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No smoking in Chile? No way.

Chileans are still the heaviest smokers in the region despite a strict anti-tobacco law.

Treating patients with tobacco-related illnesses costs $1.1 billion, according to the Health Ministry, which says that every year there are more than 16,000 tobacco-related deaths in Chile. This is more than 18 percent of total deaths in the country.

Although Chile's law complies with the Framework Convention, it falls short of WHO recommendations. First and foremost, it did not raise taxes on cigarette sales, now at 60.4 percent. This is one of the highest in the region, along with Argentina, Mexico and Uruguay. However, more could be done, say tobacco control advocates.

A Pan American Health Organization study has found that increasing taxes by 10 percent could reduce cigarette consumption by 2.2 percent in the short-run and 4.5 percent in the long-run.

Fines aren’t terribly high, either. For tobacco companies, infringing on the law carries a fine ranging from $6,800 to $67,000. Places that don’t comply with the law pay fines between $67 to $1,600, while smoking in a non-authorized area carries a fine of $100.

Currently, the frequently underfunded and understaffed regional sanitation authorities are in charge of enforcing the law, but they can only report non-compliance, not take legal action against infringers. The sanitation officials report infractions to the courts, who then levy a fine. But with other urgent matters to deal with, having the sanitation officials supervise whether someone is smoking in a non-smoking area is clearly not a priority. Prevention is also weak. Some education programs geared at students have been put in place, but they are not extensive, nor are there public information campaigns. Most prevention is through the warnings on cigarette packs, which don’t seem to be having much impact in spite of the very explicit messages that smoking kills and causes heart failure and other damage, and even bad breath.

For the Health Ministry, it is too early to measure any long-term effects of the law. But what it has done, said Marisol Acuna, responsible for tobacco issues at the ministry’s public policy division, is jump start a cultural and social trend that should gradually lower smoking rates in the future.

“People are now capable of demanding that others not smoke in non-authorized places. And smokers have also changed their behavior: they now ask others for permission to smoke or go outside to smoke, and in general, respect non-smoking areas. That is a good sign, but if we want to reach out to the group that has the highest smoking rate (19 to 34 years old), raising taxes is a strategy that must be considered,” she said.

The Health Ministry is aiming to reduce smoking by next year to 30 percent of the general population and to 20 percent of teenagers, but this goal seems practically impossible unless major changes are made to the law.

“The current law was a good start but it needs to be perfected," said Lezak Shallat, a tobacco control advocate, "especially eliminating the loopholes that keep many people, especially workers, involuntarily under clouds of secondhand smoke."