There is a growing clamor to raise the age at which tobacco products can be bought, from 18 to 21. Helping existing smokers to quit is important, says Dr Nicolas Hopkinson, who chairs the Action on Smoking and Health campaign group, but the most vital element is to prevent young people from starting in the first place. "Smoking is a contagious habit, transmitted within peer groups," he says. To back up his case, he points to the success of raising the legal age from 16 to 18, which happened in 2007. Since then, the proportion of young smokers – defined as those aged 16 to 24 – has fallen from more than one in four in 2007 to less than one in five now. Research suggests two-thirds of smokers take up the habit in their teenage years. Campaigners believe by closing the door on this older teenage market they can deal a fatal blow to the tobacco industry.

However, it is impossible to say whether that is directly linked to changing the age at which tobacco products can be bought. In the past 12 years, there has been lots of anti-smoking legislation, including: a ban on smoking in public places, restrictions on displays in shops, the introduction of graphic images on packs warning of the dangers of smoking. All have had a role in the overall decline in smoking.

But another factor – some argue even more important than any legislation that has been introduced – has been the rise in e-cigarettes use. Data suggest nearly a third of ex-smokers have been or still are vapers. Public Health England says e-cigarettes are now the most common quit aid and are helping give the nation a "fighting chance" to become smoke-free – classed as having less than 5% of people smoking. But even as arguments over what to do next on smoking develop, don't forget there could be another factor in all this – the impact of “Generation Sensible”. All the evidence suggests young people are increasingly shunning the unhealthy behaviors of previous generations. Not only are they less likely to smoke, they drink less, take drugs less and socialize less. The reason? Research suggests they have exchanged the traditional vices for social media and gaming. Could that be the thing that stubs out smoking?

Disponível em: <http://www.bbc.com/news>. Acesso em: set. 2019. Adaptado.

There is a growing clamor to raise the age at which tobacco products can be bought, from 18 to 21. Helping existing smokers to quit is important, says Dr Nicolas Hopkinson, who chairs the Action on Smoking and Health campaign group, but the most vital element is to prevent young people from starting in the first place. "Smoking is a contagious habit, transmitted within peer groups," he says. To back up his case, he points to the success of raising the legal age from 16 to 18, which happened in 2007. Since then, the proportion of young smokers – defined as those aged 16 to 24 – has fallen from more than one in four in 2007 to less than one in five now. Research suggests two-thirds of smokers take up the habit in their teenage years. Campaigners believe by closing the door on this older teenage market they can deal a fatal blow to the tobacco industry.

However, it is impossible to say whether that is directly linked to changing the age at which tobacco products can be bought. In the past 12 years, there has been lots of anti-smoking legislation, including: a ban on smoking in public places, restrictions on displays in shops, the introduction of graphic images on packs warning of the dangers of smoking. All have had a role in the overall decline in smoking.

But another factor – some argue even more important than any legislation that has been introduced – has been the rise in e-cigarettes use. Data suggest nearly a third of ex-smokers have been or still are vapers. Public Health England says e-cigarettes are now the most common quit aid and are helping give the nation a "fighting chance" to become smoke-free – classed as having less than 5% of people smoking. But even as arguments over what to do next on smoking develop, don't forget there could be another factor in all this – the impact of “Generation Sensible”. All the evidence suggests young people are increasingly shunning the unhealthy behaviors of previous generations. Not only are they less likely to smoke, they drink less, take drugs less and socialize less. The reason? Research suggests they have exchanged the traditional vices for social media and gaming. Could that be the thing that stubs out smoking?

Disponível em: <http://www.bbc.com/news>. Acesso em: set. 2019. Adaptado.

There is a growing clamor to raise the age at which tobacco products can be bought, from 18 to 21. Helping existing smokers to quit is important, says Dr Nicolas Hopkinson, who chairs the Action on Smoking and Health campaign group, but the most vital element is to prevent young people from starting in the first place. "Smoking is a contagious habit, transmitted within peer groups," he says. To back up his case, he points to the success of raising the legal age from 16 to 18, which happened in 2007. Since then, the proportion of young smokers – defined as those aged 16 to 24 – has fallen from more than one in four in 2007 to less than one in five now. Research suggests two-thirds of smokers take up the habit in their teenage years. Campaigners believe by closing the door on this older teenage market they can deal a fatal blow to the tobacco industry.

