Brazilian Rural Population Research Articles

Demographics, smoking status, and systemic health factors associated with apical periodontitis in a Brazilian rural population: a cross-sectional study.

To determine whether the systemic diseases diabetes mellitus (DM) and arterial hypertension (AH), and smoking status are associated with apical periodontitis (AP) in a representative rural population. Cross-sectional study using a representative sample of individuals obtained from a population-based epidemiological survey carried out in the rural area of the city of Rosário do Sul, RS, Brazil, from March 2015 to May 2016. Data were collected through structured questionnaires and clinical examination. Binary logistic regression analysis was performed to identify variables independently associated with AP. Of the 584 individuals included in the study, 353 (60.4%) had AP. The presence of AP was independently associated with age ≥ 40years (odds ratio [OR] = 1.867, 95% confidence interval [CI]: 1.193-2.923, p = 0.006), non-white ethnicity (OR = 1.509, 95% CI: 1.029-2.115, p = 0.035), active or former smoker (OR = 2.087, 95% CI: 1.241-3.510, p = 0.006) and DM or prediabetes (OR = 1.676, 95% CI: 1.150-2.443, p = 0.007). The study identified significant associations between AP and demographics, smoking status, and systemic disease in a Brazilian rural population. The study emphasized the significance of comprehending and managing associated factors in preventing and treating AP.

Subjective sleep quality before and during the COVID-19 pandemic in a Brazilian rural population

ObjectivesPrior studies have examined sleep during the coronavirus disease 2019 (COVID-19) pandemic, but have few compared sleep measured both during and prior to COVID. We examined the impact of the COVID-19 pandemic on subjective sleep quality in general and separately by gender and age (<50 vs. ≥50 years). Further, we compared sleep quality between those who did and did not follow quarantine orders. MethodsThis sample is from the Baependi Heart Study, a family-based cohort of adults in South-eastern Brazil. Longitudinal data were from 417 individuals who completed the Pittsburgh Sleep Quality Index (PSQI) twice: between January 2010 and September 2014 (pre-COVID) and during the COVID-19 stay-at-home order March-June, 2020. Cross-sectional analysis included 800 participants. ResultsMean (±SD) PSQI scores were significantly higher during than before COVID-19 (5.7 ± 3.8 vs. 5.0 ± 3.3, p < .01). This increase was significant among women and among adults ≥50 years but not in men or younger adults. The significant increase in PSQI was only observed in those who quarantined during COVID-19 (5.9 ±3.7 vs. 5.2 ±3.4, p < .01) and not those who did not quarantine (5.0 ± 3.7 vs. 4.5 ± 3, p = .12). In cross-sectional analyses, individuals who quarantined had higher PSQI scores than nonquarantined individuals (6.1 ± 3.9 vs. 5.0 ± 3.5, p < .01). The quarantine status-dependent differences were significant for women (6.4 ± 4 vs. 5.2 ± 3.7, p < .01) and older adults (6.6 ± 0.1 vs. 5.5 ± 3.3, p = .04). Differences by quarantine status were attenuated after adjusting for age and gender. ConclusionsSubjective sleep quality declined during the COVID-19 pandemic, particularly among women, older adults, and those compliant to quarantine orders.

Rural-urban differences in oral health among older people in Southern Brazil.

This study aimed to assess the association between oral health and rurality in an older Brazilian population. Population-based samples of 1,451 urban and 411 rural elders were obtained from two databases. Several oral health and related measures, including the number of teeth lost, use of dental prostheses, dental visits, self-reported oral health, and perceived need for a dental prosthesis, were compared. Oral health-related information was obtained by a trained research team with interviews conducted in the individuals' homes. Regression models were used to verify the association between living in rural areas and oral health outcomes after adjusting for possible confounding factors. The elderly population mostly comprised of women in rural or urban areas, and the mean age was 70 years in both locations. Less-educated individuals (without or with complete elementary schooling) were more common in rural regions than in urban areas. After adjustment for socioeconomic characteristics, living in rural areas was associated with a lower perceived need for dental prostheses (PR 0.68, 95% CI 0.56-0.84), poor self-reported oral health (OR 1.24; 95% CI 1.05-1.46), and having fewer teeth (β -1.31; 95% CI -2.18 to -0.45). The place of residence had a significant impact on oral health indicators, with rurality negatively influencing oral health. These findings suggest that preventive and curative strategies for dental services may be needed for the Brazilian rural population.

