Em nome de quem? Governo, instituições e economia política no campo do combate às doenças respiratórias: o caso da lei antitabaco em Portugal (original) (raw)

Dificuldades políticas, éticas e jurídicas na criação e aplicação da legislação sobre álcool e tabaco: contributo para o desenvolvimento da investigação em Direito da Saúde Pública

Introduction: The application of laws of Public Health in the area of health determinants related to lifestyles and behaviors, which include the fight against harmful use of alcohol and tobacco control, needs to be analyzed and discussed taking into account the very particular complexity of this reality, where it is not possible to decouple the action to be taken from the various social stakeholders involved. Indeed, in these areas, the lobbying activities of industry and distribution and sales sectors, show the existence of competing interests with the policies of Public Health, interfering in the results of these and preventing their effectiveness. Material and methods: Taking as a background the above mentioned assumption, this article presents a brief reflection on the strengths and weaknesses of the use of legal instruments in Public Health, taking as example the Portuguese laws on alcohol and tobacco, for which situations of ambiguity and imprecision in its enforcement and a lack of effective monitoring and sanctioning of its non-compliance have put a stop to a effectiveness of the same legislation in practice. The article also shows recent foreign examples which illustrate the pitfalls that can arise even in Public Health laws with clear objectives to reduce the consumption of health hazardous substances and their potential harm. Such is the case with U.S. Law No. 111-31 of 22 June 2009 which gave the FDA (Food and Drug Administration) the power to control tobacco products and has been the aim of harsh criticism from Public Health authorities and academics. In this article, although affirming the undeniable power of the legislative instrument to change attitudes and behaviors we, express, however, some concerns respecting the fact that the law is still an unexplored and poorly evaluated instrument in the Public Health domain. To identify the strengths and weaknesses in the laws concerning public health is indeed as complex as the multidisciplinary sciences and the social diversity of the actors there involved. Therefore, one of the premises of the drafting and implementation of future good public health laws is the need of a thorough understanding of the context to which these same laws will apply, including the environment and stakeholders who are their main target. The potential effects of the law are difficult to predict or to standardize, Rev Port Saúde Pública. 2010;28(2):205-218 207 however, in the line of some authors who have focused recently on the subject, this article supports the use of a logical model to analyze and evaluate the legislative process in Public Health and its obtained results. Knowing that although alcohol consumption and the harm associated with it as well as the dangers of tobacco use and environment tobacco smoking are fully documented with regard to individual and collective health risks, public policies advocated are still far from be effective to curb these life style behaviors, it appears to be essential to deepen the discussion on the question of an ideal conception of Public Health Law in order to start to achieve more desired results in public health and not just the possible outcomes from the clash with the interests at stake. Conclusion: With the reflections in this article, we wish to equip the actors and bodies acting on behalf of Public Health in Portugal with some tools and arguments that will benefit the discussion to promote a better action of the law in the areas mentioned above. This also includes a more enlightened and pro-active legislation procedure, and a contribution to the development of research in Public Health Law, plus the construction and use of effective methods of evaluating the impact of laws and policies concerning behavioral outbreaks related to lifestyle in order to improve their results and thereby to promote a healthier society. ©2010 Published by Elsevier España, S. L. on behalf of Escola Nacional de Saúde Pública. All rights reserved

A construção do tabagismo como problema de Saúde Pública: uma confluência entre interesses políticos e processos de legitimação científica

2009

The aim of this article is to analyze some aspects of the social construction of smoking as a Public Health problem within the context of the formulation of transnational health policies. Adopting the constructionist perspective, we start from the premise that social phenomena are collective constructions that are historically situated and culturally contingent. We argue that the participation of diverse social actors that can act as spokespeople for specific communities - economic, political, social or scientific - is necessary so that smoking emerges as a Public Health problem. We propose that the current anti-tobacco scenario results from the merging of two narratives: one concerning the constitution of smoking as a health hazard, the other pertaining to the emergence of the transnational political scenario associated with a globalized society.

O papel do direito internacional na legislação interna sobre o controle do tabaco

O presente artigo, tendo em vista o avanço do direito internacional e a necessidade de efetivação interna das normas da Convenção-Quadro de Controle do Tabaco (CQCT), tem como objeto a análise da competência Para concretizar a regulamentação interna e internacional, com o intuito de se criarem políticas públicas coordenadas de controle do tabaco. Para tanto, foram analisadas as normas internacionais e internas sobre o tema, visitando-se a interpretação a elas dada pela doutrina e pelas decisões judiciais, tanto pela ótica do direito interno quanto internacional e comparado. Nesse sentido, é possível defender que a CQCT abre espaço para regulação internacional por meio das diretrizes, estabelecidas nas Conferências das Partes (COPs), que são, assim, vinculantes a todos os Estados-Membros da convenção. A regulação internacional nasce do chamado direito administrativo internacional, que permite o exercício do poder regulamentar, ou normativo, da administração. Internamente, a regulação deve seguir as diretrizes da COP, havendo espaço para que órgãos, como a Anvisa, no Brasil, concretizem as diretrizes, como a referente aos arts. 9 e 10 da CQCT, que limitou o uso de aditivos de sabores nos produtos de tabaco, sendo uma forma de efetivação das normas internacionais internamente. Também não existe conflito entre a livre iniciativa e o controle do tabaco, pois, como dito pela Corte Constitucional colombiana, no processo em que se discutia a constitucionalidade das restrições à publicidade do tabaco, é um mercado que não deve ser incentivado, apenas tolerado.

Política pública de controle do tabaco no Brasil e Portugal: impostos e acessibilidade ao produto

Lex Humana, 2018

O estudo analisa a evolucao dos impostos sobre cigarros e niveis de acessibilidade ao produto entre os anos de 2006 e 2016 como resultado das politicas de controle do tabaco implementadas no Brasil e Portugal, no escopo da Administracao Publica, sob as diretrizes da Convencao-Quadro da OMS para o Controle do Tabaco (CQCT/OMS). Foram extraidos dados da Secretaria da Receita Federal do Brasil, da Direcao-Geral de Saude de Portugal, da Direcao-Geral do Orcamento de Portugal, da Procuradoria-Geral Distrital de Lisboa e do Banco Mundial para construir os graficos e apresentar os resultados dos dois paises. O objetivo do estudo e comparar os niveis tributarios sobre cigarros nos dois paises e avaliar se vem gerando um real aumento nos precos dos cigarros e tornando o produto menos acessivel a populacao, conforme determinado no artigo 6o da CQCT/OMS. O enquadramento teorico refere-se a implementacao de politica publica, que define criterios e recomendacoes aos formuladores de politicas, co...