Background:
World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in its article 18 recommends Parties to protect environment and human health against impacts of tobacco farming. Last Conferences of the Parties of WHO FCTC have made recommendations to the development of educational programs to the dissemination of harmful health and environmental impacts of tobacco farming among tobacco growers. The intention of this study was to propose guidelines for the development of health education programs addressed to tobacco growers, based on the historical, social and cultural context of tobacco farming in southern Brazil.

Methods:
In this exploratory study, secondary data were analyzed from a research project conducted by Oswaldo Cruz Foundation in a small tobacco-growing municipality, in 2013. The original study described women tobacco farmers' opinions, beliefs and concerns on relationship between tobacco farming, environment, and health. Data were analyzed qualitatively, looking for elements to support health education programs.

Results:
Main elements identified were: knowledge and naturalization of health risks; knowledge of negative impacts of tobacco farming on environment, but without believing that they have the potential to compromise their health; disbelief in performance of public services (government).
Health education programs in tobacco growing areas should be based on the reality of each territory (historical, social and cultural context). Dialogic processes should be the basis of programs, leading to the empowerment of farmers as protagonists of their personal issues. Social organization should be organized in the tobacco growing areas to strengthen local support networks and social control over public policies. Strengthening social organization can aid to weaken tobacco industry interference with the lives of farmers. Health education programs should be developed from an intersectoral and integrative perspective.

Conclusions:
Health education programs should be guided by the concerns and needs experienced by tobacco growers to strengthen their autonomy and promote reflection on healthier livelihoods.