Relationship between marital status and incidence of type 2 diabetes mellitus in a Brazilian rural population: The Baependi Heart Study.

Many factors influence the incidence of type 2 diabetes mellitus (T2DM). Here, we investigated the associations between socio-demographic characteristics and familial history with the 5-year incidence of T2DM in a family-based study conducted in Brazil. T2DM was defined as baseline fasting blood glucose ≥ 126 mg/dL or the use of any hypoglycaemic drug. We excluded individuals with T2DM at baseline or if they did not attend two examination cycles. After exclusions, we evaluated a sample of 1,125 participants, part of the Baependi Heart Study (BHS). Mixed-effects logistic regression models were used to assess T2DM incident given different characteristics. At the 5-year follow-up, the incidence of T2DM was 6.7% (7.2% men and 6.3% women). After adjusting for age, sex, and education status, the model that combined marital and occupation status, skin color, and familial history of T2DM provided the best prediction for T2DM incidence. Only marital status was independently associated with T2DM incidence. Individuals that remained married, despite having significantly increased their weight, were significantly less likely to develop diabetes than their divorced counterparts.

Prevalence and factors associated with arterial hypertension in a Brazilian rural working population

OBJECTIVES:To determine the prevalence of hypertension and associated factors in farmers in a rural region of Brazil.METHODS:A cross-sectional study was conducted involving a sample of 790 farmers who were residents of Espírito Santo, Brazil.RESULTS:The prevalence of hypertension was 35.8% (95%CI: 32.5-39.1%, n=283); however, it was higher in men (36.6%, n=151, p<0.001) and in those with excess weight (48.9%, n=197, p<0.001). Of the 283 hypertensive patients, 125 (44.2%) did not use antihypertensive drugs. In men, lower level of schooling (p=0.004), working in the field for fewer daily hours (p<0.001), and having greater abdominal adiposity (p=0.039) were associated with the presence of increased blood pressure. In women, age (p=0.002), lower schooling (p=0.021), and increased central adiposity (p=0.003) were independent predictors of blood pressure.CONCLUSION:The highest prevalence of hypertension was observed in men, with elevated blood pressure being strongly associated with social and economic factors. In women, the association with the classic factors (age, increase in abdominal adiposity, and low schooling) was stronger. In addition, most hypertensive patients are not adequately diagnosed or treated.

Microbiolização na qualidade de sementes e crescimento inicial de plantas de Vigna unguiculata L. Walp

Vigna unguiculata L. Walp (feijão-caupi) tem grande importância como fonte de alimento e como gerador de emprego e renda para a população rural brasileira. O tratamento de sementes por meio da microbiolização pode beneficiar a germinação de sementes, emergência e desenvolvimento das plântulas e produção de grãos. Objetivou-se com esta pesquisa avaliar o efeito da microbiolização na germinação e sanidade de sementes, assim como o crescimento inicial de plantas de Vigna unguiculata L. Walp cv. BRS Pujante. Os organismos utilizados na microbiolização das sementes foram Bacillus subtilis (LCB30), Bacillus subtilis (LCB45), Bacillus sp. (BMH), Bacillus sp. (INV) e Trichoderma sp. Avaliou-se o percentual de germinação, o crescimento da radícula e a incidência de fungos nas sementes microbiolizadas. Em viveiro, foram utilizados os mesmos microrganismos para microbiolização em um delineamento experimental inteiramente casualizado, com 4 repetições para teste de germinação, e 10 repetições para teste em casa de vegetação. Após 51 dias de crescimento das plantas, foram analisadas a massa fresca da parte aérea (MFPA) e da raiz (MFR), massa seca da parte aérea (MSPA) e da raiz (MSR) e a contagem de nódulos (NN). Todos os tratamentos proporcionaram o incremento na germinação de sementes de V. unguiculata BRS Pujante, exceto INV, com apenas 81% das sementes germinadas. Todas as sementes microbiolizadas reduziram a incidência de fungos. A microbiolização das sementes com os diferentes microrganismos não apresentou eficiência na nodulação das plantas. O isolado LCB 30 promoveu aumento significativo na MSPA e MSR de plantas de V. unguiculata.

