Democratic agendas for the 21st century: Brazilian's perceptions about marijuana decriminalization and legalization

Marcelo Rasga Moreira Antônio Ivo de Carvalho José Mendes Ribeiro Fernando Manuel Bessa Fernandes About the authors

ABSTRACT

The objective of the present work is to contribute to a better understanding of perceptions about marijuana decriminalization and legalization. For this, a national opinion survey was conducted, between October 07 and November 26, 2014, by means of 3.007 telephone interviews. The results point that the debate on the subject is not well done in Brazil; the interviewees consider themselves poorly informed and a significant part of them does not want information; TV and the internet are the main sources of information; education and health services are not seen as a source of information; women over 45 with low schooling and income have more negative perceptions regarding decriminalization and legalization, if compared to young men with higher schooling and income.

KEYWORDS:
Democracy; Crime; Cannabis

Introduction

The political crisis that Brazil goes through since 2013 brings concrete threats to its already incipient democracy. The open conflict between the powers of the republic in this final 2016, a corollary of the coup that dismissed President Dilma Roussef, illustrates the radicalization of political polarization in society.

Since the so-called 'manifestations of June 2013', actions of intolerance, violence, prejudice, racism and fascism have disputed the public space with those that seek to promote freedom, coexistence among different people, advancement of individual and social rights, and the intensification of democratization.

This conflict tends to follow the contemporary political spectrum of the right-wing and left-wing alignments. It is up to those who align to the left-wing, in their different ways and conceptions, to build new democratic agendas capable, on the one hand, of preventing the dismantling of the social and protection policies built in the Country since 2003, and, on the other hand, to advance in identity struggles.

In this context, the issue of drugs is highlighted, as it involves both the need for social protection policies and respect for identities. It constitutes, therefore, a fundamental agenda in the search for democratic radicalization, in this second decade of the twenty-first century.

The agenda hitherto hegemonic, in this field, has been the 'war on drugs', which, belonging to the political universe of right-wing coalitions, commonly accompanies propositions against abortion, immigration and policies of positive discrimination. It is against it that this article manifests itself.

The 'war on drugs' failed. From any point of view that considers peace, social justice, public health and even the effectiveness of confrontation, its executors are not able to point to any significant gain that can be used as an argument in their favor.

On the contrary, its main results articulate strong negative impacts, both in the scope of the individual and in the scope of the society. Being so deleterious, they succeeded in transforming the damage caused by the attempts to access and purchase of drugs - by the way they are used and by social and political repression of consumers - in much heavier damages than those caused by the effect of drugs itself (TRANSFORM DRUG POLICY FOUNDATION, 2009TRANSFORM DRUG POLICY FOUNDATION. After the War on Drugs: Blueprint for Regulation. Transform Drug Policy Foundation. 2009. Disponível em: <http://www.tdpf.org.uk>. Acesso em: 1 dez. 2016.
http://www.tdpf.org.uk...
).