However, it is impossible to say whether that is directly linked to changing the age at which tobacco products can be bought. In the past 12 years, there has been lots of anti-smoking legislation, including: a ban on smoking in public places, restrictions on displays in shops, the introduction of graphic images on packs warning of the dangers of smoking. All have had a role in the overall decline in smoking.

But another factor – some argue even more important than any legislation that has been introduced – has been the rise in e-cigarettes use. Data suggest nearly a third of ex-smokers have been or still are vapers. Public Health England says e-cigarettes are now the most common quit aid and are helping give the nation a "fighting chance" to become smoke-free – classed as having less than 5% of people smoking. But even as arguments over what to do next on smoking develop, don't forget there could be another factor in all this – the impact of “Generation Sensible”. All the evidence suggests young people are increasingly shunning the unhealthy behaviors of previous generations. Not only are they less likely to smoke, they drink less, take drugs less and socialize less. The reason? Research suggests they have exchanged the traditional vices for social media and gaming. Could that be the thing that stubs out smoking?

Disponível em: <http://www.bbc.com/news>. Acesso em: set. 2019. Adaptado.

There is a growing clamor to raise the age at which tobacco products can be bought, from 18 to 21. Helping existing smokers to quit is important, says Dr Nicolas Hopkinson, who chairs the Action on Smoking and Health campaign group, but the most vital element is to prevent young people from starting in the first place. "Smoking is a contagious habit, transmitted within peer groups," he says. To back up his case, he points to the success of raising the legal age from 16 to 18, which happened in 2007. Since then, the proportion of young smokers – defined as those aged 16 to 24 – has fallen from more than one in four in 2007 to less than one in five now. Research suggests two-thirds of smokers take up the habit in their teenage years. Campaigners believe by closing the door on this older teenage market they can deal a fatal blow to the tobacco industry.

However, it is impossible to say whether that is directly linked to changing the age at which tobacco products can be bought. In the past 12 years, there has been lots of anti-smoking legislation, including: a ban on smoking in public places, restrictions on displays in shops, the introduction of graphic images on packs warning of the dangers of smoking. All have had a role in the overall decline in smoking.

But another factor – some argue even more important than any legislation that has been introduced – has been the rise in e-cigarettes use. Data suggest nearly a third of ex-smokers have been or still are vapers. Public Health England says e-cigarettes are now the most common quit aid and are helping give the nation a "fighting chance" to become smoke-free – classed as having less than 5% of people smoking. But even as arguments over what to do next on smoking develop, don't forget there could be another factor in all this – the impact of “Generation Sensible”. All the evidence suggests young people are increasingly shunning the unhealthy behaviors of previous generations. Not only are they less likely to smoke, they drink less, take drugs less and socialize less. The reason? Research suggests they have exchanged the traditional vices for social media and gaming. Could that be the thing that stubs out smoking?

Disponível em: <http://www.bbc.com/news>. Acesso em: set. 2019. Adaptado.

Fred Sóter nasceu em um corpo feminino, mas sempre teve fascinação pelo universo masculino. A voz aguda e os traços delicados o incomodavam e, mesmo criança, sentia-se diferente das três irmãs. Ao chegar à adolescência, percebeu com clareza que não era habitante do próprio corpo.

Hoje, aos 22 anos, Fred é um homem transexual, casado e feliz com sua condição. Até chegar a esse ponto, contudo, houve uma longa jornada. Aos 16, ele passou a se apresentar como trans socialmente, mas precisou de mais dois anos para falar sobre o assunto com a família. A partir daí, começou seu processo de transição, com a terapia hormonal e, mais tarde, com a cirurgia de mastectomia (retirada dos seios). “Foi libertador”, lembra.

Ele, no entanto, sabe que é privilegiado. Depois de não conseguir atendimento no Sistema Único de Saúde (SUS), obteve o tratamento na rede particular. Mas o serviço privado não eliminou as dificuldades. “O maior problema foi achar um especialista que receitasse hormônios. Há muita falta de informação. A maioria dos endocrinologistas que procurei alegava que não podia me acompanhar porque não sabia o que fazer”, conta.

A atenção à saúde de transexuais e travestis é recente e ainda precária no Brasil. Até 1997, por exemplo, a cirurgia de redesignação sexual (adequação dos genitais ao gênero com o qual a pessoa se identifica) era proibida no país. E a oferta do processo transexualizador – que inclui atendimento psicológico, hormonioterapia e cirurgias – pelo SUS só começou em 2008, apenas dois anos antes de Fred assumir sua identidade masculina.