Food and nutritional insecurity in families in the Brazilian rural environment: a systematic review

This review sought to analyze food and nutritional insecurity in the Brazilian rural environment, and the measurement instruments used to assess this situation. A systematic review was conducted in the SciELO, PubMed and CAPES databases, using the search terms: 'food security' and 'rural,' Subsequently, a reverse search was performed in the 12 articles selected. The inclusion criteria were: original articles related to food and nutritional (in)security in the Brazilian rural population. Twelve studies were included. Most of them used the Escala Brasileira de Insegurança Alimentar - EBIA (Brazilian Scale for Food Insecurity) and socioeconomic questionnaires to assess food insecurity (FI), an association being found between them. Five studies addressed the nutritional aspect by anthropometry but found no association with FI. Food consumption was assessed by four studies and an association was detected. The results show a high prevalence of FI in rural areas in relation to the population analyzed in the Pesquisa Nacional por Amostra de Domicílio - PNAD (National Household Sample Survey) in the years 2009 and 2013, as well as a high prevalence of severe FI. The conclusion reached is that the rural environment is vulnerable, mainly regarding food and nutritional issues and the associated socioeconomic determinants.

Reliability and concurrent validity of the Global Physical Activity Questionnaire in adults from a Brazilian rural area

&#x0D; &#x0D; &#x0D; The aim of this study was to test reliability of the Global Physical Activity Questionnaire (GPAQ), and its concurrent validity using accelerometers, in a Brazilian rural population. Fifty-five adults (18+ years) living in a rural Brazilian city were selected to wear an accelerometer for one week and to answer the GPAQ twice in a week period interval. Reliability was verified using Intraclass Correlation Coefficients and the concurrent validity was analyzed based on Bland and Altman’s diagrams. We found relatively high reliability for the total physical activity (ICC = 0.78; 95%CI: 0.63; 0.87). The average di erence between both GPAQ measures was 192 minutes (95%CI: -69.63; 453.75). Wider differences were found when participants reported &gt; 400 minutes of physical activity per week. There was limited agreement between the GPAQ and accelerometer measures (total average difference = -1043 minutes; 95%CI: -1452.23; -634.09). Thus, the questionnaire presented limited concurrent validity and acceptable reliability, being able to be used in rural populations. However, there is still a need of new physical activity instruments focused on rural populations.&#x0D; &#x0D; &#x0D;

Anthropometric changes and their effects on cardiometabolic risk factors in rural populations in Brazil.

