? All patients Free? Limited resources HbA1C No Not applicable Diabetic foot examination No Not applicable Electrocardiogram CERVICAL CANCER Cervical cytology or PAP HPV DNA testing Visual inspection techniques (VIA) VIA & cryotherapy in a single visit BREAST CANCER Clinical examination Mammography COLORECTAL CANCER Fecal occult blood test Digital exam Available? All patients Free? Notes: HPV: Human Papillomavirus; DM: Diabetes mellitus; CVD: Cardiovascular disease; CV: Cardiovascular. Limited resources SPECIALIZED CARE Available? All patients Free? Limited resources CANCER DIAGNOSIS AND TREATMENT Colposcopy Diagnostic mammography Chemotherapy Radiotherapy CVD MANAGEMENT Cardiac bypass No Not applicable Angioplasty No Not applicable DIABETES MANAGEMENT Available? All patients Free? Limited resources Eye exams No Not applicable Photocoagulation for retinopahty No Not applicable Dialysis No Not applicable OTHER Home care for patients with terminal or advanced disease No Not applicable NON COMMUNICABLE DISEASES MEDICINES Insulin Aspirin Metformin Glibenclamide Thiazide diuretics Available? All patients Free? Limited resources Available? All patients Free? Limited resources Calcium channels blockers No Not applicable Beta blockers Statins Tamoxifen Not specified ACE inhibitors Oral morphine Not specified 48 Sources:»» Sociodemographic indicators and risk factors: Pan American Health Organization. Non communicable disease project, health inforamtion and analysis prject and sustainable development and environment area: Non communicable diseases in the Americas: Basic indicators 2011, Washington DC, USA, 2011.»» Premature mortality: PAHO/WHO Mortality Information System (updated on May 2011).»» Country capacity: 2012 Country Capacity Survey in preparation for the CARMEN meeting, completed by Aldo Tomás Tecse Silva, National Coordinator, Ministry of Health of Peru.

11 Peru - Lima (Ages 13-15) Global Youth Tobacco Survey (GYTS) FACT SHEET The Peru-Lima GYTS includes data on prevalence of cigarette and other tobacco use as well as information on five determinants of tobacco use: access/availability and price, exposure to secondhand smoke (SHS), cessation, media and advertising, and school curriculum. These determinants are components Peru-Lima could include in a comprehensive tobacco control program. The Peru-Lima GYTS was a school-based survey of Students in Secondary 1 5, conducted in A two-stage Prevalence 45.9% of students had ever smoked cigarettes (Boy = 44.6%, Girl = 46.1%) 19.6% currently use any tobacco product (Boy = 19.9%, Girl = 18.2%) 16.5% currently smoke cigarettes (Boy = 16.7%, Girl = 15.2%) 3.4% currently use other tobacco products (Boy = 3.8%, Girl = 3.1%) 26.2% of never smokers are likely to initiate smoking next year Knowledge and Attitudes 20.1% think boys and 17.8% think girls who smoke have more friends 9.3% think boys and 8.9% think girls who smoke look more attractive Access and Availability - Current Smokers 5.4% usually smoke at home 74.6% buy cigarettes in a store 74.1% who bought cigarettes in a store were NOT refused purchase because of their age Exposure to Secondhand Smoke (SHS) 25.7% live in homes where others smoke in their presence 48.9% are around others who smoke in places outside their home 88.0% think smoking should be banned from public places 58.7% think smoke from others is harmful to them 35.8% have one or more parents who smoke 16.2% have most or all friends who smoke Cessation - Current Smokers 69.1% want to stop smoking 64.7% tried to stop smoking during the past year 55.0% have ever received help to stop smoking Media and Advertising 74.9% saw anti-smoking media messages, in the past 30 days 72.2% saw pro-cigarette ads on billboards, in the past 30 days 65.3% saw pro-cigarette ads in newspapers or magazines, in the past 30 days 9.5% have an object with a cigarette brand logo 9.2% were offered free cigarettes by a tobacco company representative School 52.7% had been taught in class, during the past year, about the dangers of smoking 46.5% had discussed in class, during the past year, reasons why people their age smoke 44.1% had been taught in class, during the past year, the effects of tobacco