If the aim is to produce a social scenario in which repression inhibits consumption, it is far from successful, and lives daily with pain and suffering. In Brazil, the damages manifest most sharply in the morbidity and mortality of the most vulnerable populations, especially poor young people, male, black and mulatto, slum and peripheral residents (NEVES; GARCIA, 2015NEVES, A. C. M.; GARCIA, L. P. Mortalidade de jovens brasileiros: perfil e tendências no período 2000-2012. Epidemiol. Serv. Saúde, Brasília, DF, v. 24, n. 4, p. 595-606, out. /dez. 2015.; ASSIS; DESLADES; SANTOS, 2005ASSIS, S. G.; DESLANDES, S. F.; SANTOS, N. C. Violência na adolescência: sementes e frutos de uma sociedade desigual. In: BRASIL, Ministério da Saúde, Secretaria de Vigilância em Saúde. Violência na adolescência: sementes e frutos de uma sociedade desigual. Brasília, DF, 2005. p. 79-115.); in the overcrowding of prison and socio-educational systems, which produce absolutely degrading living conditions (FERNANDES; RIBEIRO, MOREIRA, 2015FERNANDES, F. M. B.; RIBEIRO, J. M.; MOREIRA, M. R. A saúde do adolescente privado de liberdade: um olhar sobre políticas, legislações, normatizações e seus efeitos na atuação institucional. Saúde em Debate, Rio de Janeiro, v. 39, n. esp., p. 120-131, dez. 2015.; SCISLESKI , 2014SCISLESKI, A. C. C. et al. Medida Socioeducativa de Internação: dos Corpos Dóceis às Vidas Nuas. Psicol. Ciênc. Prof. , Brasília, DF, v. 34, n. 3, p. 660-675, 2014.; FERNANDES , 2014FERNANDES, L. H. et al. Necessidade de aprimoramento do atendimento à saúde no sistema carcerário. Rev. Saúde Públ., São Paulo, v. 48, n. 2, p. 275-283, 2014.); reinforcing police repression and corruption (MUNIZ, PROENÇA JR., 2007MUNIZ, J. O.; PROENÇA JR., D. Muita politicagem, pouca política os problemas da polícia são. Estud. Av., São Paulo, v. 21, n. 61, p. 159-172, 2007.); in the unbridled multiplication of the demand for mental health services (RIBEIRO , 2016RIBEIRO, J. M. et al. Acesso aos serviços de atenção em álcool, crack e outras drogas - o caso do município do Rio de Janeiro, Brasil. Ciênc. Saúde Coletiva. Rio de Janeiro, v. 21, n. 1, p. 71-81, 2016.; SILVA; CRUZ; VARGAS, 2015SILVA, C. C.; CRUZ, M. M.; VARGAS, E. P. Práticas de cuidado e população em situação de rua: o caso do Consultório na Rua. Saúde em Debate, Rio de Janeiro, v. 39, n. esp., p. 246-256. dez. 2015.); and in the organization of drug trafficking in an economic dynamic that integrates the legal, informal and illegal market, becoming an extremely profitable activity, that seeks to infiltrate on party and electoral politics (CRUZ NETO; MOREIRA; SUCENA, 2001CRUZ NETO, O.; MOREIRA, M. R.; SUCENA, L. F. M. Nem Soldados Nem Inocentes: juventude e tráfico de drogas no Rio de Janeiro. Rio de Janeiro: Fiocruz, 2001.).

Faced with these results, the debate about the legalization and decriminalization of drugs has grown in several countries and aroused the interest of different organized segments of society, from militant groups of drug users to the media, through think tanks, political parties and fringes of the judiciary.

Like any important social debate, it also has a broad spectrum of positions, from the most radical, which, including the consumption of any drug - even the most moderate ones - as a business model, advocate legalization, focus their action on drugs of greater social acceptance and advocate the incremental improvement of the legal apparatus aimed at the socially more accepted ones.

It is in this context that the debate about the legalization and decriminalization of marijuana has become the most active in different societies, in a movement that was reinforced by the discovery of its therapeutic properties and possibilities of medical use. In the last years, several countries have made important changes to their marijuana laws. Particular emphasis must be given to certain states of the USA, that have opted for the free market; and Uruguay, which, following the opposite route, nationalized the production and distribution process.

In Brazil, the repercussion of these measures on the organized sectors of society was intense. Non-Governmental Organizations (NGO) and civil institutions have gained new breath and more space to advance in the theme; projects were presented to the national congress; the Brazilian Commission on Drugs and Democracy (CBDD) was created, with broad social representation; and, as it has become increasingly common in the brazilian political process, the Judiciary has entered into the debate, which is now in abeyance, awaiting the Federal Supreme Court (STF) to judge an action whose outcome can produce a clear legal change, open precedents and make the Country's highest court the main arena of this debate at the national level.

Despite the importance of the mobilization of the organized sectors and the value of the cause, there is an unknown: And the brazilians, what do they think? This is the objective of the article: to contribute to the understanding of what brazilian men and brazilian women think about the decriminalization and legalization of marijuana, supporting ways for a social change that, if there is any, is the result of a process that incorporates citizen participation, and not just a pact between more active and organized elites.

Methodological aspects

The present article is the result of the study 'The perception of brazilians on issues related to the decriminalization of marijuana', developed by the Center for Strategic Studies of the Oswaldo Cruz Foundation (CEE-Fiocruz), which, between october 7 and november 26, 2014, conducted a national opinion survey, using 3.007 telephone interviews with people over 18 years old, in all states of the Country. The margin of error is plus or minus 1, 4%, with a 95% confidence interval.