This article aims to evaluate associations between anthropometric changes in five years with lipid and blood pressure levels in Brazilian rural population. This longitudinal study evaluated 387 individuals aged 18 to 75 residents of two rural communities. Demographic, lifestyle, anthropometric, biochemical and hemodynamic characteristics were assessed in 2004 and repeated in 2009. Multivariate linear regression was used. Positive change in BMI was associated with increased diastolic blood pressure (DBP) (β = 0.07; 95%CI: 0.03-0.11), low-density lipoprotein (LDL-C) (increase of 0.01% to 10%: β = 0.08; 95%CI: 0.02-0.14, more than 10% increase: β = 0.09; 95%CI: 0.01-0.16) and low density lipoprotein/high density lipoprotein cholesterol ratio (LDL-C/HDL-C) (increase of 0.01% to 10%: β = 0.15; 95%CI: 0.06-0.25, more than 10% increase: β = 0.14; 95%CI: 0.02-0.25). Our results showed no association between positive changes in WC and lipid levels increase, only with blood pressure levels increase (SBP: β = 0.06; CI95%:0.02-0.10; DBP: β = 0.09; CI95%: 0.04;0.13). Positive changes in BMI are independent predictors of increased lipid and blood pressure levels and positive changes in WC of increased blood pressure.

Occupational exposure to pesticides in family agriculture and the oxidative, biochemical and hematological profile in this agricultural model

AimsFamily agriculture represents 80% of the Brazilian rural population, and rural workers linked to this agricultural model are also occupationally exposed to pesticides, which causes health risks for this part of the population. Thus, assessing health conditions becomes important and necessary as a form of biomonitoring of markers that can be used in effective health programs for agricultural workers. Materials and methodsA total of 152 farmers, with an average age of 52 years, who answered the questionnaire and performed anthropometric, blood pressure, and blood dosages to determine the biochemical profile, hematological, markers of oxidative stress and mutagenicity. The sample was divided according to the interview report in two groups: volunteers who use pesticides in agricultural work (n = 84), and volunteers who do not use pesticides (n = 68). Key findingsThe group that uses pesticides presented higher values for measuring the circumference of the neck, and significant changes for the markers of oxidative stress, TBARS and Carbonyl, as well as significant reduction of antioxidant enzymes SOD, GPx e GSH, and in the dosages of total cholesterol, alkaline phosphatase, albumin, total leukocytes, monocytes and platelets. No mutagenic damage was verified according to the micronucleus test (MN). SignificanceThe parameters that presented changes for the group that uses pesticides prove that even the low exposure can cause alteration of biomarkers, likely to compromise the health of the rural population. The results indicate the need for biomonitoring, and evaluation of its long-term impacts on farmers' health.

Prevalence of Peripheral Artery Disease and Associated Risk Factors in a Brazilian Rural Population: The Baependi Heart Study

Abstract Background: The identification of peripheral artery disease (PAD) can help prevent further progression of the disease and additional complications, considering that this condition is a risk factor for all-cause mortality and cardiovascular death. Objective: To assess the prevalence of PAD in the Baependi Heart Study and investigate associated risk factors in different age groups. Methods: A total of 1,627 individuals (of both genders and aged 18 – 102 years) residing in the municipality of Baependi (Minas Gerais, Brazil) were [...]

Serum metabolomics profile of type 2 diabetes mellitus in a Brazilian rural population

The development of common forms of diabetes comes from the interaction between environmental and genetic factors, and the consequences of poor glycemic control in these patients could result in several complications. Metabolomic studies for type 2 diabetes mellitus in serum/plasma have reported changes in numerous metabolites, which might be considered possible targets for future mechanistic research. However, the specific role of a particular metabolite as cause or consequence of diabetes derangements is difficult to establish. As type 2 diabetes is a disease that changes the metabolic profile in several levels, this work aimed to compare the metabolomic profiles of type 2 diabetes mellitus and non-diabetic participants. In addition, we exploited our family-based study design to bring a better understanding of the causal relationship of identified metabolites and diabetes. In the current study, population based metabolomics was applied in 939 subjects from the Baependi Heart Study. Participants were separated into two groups: diabetic (77 individuals) and non-diabetic (862 individuals), and the metabolic profile was performed by GC/MS technique. We have identified differentially concentrated metabolites in serum of diabetic and non-diabetic individuals. We identified 72 metabolites up-regulated in type 2 diabetes mellitus compared to non-diabetics. It was possible to recapitulate the main pathways that the literature shows as changed in diabetes. Also, based on metabolomic profile, we separated pre-diabetic individuals (with glucose concentration between 100–125 mg/dL) from non-diabetics and diabetics. Finally, using heritability analysis, we were able to suggest metabolites in which altered levels may precede diabetic development. Our data can be used to derive a better understanding of the causal relationship of the observed associations and help to prioritize diabetes-associated metabolites for further work.