use cluster sample design was used to produce representative data for all of Peru-Lima. At the first stage, schools were selected with probability proportional to enrollment size. At the second stage, classes were randomly selected and all students in selected classes were eligible to participate. The school response rate was 100%, the class response rate was 98.6%, the student response rate was 87.8%, and the overall response rate was 86.6%. A total of 1,671 students aged participated in the Peru-Lima GYTS. Highlights 19.6% of students currently use any form of tobacco; 16.5% currently smoke cigarettes; 3.4% currently use other tobacco products. SHS exposure is very high onequarter of the 4 students live in homes where others smoke; almost half are exposed to smoke in public places; more than onethird of the students have one or more parents who smoke. Almost 6 in 10 students think that smoke from others is harmful to them. Nearly 9 in 10 students think smoking in public places should be banned. Seven in 10 smokers want to stop. 9.5% students have an object with a cigarette brand logo on it. Three-quarters of the students saw anti-smoking media messages in the past 30 days; more than two-thirds of the students saw pro-smoking media messages in the past 30 days. For additional information, please contact: Alfonso Zavaleta

12 Peru Huancayo (Ages 13-15) Global Youth Tobacco Survey (GYTS) FACT SHEET The Peru - Huancayo GYTS includes data on prevalence of cigarette and other tobacco use as well as information on five determinants of tobacco use: access/availability and price, exposure to secondhand smoke (SHS), cessation, media and advertising, and school curriculum. These determinants are components Peru - Huancayo could include in a comprehensive tobacco control program. The Peru - Huancayo GYTS was a school-based survey of Students in Secondary 1 5, conducted in A two-stage Prevalence 48.4% of students had ever smoked cigarettes (Boy = 60.6%, Girl = 35.2%) 21.3% currently use any tobacco product (Boy = 28.0%, Girl = 13.7%) 17.0% currently smoke cigarettes (Boy = 24.3%, Girl = 9.4%) 4.5% currently use other tobacco products (Boy = 6.5%, Girl = 2.3%) 28.4% of never smokers are likely to initiate smoking next year Knowledge and Attitudes 22.0% think boys and 18.6% think girls who smoke have more friends 14.8% think boys and 11.5% think girls who smoke look more attractive Access and Availability - Current Smokers 11.4% usually smoke at home 59.2% buy cigarettes in a store 59.9% who bought cigarettes in a store were NOT refused purchase because of their age Exposure to Secondhand Smoke (SHS) 18.0% live in homes where others smoke in their presence 41.7% are around others who smoke in places outside their home 86.5% think smoking should be banned from public places 54.0% think smoke from others is harmful to them 27.4% have one or more parents who smoke 9.0% have most or all friends who smoke Cessation - Current Smokers 56.1% want to stop smoking 65.7% tried to stop smoking during the past year 66.3% have ever received help to stop smoking Media and Advertising 80.6% saw anti-smoking media messages, in the past 30 days 65.9% saw pro-cigarette ads on billboards, in the past 30 days 64.9% saw pro-cigarette ads in newspapers or magazines, in the past 30 days 9.6% have an object with a cigarette brand logo 12.1% were offered free cigarettes by a tobacco company representative School 55.2% had been taught in class, during the past year, about the dangers of smoking 44.0% had discussed in class, during the past year, reasons why people their age smoke 44.3% had been taught in class, during the past year, the effects of tobacco use cluster sample design was used to produce representative data for all of Peru - Huancayo. At the first stage, schools were selected with probability proportional to enrollment size. At the second stage, classes were randomly selected and all students in selected classes were eligible to participate. The school response rate was 100%, the class response rate was 100%, the student response rate was 91.8%, and the overall response rate was 91.8%. A total of 1,183 students aged participated in the Peru - Huancayo