To gather information and perceptions of the interviewees about the subject and its relations with health, violence and public safety, this research counted on an instrument composed of 32 questions - 3 open, 26 closed (13 with concordance/discordance scales) and 3 mixed.

Due to its telephone character, national coverage and sample size, the researchers who conducted the telephone interviews had a script that began with the following:

Good morning/good afternoon, my name is [...] and at the moment we are doing a research for Fiocruz on the opinion of people about public health issues, especially the drugs issue. Could you participate?

To ensure the principles of bioethics in the research, interviewers were trained to clarify questions about the instrument and, above all, to immediately accept, without negotiating, a denial of participation. The people who accepted were informed that their names, addresses and any possible data that could identify them would be kept confidential. It was reinforced, yet, the idea that their responses would be used exclusively within the scope of the research, which would involve the publication of reports, articles and books. Moreover, they were assured that even in those publications the data would never be divulged in an individual way, reinforcing the promised secrecy and anonymity, and preserving the principle of non-maleficence.

The data of this survey were extremely rich and extensive. For the present article, it was adopted as cut-off the focus on the perception of the interviewees about the 'degree of information' on the debate about marijuana decriminalization/legalization; 'health repercussions' and 'violence' stemming from a possible decriminalization/legalization of marijuana; and 'expectations' regarding use/consumption, if marijuana were decriminalized/legalized.

The results were developed, as will be seen from the next topic, through a strategy that favored the percentage presentation of the general result and distributed it, also in percentage, in the following population strata: housing region, gender, age range, monthly income and schooling. For the reading to be fluid and comprehensible, it was chosen to present the percentage distributions per stratum, in situations in which they presented contrasts with the general result or with each other, allowing, thus, a better knowledge of the convergences and divergences found.

At that, as a consequence of the work developed, it is understood that the dissemination of the knowledge built with the interviewees around the theme improves the explanatory possibilities of the researchers and contributes to the overcoming of common sense, promoting the principle of beneficence.

Results and discussions: what do brazilians think about the decriminalization and legalization of marijuana?

For a better understanding of the results of the research, it was chosen to divide this section into the following topics: 'degree of information', 'perception about marijuana use/consumption and its repercussions on health', 'perception about marijuana discrimination/legalization and its repercussions on violence', and 'expectations and experiences regarding marijuana use/consumption'. In this way, it becomes easier to do both a reading of each topic and an articulation between them.

Perceptions about the 'degree of information of the society' and the 'degree of information of the individual' about the debate on decriminalization and legalization of marijuana

As shown in table 1, for 74% of respondents, the debate about marijuana decriminalization is not being well done in Brazil. Distributing the answers by the population strata developed in the research, those who consider more incisively that this debate is not being well done are: (i) male people; (ii) young people between the ages of 18 and 24 years old; (iii) residents of the Southeast Region; (iv) people with income above ten minimum wages; and (v) people who have completed higher education or an even higher level of education.

Table 1
Is the marijuana debate being well done in the Country? Distribution by region, gender, age range, income and schooling. Brazil, 2014

Referring to itself, the absolute majority of respondents, 57, 8%, do not consider themselves well informed to participate in the debate, with 46, 6% of them mentioning that they were 'poorly informed' and 11, 2%, 'very poorly informed'. On the other hand, 37, 9% declared themselves, somehow, informed, with 2, 9% 'very well informed' and 33% 'well informed'.

Among those who declare themselves uninformed, the following stand out: female (65, 1%); those who are 60 years old or older (63, 2%); those with incomes of up to one minimum wage (65%); those who did not complete elementary school (77%); and the residents of the Central-West Region (62, 5%).

It is interesting to point out that 53% of the respondents said they know that "decriminalizing marijuana means a change in the law, whereby marijuana smokers no longer commit a crime", while 67, 8% know that

legalizing marijuana means that the buying and selling of marijuana in official establishments become legal, and that the crack houses remain a crime.

This seems to indicate that the level of disinformation reported by the interviewees is more related to the repercussions that decriminalization/legalization can bring to society and the individual, than to the knowledge of its meaning.

In the following topics, there are data that reinforce this hypothesis. For now, such scenario of misinformation may be more comprehensible as far as the main sources of information of the respondents are known: 22, 5% declare that they do not consult any source of information, a percentage that rises in the Southeast Region (24, 6%), among female (25%), those who are 60 years old or older (28, 1%), those earning up to a minimum wage (32, 3%) and those who did not complete elementary school (35, 3%).