As Famílias Pluriativas e Não Agrícolas no Rural Brasileiro: condicionantes e diferenciais de renda

Resumo: Frente à discussão em torno da renda proveniente de atividades não agrícolas e sua importância para a população rural brasileira, este artigo analisa (i) os condicionantes da pluriatividade e da condição não agrícola das famílias rurais e (ii) os impactos das atividades não agrícolas na renda das famílias rurais. As análises baseiam-se em dados empilhados da PNAD de 2001 a 2013, período caracterizado por marcantes transformações na economia e sociedade rural. Os resultados destacam como as chances de a família rural possuir atividade não agrícola dependem tanto de fatores endógenos à estrutura familiar, como a presença de filho em idade adulta e escolaridade da pessoa responsável, quanto de fatores exógenos, como a proximidade do domicílio às áreas urbanas e região geográfica. Apesar das sensíveis melhoras no emprego e renda agrícola nos anos 2000, manteve-se o ritmo histórico de redução das famílias com atividade exclusivamente agrícola no rural brasileiro. Essa dinâmica justificar-se-ia, em parte, pela renda das famílias com atividades não agrícola, que é maior que a das famílias exclusivamente agrícolas e apresentou crescimento superior no período, contribuindo para a intensificação das disparidades de renda no meio rural.

Glycemic control and arterial stiffness in a Brazilian rural population: Baependi Heart Study.

BackgroundIncreased arterial stiffness predicts morbidity and mortality, independently of other cardiovascular risk factors, and glycemic control impairments are related to higher vascular stiffness. The aim of this study was to evaluate the association between HbA1c levels and increased arterial stiffness in a Brazilian rural population.MethodsFor this study were selected 1675 individuals (both genders and aged over 18 years) resident in the municipality of Baependi, a city located in the Southeast of Brazil. HbA1c levels were determined by HPLC. Pulse wave velocity (PWV) was measured with a non-invasive automatic device (Complior).ResultsHbA1c levels were associated with an increased PWV. This was more relevant for the third tertile of age. In addition, logistic regression multivariate model including age, blood pressure, gender, BMI and fasting glucose showed that the elevation of a single unit percentage of HbA1c represented an increase of 54 % in the odds of increased arterial stiffness [OR 1.54 (95 % CI 1.01–2.17)]. Both, HbA1c and fasting glucose showed higher discriminatory power in the risk assessment for increased arterial stiffness in the non-diabetic when compared to the diabetic group (AUC of HbA1c = 0.71 vs 0.57, p = 0.02; AUC of fasting glucose = 0.66 vs 0.45, p = 0.0007, respectively).ConclusionOur findings indicate that a increase in HbA1c levels is associated with increased arterial stiffness and that both, HbA1c and fasting glucose, presented higher discriminatory power in the risk assessment for increased arterial stiffness in the non-diabetic group as compared to diabetic individuals.

Evolução da Ocupação e do Rendimento das Pessoas no Espaço Rural Brasileiro no Período de 2001 a 2009