GYTS. Highlights 21.3% of students currently use any form of tobacco; 17% currently smoke cigarettes; 4.5% currently use other tobacco products. SHS exposure is high almost 2 in 10 students live in homes where others smoke; more than 4 in 10 are exposed to smoke in public places; nearly 3 in 10 students have one or more parents who smoke. More than half the students think that smoke from others is harmful to them. Over 8 in 10 students think smoking in public places should be banned. Close to 3 in 5 smokers want to stop. One in 10 students has an object with a cigarette brand logo on it. Eight in 10 students saw antismoking media messages in the past 30 days; more than 6 in 10 students saw pro-smoking media messages in the past 30 days. For additional information, please contact: Alfonso Zavaleta

13 Peru - Ica City (Ages 13-15) Global Youth Tobacco Survey (GYTS) FACT SHEET The Peru - Ica City GYTS includes data on prevalence of cigarette and other tobacco use as well as information on five determinants of tobacco use: access/availability and price, exposure to secondhand smoke (SHS), cessation, media and advertising, and school curriculum. These determinants are components Peru- Ica City could include in a comprehensive tobacco control program. The Peru - Ica City GYTS was a school-based survey of Students in Secondary 1 5 conducted in A two-stage Prevalence 45.6% of students had ever smoked cigarettes (Boy = 54.3%, Girl = 36.5%) 18.9% currently use any tobacco product (Boy = 23.1%, Girl = 14.6%) 15.5% currently smoke cigarettes (Boy = 20.8%, Girl = 10.4%) 4.1% currently use other tobacco products (Boy = 5.6%, Girl = 2.8%) 27.8% of never smokers are likely to initiate smoking next year Knowledge and Attitudes 21.1% think boys and 17.2% think girls who smoke have more friends 13.7% think boys and 12.3% think girls who smoke look more attractive Access and Availability - Current Smokers 9.5% usually smoke at home 63.4% buy cigarettes in a store 75.5% who bought cigarettes in a store were NOT refused purchase because of their age Exposure to Secondhand Smoke (SHS) 25.0% live in homes where others smoke in their presence 45.4% are around others who smoke in places outside their home 87.1% think smoking should be banned from public places 59.1% think smoke from others is harmful to them 32.6% have one or more parents who smoke 11.1% have most or all friends who smoke cluster sample design was used to produce representative data for all of Peru - Ica City. At the first stage, schools were selected with probability proportional to enrollment size. At the second stage, classes were randomly selected and all students in selected classes were eligible to participate. The school response rate was 100%, the class response rate was 90.7%, the student response rate was 80.9%, and the overall response rate was 73.4%. A total of 1,853 students aged participated in the Peru - Ica City GYTS. Highlights 18.9% of students currently use any form of tobacco; 15.5% currently smoke cigarettes; 4.1% currently use other tobacco products. SHS exposure is high onequarter of the students live in homes where others smoke; more than 4 in 10 are exposed to smoke in public places; close to onethird of the students have one or more parents who smoke. Six in 10 students think that smoke from others is harmful to them. Nearly 9 in 10 students think smoking should be banned in public places. Cessation - Current Smokers 73.1% want to stop smoking 76.4% tried to stop smoking during the past year 68.5% have ever received help to stop smoking Media and Advertising 81.4% saw anti-smoking media messages, in the past 30 days 64.1% saw pro-cigarette ads on billboards, in the past 30 days 65.8% saw pro-cigarette ads in newspapers or magazines, in the past 30 days 7.1% have an object with a cigarette brand logo 11.0% were offered free cigarettes by a tobacco company representative 7.1% of students have an object with a cigarette brand logo on it. Almost three-quarters of smokers want to stop. More than 8 in 10 students saw anti-smoking media messages in the past 30 days; over 6 in 10 students saw pro-smoking media messages in the past 30 days. School 56.8% had been taught in class, during the past year, about the dangers of smoking 47.4% had discussed in class, during the past year, reasons why people their age smoke 48.3% had been taught in class, during the past year, the effects of tobacco use For additional information, please contact: Alfonso Zavaleta