Among the sources of information (question of multiple answers), the most cited were TV (37, 9%), internet (31, 5%), newspapers (14, 1%) and magazines (4, 7%). In addition to those who cited radio (1, 7%) and 'media in general' (0, 9%), it is found that among those who seek information, the media are their great source.

There is an inversion of this situation among young people between the ages of 18 and 24 years old: the internet becomes the most sought after source for 50, 9% of them, followed by TV, with 25, 7%. The same situation, although in smaller proportions, appears for those who are between 25 and 34 years old: 41, 5%, internet and 34, 4%, TV.

In the age range above 34 years, TV reassumes the position of most sought source, followed by the internet, with an exception given in the range of 60 years old or more, in which magazines take second place (18, 2%), becoming the internet the third source (8, 2%). It is important to emphasize that this last one is also the age range in which the TV has its greater percentage, 47, 7%.

Focusing on the income of the respondents, TV is the most important source for those receiving up to five minimum wages. In the ranges between '5 to 10' and 'more than 10' minimum wages, the internet takes the first position, while, in this second range, the magazines surpass the TV in the second position.

Family and friendships networks appear as the traditional institutions most used as sources of information by the interviewees, but in a much lower proportion than those already mentioned: 5, 4%.

The religious support also appears not to be a source of information sought, with regard to the debate on marijuana decriminalization, as only 0, 4% cited 'church'.

The public policies and their institutions are seen as sources of information for very few interviewees: while the school/university was cited by 4, 1% (one can add 0, 3% cited by teacher/educator), health services had a poor participation, with a negligible 0, 3%. Even if the 0, 4% that cited the 'doctor' was added to it, the health sector would not even reach 1%.

A shocking data concludes this scenario: 45, 8% of respondents, when asked about what information they would like to have about the topic, they answered "none/do not want information", item that was the most cited.

Perceptions about the use/consumption of marijuana and their repercussions on health

When they were presented to the phrase "If people have the right to drink alcohol, they should also have the right to use marijuana", 46, 9% of the interviewees disagreed completely. In addition to those who 'disagree more than agree' (15, 3%), it is found that 62, 2% revealed some level of disagreement of the phrase.

These levels of discordance remain in the stratifications worked by the research, but with distinct differences, with more intensity (i) among women (67, 7%, being 51, 6% with total disagreement and 16, 1%, with partial disagreement) than among men (56, 4%, of which 41, 9% totally disagree and 14, 5%, with partial disagreement); (ii) people who are 60 years old or more (72, 1% with total disagreement, 58, 1% disagree more than agree and 14% with partial disagreement) and in the age range between 45 and 59 years old (65, 8%, 51, 4% and 14, 4%, respectively) than among 18 to 24 years old (52, 3%, 37, 1% and 15, 2%); (iii) among those with incomes of up to 1 minimum wage (78, 5%, 63, 9%, 14, 6%) than those with income above 10 minimum wages (50, 4%, 41, 5%, 8, 9%); and (iv) among those with incomplete elementary education (73, 8%, 63, 9%, 14, 6%) than among those with a higher education degree or an even higher level of education (57, 2%, 43, 6% and 13, 6%).

When questioned about the degree of agreement/disagreement about the phrase "Alcoholic beverages do more harm to health than marijuana", 44, 1% had some degree of agreement (24, 7% agreed totally, while 19, 4% agreed more than disagreed). Adding to these the 27, 3% who 'do not agree or disagree', it is verified that 27, 7% presented disagreement of the phrase, and only 16, 1% disagree totally.

Opening a sequence of negative perceptions about marijuana use/consumption, 71% showed some degree of agreement with the phrase "Marijuana ends up with the life of people". Table 2 illustrates these responses, indicating important divergences in the stratifications of the interviewees, that point, mostly, to more negative perceptions among women, people who are over 60 years old, receive up to 1 minimum wage and who did not complete elementary school.

Table 2
Level of agreement/disagreement with the phrase “Marijuana ends up with the life of people”: distribution by region, gender, age range, schooling and income. Brazil, 2014

Before the phrase "Marijuana is the entrance door to other drugs", 86, 5% showed some level of agreement with it, with 7, . 4% totally agreeing and 12, 1% agreeing partially. The distributions among the population strata studied follow profiles like those already mentioned.