Resumo:Na última década do século XX constatou-se uma crescente diversificação na composição ocupacional e um lento crescimento da população rural brasileira em idade ativa. O objetivo deste estudo é apresentar, para o período de 2001 a 2009, as principais tendências de ocupação e rendimento das pessoas residentes no meio rural brasileiro. A partir dos microdados da Pesquisa Nacional por Amostra de Domicílios (PNAD) e com base em um modelo de regressãolog-linear, foram analisadas as variações na população, no rendimento, no rendimento médio e no índice de Gini. Constatou-se que, não obstante o declínio na PEA rural ocupada na agricultura mercantil, a população rural brasileira se manteve estável devido, principalmente, à expansão da PEA com ocupação não agrícola. A mudança no perfil do meio rural brasileiro foi mais evidente no âmbito do rendimento das pessoas. Tais tendências se associaram à diversificação da composição ocupacional, ao aumento do poder aquisitivo, à redução na desigualdade econômica e da informalidade na relação de emprego. A continuidade dessas tendências pode fazer com que, na área rural, a ocupação e renda das atividades agrícolas sejam superadas pelas oriundas de atividades não agrícolas. Portanto, há necessidade de readequação das iniciativas de desenvolvimento rural.

Generation of Domestic Solid Waste in Rural Areas: Case Study of Remote Communities in the Brazilian Amazon

The Brazilian rural population is estimated to be around 30 million people and many rural areas do not have universal access to basic infrastructure services, including those related to solid waste. There are very few scientific studies on rural domestic solid waste and more investigative work is needed to provide information for appropriate solid waste management policies. This paper aims to characterize rural domestic solid waste in terms of quantity and quality. Amazonian rural communities were chosen for our case study. The issue of domestic solid waste was characterized both by means of interviews, at household level, and by a study of industrialized products traded in the communities located along the banks of the Jurua River, in the Brazilian Amazon. Quantitative results have shown that generation of solid waste in these rural communities reaches 0.5 kg/person/day. Organic matter represents 90 % of domestic solid waste generation and is mainly reused to feed animals and/or is composted using a method called pau. Inorganic solid waste (10 %) is either reused, burned or inadequately dumped in open sites. Based on these data, the annual production of solid waste is 437 tons per year in these communities. Since infrastructure services are virtually non-existent in this rural context, even this amount of solid waste may have a serious environmental impact, with negative effects on the population’s health, particularly in terms of hazardous waste. Even though solid waste management solutions for rural populations might not always be based on economic efficiency, decision makers responsible for development and planning should present solutions that are socially, technologically, environmentally and economically suitable for this context.

Inequities in Pap smear screening for cervical cancer between Brazilian urban and rural populations.

e12510 Background: Cervical cancer (CC) represents an important public health problem in Brazil being the second most common cancer in women. The expected incidence rate in 2012 was 17.5 per 100,000 women while the age-standardized mortality rate in 2010 was 4.04 per 100,000 women. Inequities in access to health preventive programs contribute to this figure. The goal of this analysis is to identify inequities in Pap smear screening in women from urban and rural populations from Brazil. Methods: Using the Health Supplement of the National Household Sample Survey 2008 (PNAD) with 102,108 Brazilian women aged 25-64 years Pap smear screening was analyzed dichotomously as women having ever or never been screened. Residence area was categorized as urban or rural. Age-adjusted prevalence of never-screened was analyzed using chi-squared test. Poisson regression modeling, crude and full adjusted for age, income, number of children, education, skin color, having visited a physician in the previous 12 months and healthcare insurance were performed for Brazil in general and for Brazilian major regions. Results: The prevalence of never-screened women for CC was 12.9% in Brazil, 11.5% in urban and 22.2% in rural areas. The poorest Brazilian major-regions showed the highest prevalence of never-screened women: North (17.4% in general, 14.7% in urban and 27.3% in rural areas) and Northeast (14.7% in general, 12.8% in urban and 23.7% in rural areas). After full-adjustment, the rural population showed a higher relative risk for never-screened as compared to those living in urban areas [PR=1.23 (95%CI 1.14; 1.31); p&lt;0,001]. The highest risk was also found in the North [PR=1.39 (1.13; 1.31); p=0.002]. However, South and Central-west regions showed no association between never-screened and area [PR=1.06 (0.88; 1.28); p=0.541; PR=1.18 (0.87; 1.58); p=0.270, respectively]. Conclusions: Our findings point out inequities in Pap smear screening between Brazilian urban and rural population. These inequities possibly contribute to the high incidence and mortality rate of CC in Brazil.