Desde então, a expansão da rede acontece de forma muito lenta para a demanda existente. Embora não haja levantamentos precisos sobre quantos transexuais existem no Brasil, estudos mencionados em junho passado, pela revista especializada The Lancet, apontam que entre 0,4% e 1,3% das pessoas com mais de 15 anos não se identifica com seu sexo biológico, o que permite estimar em, pelo menos, 25 milhões o total de trans no mundo. Utilizando esses índices para a população brasileira, é possível afirmar que há entre 752 mil e 2,4 milhões de trans vivendo no país.

Para toda essa população, porém, só existem ambulatórios especializados em 11 cidades. Já as instituições habilitadas pelo Ministério da Saúde para realizar a cirurgia de adequação sexual são quatro, localizadas em Porto Alegre, Recife, Rio de Janeiro e São Paulo — até recentemente, o procedimento era realizado também no Hospital das Clínicas da Universidade Federal de Goiás (UFG), mas o serviço foi interrompido.

Procurado pelo Correio, o Ministério da Saúde se pronunciou por meio de nota na qual descreve os procedimentos oferecidos pela rede pública e ressalta que o governo federal “financia os procedimentos necessários, mas a implantação/credenciamento de novos serviços, bem como a ampliação do número de cirurgias e acompanhamentos ambulatoriais, é de competência dos gestores locais”.

LEITE, Hellen. A saúde negada. Disponível em: <http://especiais.correiobraziliense.com.br>. Acesso em: set. 2019. Adaptado

Fred Sóter nasceu em um corpo feminino, mas sempre teve fascinação pelo universo masculino. A voz aguda e os traços delicados o incomodavam e, mesmo criança, sentia-se diferente das três irmãs. Ao chegar à adolescência, percebeu com clareza que não era habitante do próprio corpo.

Hoje, aos 22 anos, Fred é um homem transexual, casado e feliz com sua condição. Até chegar a esse ponto, contudo, houve uma longa jornada. Aos 16, ele passou a se apresentar como trans socialmente, mas precisou de mais dois anos para falar sobre o assunto com a família. A partir daí, começou seu processo de transição, com a terapia hormonal e, mais tarde, com a cirurgia de mastectomia (retirada dos seios). “Foi libertador”, lembra.

Ele, no entanto, sabe que é privilegiado. Depois de não conseguir atendimento no Sistema Único de Saúde (SUS), obteve o tratamento na rede particular. Mas o serviço privado não eliminou as dificuldades. “O maior problema foi achar um especialista que receitasse hormônios. Há muita falta de informação. A maioria dos endocrinologistas que procurei alegava que não podia me acompanhar porque não sabia o que fazer”, conta.

A atenção à saúde de transexuais e travestis é recente e ainda precária no Brasil. Até 1997, por exemplo, a cirurgia de redesignação sexual (adequação dos genitais ao gênero com o qual a pessoa se identifica) era proibida no país. E a oferta do processo transexualizador – que inclui atendimento psicológico, hormonioterapia e cirurgias – pelo SUS só começou em 2008, apenas dois anos antes de Fred assumir sua identidade masculina.

Desde então, a expansão da rede acontece de forma muito lenta para a demanda existente. Embora não haja levantamentos precisos sobre quantos transexuais existem no Brasil, estudos mencionados em junho passado, pela revista especializada The Lancet, apontam que entre 0,4% e 1,3% das pessoas com mais de 15 anos não se identifica com seu sexo biológico, o que permite estimar em, pelo menos, 25 milhões o total de trans no mundo. Utilizando esses índices para a população brasileira, é possível afirmar que há entre 752 mil e 2,4 milhões de trans vivendo no país.

Para toda essa população, porém, só existem ambulatórios especializados em 11 cidades. Já as instituições habilitadas pelo Ministério da Saúde para realizar a cirurgia de adequação sexual são quatro, localizadas em Porto Alegre, Recife, Rio de Janeiro e São Paulo — até recentemente, o procedimento era realizado também no Hospital das Clínicas da Universidade Federal de Goiás (UFG), mas o serviço foi interrompido.

Procurado pelo Correio, o Ministério da Saúde se pronunciou por meio de nota na qual descreve os procedimentos oferecidos pela rede pública e ressalta que o governo federal “financia os procedimentos necessários, mas a implantação/credenciamento de novos serviços, bem como a ampliação do número de cirurgias e acompanhamentos ambulatoriais, é de competência dos gestores locais”.

LEITE, Hellen. A saúde negada. Disponível em: <http://especiais.correiobraziliense.com.br>. Acesso em: set. 2019. Adaptado