14 Peru - Rest of Urban (Ages 13-15) Global Youth Tobacco Survey (GYTS) FACT SHEET The Peru - Rest of Urban GYTS includes data on prevalence of cigarette and other tobacco use as well as information on five determinants of tobacco use: access/availability and price, exposure to secondhand smoke (SHS), cessation, media and advertising, and school curriculum. These determinants are components Peru - Rest of Urban could include in a comprehensive tobacco control program. The Peru - Rest of Urban GYTS was a school-based survey of students in 1 st, 2 nd, 3 rd, 4 th and 5 th secondary conducted in Prevalence 46.8% of students had ever smoked cigarettes (Boy = 51.8%, Girl = 42.4%) 18.5% currently use any tobacco product (Boy = 23.4%, Girl = 13.8%) 14.3% currently smoke cigarettes (Boy = 18.7%, Girl = 10.2%) 6.5% currently use other tobacco products (Boy = 7.1%, Girl = 5.2%) 22.6% of never smokers are likely to initiate smoking next year Knowledge and Attitudes 17.6% think boys and 16.3% think girls who smoke have more friends 16.0% think boys and 13.5% think girls who smoke look more attractive Access and Availability - Current Smokers 15.8% usually smoke at home 58.1% buy cigarettes in a store 75.5% who bought cigarettes in a store were NOT refused purchase because of their age Exposure to Secondhand Smoke (SHS) 25.8% live in homes where others smoke in their presence 31.8% are around others who smoke in places outside their home 86.5% think smoking should be banned from public places 52.3% think smoke from others is harmful to them 37.7% have one or more parents who smoke 11.0% have most or all friends who smoke Cessation - Current Smokers 81.1% want to stop smoking 86.6% tried to stop smoking during the past year 70.6% have ever received help to stop smoking Media and Advertising 88.6% saw anti-smoking media messages, in the past 30 days 67.2% saw pro-cigarette ads on billboards, in the past 30 days 73.4% saw pro-cigarette ads in newspapers or magazines, in the past 30 days 13.3% have an object with a cigarette brand logo 9.5% were offered free cigarettes by a tobacco company representative School 57.4% had been taught in class, during the past year, about the dangers of smoking 48.0% had discussed in class, during the past year, reasons why people their age smoke 44.5% had been taught in class, during the past year, the effects of tobacco use A two-stage cluster sample design was used to produce representative data for Peru - Rest of Urban. At the first stage, schools were selected with probability proportional to enrollment size. At the second stage, classes were randomly selected and all students in selected classes were eligible to participate. The school response rate was 100.0%, the class response rate was 100.0%, the student response rate was 92.1%, and the overall response rate was 92.1%. A total of 1,279 students aged participated in the Peru - Rest of Urban GYTS. Highlights 18.5% of students currently use any form of tobacco; 14.3% currently smoke cigarettes; 6.5% currently use some other form of tobacco. SHS exposure is high onequarter of the students live in homes where others smoke, and 3 in 10 students are exposed to smoke around others outside of the home; close to 2 in 5 students have at least one parent who smokes. Over half the students think smoke from others is harmful to them. Close to 9 in 10 students think smoking in public places should be banned. Eight in 10 current smokers want to stop smoking. Over 1 in 7 students have an object with a cigarette brand logo on it. Nearly 9 in 10 students saw anti-smoking media messages in the past 30 days; 7 in 10 students saw pro-cigarette ads on billboards and in newspapers or magazines in the past 30 days. For additional information, please contact: Alfonso Zavaleta