To finalize this topic, table 3, which focuses on the agreement of the respondents (sum of the answers 'agree totally' and 'agree more than disagree') with the aforementioned phrases, distributes the answers by the variable in which people considered themselves 'well informed' or not, illustrating that negative perceptions are always and considerably more intense among those who considered themselves 'bad' or 'very poorly' informed.

Table 3
Perception of interviewees about questions regarding the repercussions of marijuana decriminalization on the health of individuals. Distribution of concordant responses by degree of information about the debate. Brazil, 2014

Perceptions about marijuana decriminalization/legalization and its repercussions on violence

The absolute majority of the interviewees (55, 6%) considered that "does not commit a crime who only uses marijuana, and is not a trafficker". This percentage exceeds 60% in the strata, in the age ranges between '18 and 24 years old' (67, 4%) and '25 to 34 years old' (60, 4%); among those who receive from '5 to 10' minimum wages and above 10 (61, 7% and 60, 7%, respectively); and those with complete college education or level of education (62, 5%).

Regarding the idea that "Decriminalizing marijuana would reduce drug trafficking", 39% of those interviewed indicated some level of agreement, with 20, 5% agreeing totally and 18, 5% agreeing more than they disagree. And there are important differences in these percentages, when the population strata investigated are focused: 42, 9% of the men have some agreement, which reduces to 35, 1% of the women; 51% of young people between the ages of 18 and 24 years old, against 31, 5% of those over 60 years old. However, there is little agreement between the income strata (39, 8% of those who receive between '5 and 10' minimum wages, while 34, 5% of those who earn less than one minimum wage) and schooling, ranging from 35, 5% and 41%.

Regarding the phrase "Decriminalize marijuana would reduce violence", 28, 9% of the respondents showed some agreement with it, with 14, 5% totally agreeing and 14, 4% having only some agreement. Especially in relation to this sentence, the variation indices were of low amplitude, maintaining the correlations already described in this article, but with percentages close to the total.

Also recalling perceptions about the relationship between marijuana decriminalization and violence, the phrase "Decriminalize marijuana will decrease police violence" obtained the agreement of 27, 8% of the interviewees.

The table 4, which focuses on the agreement of the respondents (sum of responses 'agree fully' and 'agree more than disagree') with the phrases given above, distributes responses by the variable in which people considered themselves 'well informed' or not, showing that the degree of agreement varies between 1/4 and ⅓ of the respondents, being always smaller among those who considered themselves 'poorly' or 'very poorly' informed.

Table 4
Perception of the interviewees about questions related to the repercussions of decriminalization of marijuana in the scenario of violence. Distribution of concordant responses by degree of information about the debate. Brazil, 2014

Expectations and experiences about the marijuana use

Regarding the question "If buying marijuana in Brazil were legal, would you buy it?", 91, 4% of respondents said no. Although there are differences in population strata, the proportion of 'no' is less than 90% among men (85%); young people between 18 and 24 years old (85%) and 25 to 34 years old (89, 1%); with income of 5 to 10 minimum wages (87, 6%) and more than 10 minimum wages (88, 1%).

Curiously, with the phrase "If marijuana is decriminalized, will its use increase", 70, 9% presented levels of agreement, with 54, 8% totally agreeing and 16, 1% agreeing more than they disagreed.

As shown in table 5, this level of agreement above 70% is maintained in almost all strata, and those below this level do not present less than 60%. The highest percentages of agreement occur in the Central-West Region (77, 5%), among women (71, 7%), people over 60 years old (74, 1%), among those with income from 1 to 2 minimum wages (74, 1%) and those with complete elementary school and incomplete high school (72, 3%).

Table 5
Level of agreement/disagreement with the phrase “If marijuana is decriminalized, will its use increase?”: Distribution by region, gender, age range, schooling and income. Brazil, 2014

Final considerations

The results of the research allow to delineate directions and actions for the construction of a democratizing agenda, regarding the decriminalization and the legalization of marijuana.

The first and most relevant one concerns the need to develop direct dialogues with the population, which admits to be poorly informed. Logically, this is directly related to the fact that public health and education services are not, by far, the source of information. If TV and social networks continue to play this role, it will be difficult to overcome a series of negative perceptions, which, as seen before, prevail among those who declare themselves to be ill-informed.