Tradutores, intérpretes ou promotores de mudança? Cientistas sociais, educação sanitária rural e resistências culturais (1940-1960)

Este trabalho objetiva analisar as relações entre ciências sociais e saúde pública no Brasil, privilegiando o papel de sociólogos e antropólogos que se colocaram na posição de "tradutores" entre os profissionais de saúde e as populações rurais objeto da ação de organismos governamentais. Educação sanitária, saneamento, profilaxia e medicina curativa, medicina preventiva passam a ser percebidos como ações cuja eficiência dependia diretamente do profundo entendimento de um universo mais amplo e complexo que a realidade concreta, ou seja, o universo cultural. Neste ponto reside a posição central dos cientistas sociais no planejamento das ações administrativas voltadas especialmente para a população rural brasileira: o seu conhecimento das questões de natureza sociocultural deveria antecipar e orientar quaisquer intervenções.

Análise combinada de fatores genéticos e ambientais na hipertensão essencial em um município da região Amazônica

In the present study, we evaluated the contribution of six genetic polymorphisms of the Renin-Angiotensis-Aldosterone system (RAAS) and clinical risk factors in the development of essential hypertension in a Brazilian rural population in the Amazon region. Eighty-two hypertensive patients and seventy-eight normotensive individuals were evaluated. Genotyping for renin (REN G1051A), angiotensinogen (AGT) M235T, insertion/deletion of angiotensin-converting enzyme (ACE I/D), angiotensin II type 1 receptor (AGTR1) A1166C and aldosterone synthase (CYP11B2) C344T polymorphisms were performed using polymerase chain reaction, with further restriction analysis when required. The influence of genetic polymorphisms and clinical risk factors on blood pressure variation was assessed by stepwise linear regression. We report the co-occurrence of clinical risk factors and angiotensin-converting enzyme (ACE) gene polymorphism in a Brazilian rural population in the Amazon region. Our results indicate that increase of systolic blood pressure (SBP) is favored by ACE I/D- D allele and advanced age, while alcohol consumption and aging are associated with high diastolic blood pressure (DBP). These findings suggest that in the Santa Isabel do Rio Negro population, the residents that carry ACE-D allele or have an alcohol consumption habit present higher values of SBP and DBP, respectively, with the passing of years.

Uso de tabaco iniciado na infância: relatos de adultos em tratamento

OBJETIVO: Coletar e analisar relatos de adultos dependentes de tabaco que começaram a fumar na infância e sobre os fatores que consideram relacionados ao início de uso. MÉTODO: Pesquisa qualitativa com entrevistas semidirigidas gravadas com 11 pacientes em tratamento ambulatorial especializado para dependência de tabaco e que mencionaram início de uso antes dos 12 anos de idade; fechamento amostral por saturação teórica, transcrição do áudio e análise de conteúdo das entrevistas com triangulação de analistas. RESULTADOS: Quatro categorias agrupam os fatores mencionados pelos entrevistados ou inferidos pelos autores: normalidade sociocultural e familiar do ato de fumar tabaco; identificação e aprendizado com figuras parentais fumantes; condições adversas de vida, incluindo trabalho infantil e poucas atividades lúdicas; e escassez de informações, incluindo uso cultural de tabaco para finalidades diversas. CONCLUSÕES: Resultados permitem maior compreensão sobre os pontos de vista e vivências de pacientes com histórias semelhantes sobre a questão, o que pode colaborar para a efetividade das abordagens motivacionais e terapêuticas e da aliança terapêutica, ao minimizar dificuldades de interação clínico-paciente. Estudos etnográficos sobre uso de tabaco na infância são indicados para a atual população rural brasileira, visando o aperfeiçoamento de abordagens preventivas.