BACKGROUND AND IMPLEMENTATION CHALLENGES: Ponta Porã, in the Brazilian, shares a dry border with Pedro Juan Caballero, Paraguay. This geographic setup facilitates the smuggling of tobacco products, sold at low prices and unregulated, exacerbating the public health impact of tobacco use in Brazil. The Brazilian Unified Health System is heavily burdened, as Basic Health Units serve both Brazilians and Paraguayans without financial compensation. Additionally, violence and threats associated with smuggling hinder local management efforts. The border, with no visible physical barriers, reinforces the circulation of illegal products and undermines tobacco control efforts.
INTERVENTION OR RESPONSE: As part of the "Sustainability through Strengthening and Coordination of Tobacco Control Initiatives at State and Municipal Levels" project, funded by the Bloomberg Initiative, a technical visit to the municipality was conducted. The intervention included interviews with health, education, and sanitary surveillance managers to map challenges and understand the impact of smuggling. Visits to retail outlets in Paraguay revealed widespread availability of tobacco products, including electronic cigarettes and hookahs, in violation of Brazilian regulation.
RESULTS AND IMPACT: The visit revealed high accessibility to smuggled products, particularly among youth, driven by low prices and aggressive marketing. An increase in the use of electronic smoking devices was identified as a gateway to tobacco use. Nevertheless, the project strengthened intersectoral collaboration, fostered dialogue among local and state managers, and highlighted the need for robust public policies for enforcement and control. The mobilization contributed to progress in raising awareness about the impact of smuggling on tobacco consumption and public health.
CONCLUSIONS: The experience in Ponta Porã underscores the importance of intersectoral strategies to combat tobacco use in border regions. Integrating health, education, and security is essential to address the challenges of smuggling and protect public health. Expanding these actions to other Brazilian border regions is recommended, ensuring greater enforcement and the implementation of tobacco control policies.