Introduction

Brazil is the largest country in South America, with an area of 8 547 403.5 square kilometres and a population of 169 799 170 (IBGE, 2000). Its geopolitical structure com-prises 26 states and one Federal District, the capital of Brazil, Brasilia. Each state is divided into municipalities, of which there are a total of 5 507.

The primary causes of death in Brazil are cardiovascular diseases and cancer and their major risk factor is tobacco use. Lung cancer is the leading cause of death by can-cer among men and the second cause among women. In 1999, there were 14 127 deaths due to lung cancer. Among women the mortality rate of lung cancer is increas-ing faster than among men. An analysis of a temporal series of cancer mortality from 1979 to 2000 showed that the lung cancer mortality rate among men rose from 7.73 per 100 000 to 12.13 per 100 000, representing a 57% increase. Among women it rose from 2.33 per 100 000 to 5.33 per 100 000, which represented a 134% increase (Ministerio da Saúde do Brasil/Instituto Nacional de Câncer, 2003).