- Member Spotlights
- Growing tobacco control and treatment throughout Latin America and the Caribbean
Growing tobacco control and treatment throughout Latin America and the Caribbean
You have been very active and passionate about tobacco control/tobacco dependence treatment. What led to your involvement?
The InterAmerican Heart Foundation was a new organization in the 1990s and there were few people involved in tobacco control in Latin America and the Caribbean On a personal level, my father was very much opposed to tobacco and would frequently complain to restaurant owners and others about allowing smoking indoors. I thought that by focusing on policy change I was more likely to have an impact than isolated complaints. Also, I had a friend and colleague in Uruguay, Santiago, who smoked and I repeatedly tried helping him quit. I figured it was easier to change the whole country of Uruguay than to try to change the behavior of this one person. With 145 million smokers in our region, what is one more smoker? But that one motivated me forward.
Tell us about your activity and passion about tobacco control
My work in tobacco control has been very varied and long-term. I started by developing a program for health professionals to help their patients quit smoking, using an existing Canadian program called “Help your patients to a tobacco free future.” The current programs being used in the region & by Global bridges are very similar to the one we started using. The main partner was the Pan American Health Organization.
In 2000 we created an internet network for all tobacco control advocates, treatment specialists and researchers (frequently all in one person) for this region and called it “Latin American Coordinating Coalition against Tobacco.” Shortly after that, we helped organize a network for the English speaking Caribbean. Thanks to support from Canada, we were able to help Mexico and other countries advance their tobacco control agendas. When funding from Bloomberg came along, we already had a strong network of people that collaborated with each other in our region. Many opportunities opened up as a result of Bloomberg funds. The Bloomberg funds opened many opportunities for us, including access to public relations firms, training, and experts, as well as legal counsel. This helped our groups in Latin America become more effective and professional.
As a result of this growth, we now have strong policies for smoke free environments and packaging warning labels in most countries of the region. Many have bans on publicity, promotion and sponsorship of tobacco products, some have been able to increase tobacco taxes. These achievements, to which my organization contributed, would have been unthinkable just 10-15 years ago.
There were—and continue to be– many memorable moments in my work on tobacco control. One that many of us remember is when the Ministry of Health of Mexico signed an agreement with the tobacco industry by which the industry provided money to fund healthcare for the poor in exchange for limiting tobacco regulation in January 2006. My organization held a press conference about the influence of the tobacco industry in Mexico and the idiocy of making such accord with the industry and we had every journalist and media outlet represented. We brought the house down. Before that event many complained that the media did not pay attention to the issue of tobacco. After that event, it was a new world. Tobacco was in the media almost daily. Tobacco was on the public agenda and could no longer be ignored.
What are some of the things you have been able to accomplish, specifically in the tobacco control arena?
We work with many people and organizations and try to stay behind the scenes. Our main role has been to help create teams that can effectively advance the tobacco agenda and recognize their work.
I am quite proud of some achievements in particular. We helped make the City of Mexico tobacco free in all indoor public places. At the time it was the largest city to make that move. We’ve kept the tobacco community together, learning from each other, celebrating accomplishments, commiserating over losses, alerting to new strategies. We have held eight journalism contests to recognize the work of journalist to tell the truth about tobacco. Many of the journalists we awarded went on to have significant roles in denouncing the deadly impact of tobacco and having major policy impact.
By creating affiliated organizations focused on tobacco: FIC Argentina, FIC Mexico and InterAmerican Heart Foundation Caribbean, we were able to expand the grass root work we could do. Each of these organizations has had a major role in advancing FCTC policies.
Our association with Global Bridges and the Mayo Clinic allowed my organization to have a significant role in the training of thousands of healthcare professionals that have gone on to use their skills in their clinical practice. While we do not have results yet, I think the Entre Ríos study, a randomized control trial, will, for the first time in our region, help us understand how training might affect clinical practice and in turn, patient outcomes. I am eager to see those results.
Describe some of the biggest challenges you face in your work?
The interference of the tobacco industry, their deceptive practices, their killer product (whose contents they manipulate to increase addiction), and their constant influence of the political processes in our countries is, without a doubt, our most significant challenge. Close behind is the indifference of many health professionals that assume this is someone else’s problem, a bad lifestyle choice, or smoke themselves, and do not act and influence others to act to stop the epidemic.
Closer to home, funding of our organizations and people is a challenge. Most of the organizations such as ours, working with “soft money,” struggle to maintain stability and stay on track.
Please tell us about Costa Rica Conference and your involvement in that.
The 4th Latin American and Caribbean Conference Tobacco or Health will take place in San José, Costa Rica, March 26-28 2014. My organization is the principal organizer and we always seek a local partner to work with us. This time our partner is the Ministry of Health of Costa Rica and I am the Conference President. We feel that the region is in the midst of a significant transition in tobacco control and that the Conference should provide a new dynamism and direction.
The conference will bring together scientists, civil society and government tobacco control leaders to share science, clinical practice and public policy experience and theory, motivate action, recognize gains, update knowledge, and build capacity in priority areas such as:
- Treatment of tobacco dependency, particularly implementation of FCTC Art 14
- Tobacco industry interference
- Fiscal policies and illicit trade
- Tobacco advertisement, promotion and sponsorship
- Packaging, labeling and product regulation. New products.
- Legal strategies, tobacco and human rights
We invite all to come. For more information go to: http://www.tobaccoorhealthlac.org/
Please tell us about some of the things you are working on now.
The Costa Rica Conference is taking a lot of my time now. It is a wonderful opportunity to learn and get up to date on many topics. I just hope that it will be all so well organized that once in Costa Rica I can focus on learning and interacting with the wonderful and smart group of people that I know will be there. They will make the conference a success.
Longer term, I would like the Pfizer-Global Bridges partnership to help provide funding for our region to make a real difference in cessation support. The InterAmerican Heart Foundation has a long history of working in tobacco dependency treatment but there is much to do to take it to another level. It is the training of health professionals but it is also making systemic changes in healthcare systems and promoting cessation among health professionals. It is quitlines, distance learning, and making cessation available and affordable. There are many elements and we have only scratched the surface. We need a spectacular lift. I think we can do this.
What else would you like to accomplish in your work with tobacco control?
I have seen the evolution of tobacco control in our region over the past 20 years. We have gone from a few pioneers in tobacco control, to highly competent and effective cessation specialists, researchers, and advocates. I find I would like our Latin American region to be stronger: civil society, government and academia. I would like to work to consolidate the great achievements of the past few years and not let them be rolled back. There are some areas such as taxation and illicit trade that require much deeper work than we have done. I hope to help make these areas shine too.
Is there anything I have not asked about that you would like to add – something that you want people to know?
While I have lived in the USA for a long time, I am Latin American through and through. I am thankful that I became an immigrant to the USA as it helped me better understand these two rather different worlds.