15 Peru - Tarapoto (Ages 13-15) Global Youth Tobacco Survey (GYTS) FACT SHEET The Peru-Tarapoto GYTS includes data on prevalence of cigarette and other tobacco use as well as information on five determinants of tobacco use: access/availability and price, exposure to secondhand smoke (SHS), cessation, media and advertising, and school curriculum. These determinants are components Peru-Tarapoto could include in a comprehensive tobacco control program. The Peru-Tarapoto GYTS was a school-based survey of Students in Secondary 1 5 conducted in A two-stage Prevalence 43.5% of students had ever smoked cigarettes (Boy = 51.0%, Girl = 36.2%) 20.0% currently use any tobacco product (Boy = 24.8%, Girl = 15.1%) 15.6% currently smoke cigarettes (Boy = 20.7%, Girl = 10.8%) 4.2% currently use other tobacco products (Boy = 4.5%, Girl = 3.9%) 28.5% of never smokers are likely to initiate smoking next year Knowledge and Attitudes 25.9% think boys and 21.5% think girls who smoke have more friends 13.7% think boys and 12.1% think girls who smoke look more attractive Access and Availability - Current Smokers 14.2% usually smoke at home 57.3% buy cigarettes in a store 62.2% who bought cigarettes in a store were NOT refused purchase because of their age Exposure to Secondhand Smoke (SHS) 29.6% live in homes where others smoke in their presence 48.0% are around others who smoke in places outside their home 90.2% think smoking should be banned from public places 59.0% think smoke from others is harmful to them 35.8% have one or more parents who smoke 10.1% have most or all friends who smoke cluster sample design was used to produce representative data for all of Peru-Tarapoto. At the first stage, schools were selected with probability proportional to enrollment size. At the second stage, classes were randomly selected and all students in selected classes were eligible to participate. The school response rate was 100%, the class response rate was 100%, the student response rate was 91.0%, and the overall response rate was 91.0%. A total of 2,128 students aged participated in the Peru-Tarapoto GYTS. Highlights 20.0% of students currently use any form of tobacco; more than 15.6% currently smoke cigarettes; 4.2% currently use other tobacco products. SHS exposure is very high 3 in 10 students live in homes where others smoke; almost half are exposed to smoke in public places; over one-third of the students have one or more parents who smoke. Six in 10 students think that smoke from others is harmful to them. Nine in 10 students think smoking in public places should be banned. Cessation - Current Smokers 79.8% want to stop smoking 77.3% tried to stop smoking during the past year 70.1% have ever received help to stop smoking Media and Advertising 83.1% saw anti-smoking media messages, in the past 30 days 69.5% saw pro-cigarette ads on billboards, in the past 30 days 63.1% saw pro-cigarette ads in newspapers or magazines, in the past 30 days 8.5% have an object with a cigarette brand logo 11.0% were offered free cigarettes by a tobacco company representative Eight in 10 smokers want to stop. 8.5% of students have an object with a cigarette brand logo on it. More than 4 in 5 students saw anti-smoking media messages in the past 30 days; two-thirds of the students saw pro-smoking media messages in the past 30 days. School 70.5% had been taught in class, during the past year, about the dangers of smoking 63.4% had discussed in class, during the past year, reasons why people their age smoke 56.6% had been taught in class, during the past year, the effects of tobacco use For additional information, please contact: Alfonso Zavaleta

16 Peru - Trujillo (Ages 13-15) Global Youth Tobacco Survey (GYTS) FACT SHEET The Peru-Trujillo GYTS includes data on prevalence of cigarette and other tobacco use as well as information on five determinants of tobacco use: access/availability and price, exposure to secondhand smoke (SHS), cessation, media and advertising, and school curriculum. These determinants are components Peru-Trujillo could include in a comprehensive tobacco control program. The Peru-Trujillo GYTS was a school-based survey of Students in Secondary 1 5 conducted in A two-stage Prevalence 41.0% of students had ever smoked cigarettes (Boy = 48.8%, Girl = 33.1%) 16.7% currently use