Now, if the twenty-first century is that of the 'society of information'; if information and communication technologies allow the development of social networks that have, around the world, produced powerful social mobilizations; and if, in some countries - such as Finland, for example -, the constituent process was conducted via web, it seems clear that, for the new democratizing agendas to succeed, they should be able to value and qualify participation and deliberation through a communication policy.

This research provides clues, also, to the segments that need to be focused by this communication policy: women, over 45 years old, with low schooling and income. It is noticed that, in this group, are mothers who suffer with violence that involves drug trafficking and affects their children. In this research, it was not aimed to identify the ethnicity of the interviewees (others must do it), but some studies show that these mothers are, for the most part, black and mulattas.

Here, two other needs of the democratizing agendas are clear: that of listening and giving voice to women, in general, who are already so battered by the machismo that dominates brazilian society: and to black women and mulattas, especially, raped by the racism that persists in occurring in the Country. To be a woman, a mother and a black woman is to have an accumulation of extremely beautiful and important characteristics for the individual and for the construction of a more just society. A democratizing agenda must incorporate these people as protagonists.

Focusing on these segments does not mean neglecting others, but, above all, it is also about bringing the strength of young people to the process of building agendas. It was they who presented the most sensitive responses to the decriminalization and legalization of marijuana, and it is these that will easily be seen by advocates of 'war on drugs' as targets of repression.

Another essential point to be highlighted is that the debate should be set in the field of public health and overcoming the violence that involves drug trafficking, which every day makes victims in the great cities of the Country. Strengthen health policies and overcoming violence demand articulated agendas, capable of bringing about vigorous improvements to the living conditions of the population.

Finally, it is emphasized that this research did not bother to ask if the interviewees are 'for or against' the decriminalization and legalization of drugs. What it really intended to understand was, and is, what people think about the factors and relationships that are part of this process, and that become completely obscured when a question like 'for or against' is made.

The paradox between the responses that reflect the fact that almost all respondents say that they would not consume marijuana if it were legalized in Brazil, and the answers that reveal that a very large percentage also considers that marijuana consumption will increase, they demonstrate that, in order to identify and comprehend what people think about a complex and delicate subject like this, researchers must go through troubled paths of corners, intersections, bifurcations and shortcuts, before arriving at a place where possibly a direct and objective answer represents an interpretation of what the interviewee thinks.

This was an option of the present research, having as intention contribute to the construction of democratizing agendas for the 21st century: to provide a first direct contact with certain individuals and their perceptions. Such an option can, of course, logically, also be seen as a limitation of the research, which, we hope, be provisioned by more and better studies.

    Financial support: non-existent

References

  • ASSIS, S. G.; DESLANDES, S. F.; SANTOS, N. C. Violência na adolescência: sementes e frutos de uma sociedade desigual. In: BRASIL, Ministério da Saúde, Secretaria de Vigilância em Saúde. Violência na adolescência: sementes e frutos de uma sociedade desigual. Brasília, DF, 2005. p. 79-115.
  • CRUZ NETO, O.; MOREIRA, M. R.; SUCENA, L. F. M. Nem Soldados Nem Inocentes: juventude e tráfico de drogas no Rio de Janeiro. Rio de Janeiro: Fiocruz, 2001.
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  • FERNANDES, L. H. et al Necessidade de aprimoramento do atendimento à saúde no sistema carcerário. Rev. Saúde Públ, São Paulo, v. 48, n. 2, p. 275-283, 2014.
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  • RIBEIRO, J. M. et al Acesso aos serviços de atenção em álcool, crack e outras drogas - o caso do município do Rio de Janeiro, Brasil. Ciênc. Saúde Coletiva Rio de Janeiro, v. 21, n. 1, p. 71-81, 2016.
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  • SILVA, C. C.; CRUZ, M. M.; VARGAS, E. P. Práticas de cuidado e população em situação de rua: o caso do Consultório na Rua. Saúde em Debate, Rio de Janeiro, v. 39, n. esp., p. 246-256. dez. 2015.
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    » http://www.tdpf.org.uk

Publication Dates

  • Publication in this collection
    Dec 2016

History

  • Received
    Dec 2016
  • Accepted
    Dec 2016
Centro Brasileiro de Estudos de Saúde RJ - Brazil
E-mail: revista@saudeemdebate.org.br