Ações voltadas para o tabagismo: análise de implementação e perfil das internações por condições sensíveis à atenção ambulatorial tabacorelacionadas no município de Juiz de Fora/MG

Abstract

Smoking is an epidemic disease caused by nicotine addiction and affects almost every organ of the body, causing disease and impairing the health of smokers in general. Because of the negative impact of smoking on health of the world population, several policies addressing tobacco control, especially the National Program of Tobacco Control (NPTC), which since1989 carries out actions aimed at reducing the prevalence of smokers and consequent morbidity and mortality from tobacco-related diseases. If the actions of the different policies for tobacco control are carried out effectively and efficiently, is expected to reduce morbidity and mortality due to tobacco-related diseases. The CDC (Centers for Disease Control and Prevention), the center of American health control and disease prevention, considers 23 categories of tobacco-related diseases organized into four groups: cancer, cardiovascular diseases, respiratory diseases and perinatal conditions. Among all tobacco-related diseases, a portion refers to ambulatory care sensitive conditions (ACSC), which represent the health problems for which an effective action in the primary health care (PHC) would reduce the risk of hospitalization. Considering the importance of conducting research that relate smoking with ACSC and that more research is needed relating the ACSC to the effectiveness of PHC services, this study intended to analyze the status of policies for tobacco control in Juiz de Fora/MG city by checking the actions of NPTC developed in primary health care units of the urban area and the establishment of the profile of tobacco-related ACSC in 2008 to serve as a baseline for future studies. Thus, respondent was the coordinator of NPTC and local professionals from 44 primary health care units of the urban area about the actions of tobacco control developed. In addition, was made a statistical description of the ACSC tobacco-related from a secondary database with information from the hospital information system for the year 2008. The following aspects were considered in the analysis of tobacco-related ICSA: sex, age, disease groups established by the CDC, administrative regions of Juiz de Fora, type of care model adopted by the units and primary health care units. It was noted municipality'sactions on health promotion and smoking cessation, with a focus on training of professionals for the implementation of treatment in primary health care units. 40.9% of respondents reported that their primary health care units offer treatment for smokers and 88.6% that the smoking issue is approached in waiting rooms, groups and individual consultations.The ACSC accounted for 17.7% of all hospitalizations, with 43.7% of ICSA are tobacco related. Of this group, 56.3% were male and 23.7% for the eastern region of Juiz de Fora city. Thus, the city has the challenge of strengthening tobacco control with intersectoral and primary care approaches. This work may serve as a baseline for future evaluations and monitoring of the implementation progress and enforcement of local tobacco control activities. The discussion and results can serve as a tool for raising awareness of the municipal health secretary and thus as support tools for the formulation of strategic actions of health for tobacco control.