any tobacco product (Boy = 19.3%, Girl = 14.1%) 14.4% currently smoke cigarettes (Boy = 17.4%, Girl = 11.5%) 2.9% currently use other tobacco products (Boy = 4.4%, Girl = 1.4%) 23.9% of never smokers are likely to initiate smoking next year Knowledge and Attitudes 17.8% think boys and 17.0% think girls who smoke have more friends 11.4% think boys and 10.4% think girls who smoke look more attractive Access and Availability - Current Smokers 8.4% usually smoke at home 60.9% buy cigarettes in a store 68.0% who bought cigarettes in a store were NOT refused purchase because of their age Environmental Tobacco Smoke 18.3% live in homes where others smoke in their presence 43.9% are around others who smoke in places outside their home 86.9% think smoking should be banned from public places 63.0% think smoke from others is harmful to them 31.4% have one or more parents who smoke 9.8% have most or all friends who smoke cluster sample design was used to produce representative data for all of Peru-Trujillo. At the first stage, schools were selected with probability proportional to enrollment size. At the second stage, classes were randomly selected and all students in selected classes were eligible to participate. The school response rate was 96.0%, the class response rate was 96.7%, the student response rate was 86.6%, and the overall response rate was 80.4%. A total of 1,857 students aged participated in the Peru-Trujillo GYTS. Highlights 16.7% of students currently use any form of tobacco; 14.4% currently smoke cigarettes; 2.9% currently use other tobacco products. ETS exposure is high nearly 1 in 5 students live in homes where others smoke; more than 4 in 10 students are exposed to smoke in public places; over 3 in 10 students have one or more parents who smoke. More than 6 in 10 students think that smoke from others is harmful to them. Close to 9 in 10 students think smoking in public places should be banned. Cessation - Current Smokers 62.6% want to stop smoking 69.4% tried to stop smoking during the past year 51.2% have ever received help to stop smoking Media and Advertising 78.7% saw anti-smoking media messages, in the past 30 days 68.1% saw pro-cigarette ads on billboards, in the past 30 days 66.0% saw pro-cigarette ads in newspapers or magazines, in the past 30 days 8.6% have an object with a cigarette brand logo 8.7% were offered free cigarettes by a tobacco company representative More than 6 in 10 smokers want to stop. 8.6% of students have an object with a cigarette brand logo on it. Almost 8 in 10 students saw antismoking media messages in the past 30 days; two-thirds of the students saw pro-smoking media messages in the past 30 days. School 59.3% had been taught in class, during the past year, about the dangers of smoking 52.8% had discussed in class, during the past year, reasons why people their age smoke 51.7% had been taught in class, during the past year, the effects of tobacco use For additional information, please contact: Alfonso Zavaleta

17 Global School-based Student Health Survey Peru 2010 Fact Sheet The 2010 Peru GSHS measured alcohol use; dietary behaviors; drug use; hygiene; mental health; physical activity; protective factors; sexual behaviors; tobacco use; and violence and unintentional injury. The Peru GSHS was a school-based survey of students in grades 2, 3, and 4. A two-stage cluster sample design was used to produce data representative of all students in grades 2, 3, and 4 in Peru. At the first stage, schools were selected with probability proportional to enrollment size. At the second stage, classes were randomly selected and all students in selected classes were eligible to participate. The school response rate was 100%, the student response rate was 85%, and the overall response rate was 85%. A total of 2882 students participated in the Peru GSHS. Students self-reported their responses to each question on a computer scannable answer sheet. For comparison purposes, only students aged years are included in the analyses for this fact sheet. Results for students aged years Total Boys Girls Alcohol Use Percentage of students who drank at least one drink containing alcohol on one or more of the past 30 days Among students who ever had a drink of alcohol (other than a few sips), the percentage who had their first drink of alcohol before age 14 years Percentage of students who drank so much alcohol that they were really drunk one or more times during their life 27.1 ( ) 66.4 ( ) 13.5 ( ) 28.4 ( ) 70.2 ( ) 16.8 ( ) 26.0 ( ) 62.0 ( ) 10.2 ( ) Dietary Behaviours Percentage of students who were underweight (< -2SD from median for BMI for age and sex) Percentage of students who were overweight (> +1SD from median for BMI for age and sex) Percentage of students who were obese (> +2SD from median for BMI for age and sex) Percentage of students who usually drank carbonated soft drinks one or more times per day during the past 30 days 0.8 ( ) 20.2 ( ) 2.9 ( ) 53.6 ( ) 0.9 ( ) 21.8 ( ) 3.0 ( ) 54.0 ( ) 0.7 ( ) 18.7 ( ) 2.7 ( ) 53.0 ( ) Drug Use Among students who ever used drugs, the percentage who first used drugs before age 14 years Percentage of students who used marijuana one or more times during their life Hygiene 59.7 ( ) 3.8 ( ) * * 5.7 ( ) 1.9 ( ) Percentage of students who usually cleaned or brushed their teeth less than one time per day during the past 30 days Percentage of students who never or rarely washed their hands after using the toilet or latrine during the past 30 days 4.3 ( ) 6.6 ( ) 4.8 ( ) 6.5 ( ) 3.9 ( ) 6.6 ( ) Mental Health Percentage of students who ever seriously considered attempting suicide during the past 12 months Percentage of students who actually attempted suicide one or more times during the past 12 months Percentage of students who had no close friends 19.5 ( ) 17.0 ( ) 5.5 ( ) 11.1 ( ) 12.0 ( ) 5.7 ( ) 27.9 ( ) 22.0 ( ) 5.3 ( ) 2010 Page 1

18 Global School-based Student Health Survey Peru 2010 Fact Sheet Results for students aged years Total Boys Girls Physical Activity Percentage of students who were physically active for a total of at least 60 minutes per day on five or more days during the past seven days 24.5 ( ) 27.0 ( ) 22.2 ( ) Percentage of students who went to physical education (PE) class on three or more days each week during the school year 2.4 ( ) 2.2 ( ) 2.5 ( ) Percentage of students who spent three or more hours per day during a typical or usual day doing sitting activities 28.9 ( ) 28.4 ( ) 29.5 ( ) Protective Factors Percentage of students who missed classes or school without permission on one or more of the past 30 days 34.4 ( ) 37.5 ( ) 31.3 ( ) Percentage of students whose parents or guardians understood their problems and worries most of the time or always during the past 30 days 35.9 ( ) 33.5 ( ) 38.4 ( ) Percentage of students whose parents or guardians really knew what they were doing with their free time most of the time or always during the past 30 days 36.8 ( ) 33.1 ( ) 40.4 ( ) Sexual Behaviours Percentage of students who ever had sexual intercourse 16.9 ( ) 24.3 ( ) 9.6 ( ) Among students who ever had sexual intercourse, the percentage who had sexual intercourse for the first time before age 14 years 53.9 ( ) 58.1 ( ) * Among students who ever had sexual intercourse, the percentage who used a condom the last time they had sexual intercourse 62.3 ( ) 62.4 ( ) 62.9 ( ) Tobacco Use Percentage of students who smoked cigarettes on one or more days during the past 30 days Among students who ever smoked cigarettes, the percentage who first tried a cigarette before age 14 years 17.3 ( ) 67.3 ( ) 22.9 ( ) 68.3 ( ) 11.9 ( ) 65.5 ( ) Percentage of students who reported people smoked in their presence on one or more days during the past seven days 57.9 ( ) 58.2 ( ) 57.7 ( ) Violence and Unintentional Injury Percentage of students who were in a physical fight one or more times during the past 12 months Percentage of students who were seriously injured one or more times during the past 12 months Percentage of students who were bullied on one or more days during the past 30 days 36.9 ( ) 48.9 ( ) 47.4 ( ) 52.4 ( ) 53.8 ( ) 46.7 ( ) 21.5 ( ) 44.2 ( ) 48.2 ( ) * Indicates less than 100 students. For additional information, please contact: Maria Edith Baca PAHO, Peru, 2010 Page 2

19 ENCUESTA GLOBAL DE SALUD ESCOLAR Resultados - Perú 2010

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