2026
Saura J, Enríquez M, Feliu A, Roca X, Mondón S, Barrio P, Andreu M, Segura L, Ballbè M, Fu M, Fernández E, Martínez C, clinical DuCATA group.
Addict Behav Rep. 2026;23:100656.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid41531671,
title = {Consumption patterns and withdrawal symptoms in dual cannabis-tobacco users in Spain: Cross-sectional study},
author = {Saura J and Enríquez M and Feliu A and Roca X and Mondón S and Barrio P and Andreu M and Segura L and Ballbè M and Fu M and Fernández E and Martínez C and DuCATA clinical group},
doi = {10.1016/j.abrep.2025.100656},
issn = {2352-8532},
year = {2026},
date = {2026-06-01},
journal = {Addict Behav Rep},
volume = {23},
pages = {100656},
abstract = {BACKGROUND: Cannabis use has increased worldwide, with over 188 million users annually. In Spain, past-year prevalence among people aged 15-64 is 10.6%. Dual use of cannabis and tobacco is common, increasing health risks and complicating cessation. This study examines consumption patterns and cannabis withdrawal severity among dual users undergoing treatment for cannabis use disorder (CUD).nnMETHOD: A cross-sectional study was conducted in substance use treatment programs in Catalonia, Spain. Participants were cannabis users initiating CUD treatment. A questionnaire collected sociodemographic data, cannabis and tobacco use characteristics (e.g., number of spliffs, tobacco amount), nicotine dependence, motivation to quit, and cannabis withdrawal symptoms. Hierarchical cluster analysis using Gower's distance identified behavioral patterns among participants.nnRESULTS: Data from 94 participants seeking CUD treatment were included. Daily tobacco use was reported by 91.5%, with a mean Fagerström score of 4.2/10. Most participants (88.1%) co-used cannabis with tobacco, and 75.8% experienced cannabis withdrawal symptoms, with women reporting greater severity. Cluster analysis revealed two profiles: Cluster 1 (71.0%) included mostly older males with higher motivation to quit and fewer withdrawal symptoms; Cluster 2 (29.0%) was younger, more sex-balanced, and showed higher nicotine dependence, and more severe withdrawal symptoms.nnCONCLUSIONS: Co-use of cannabis and tobacco is highly prevalent among individuals entering CUD treatment. Higher nicotine dependence is associated with more severe withdrawal symptoms. Older males with higher motivation and fewer withdrawal symptoms may have better prognosis, highlighting motivation as cessation predictor. Findings underscore the need to enhance motivation to quit both substances and integrated treatment. The DuCATA project has been registered at Clinicaltrials.gov under the identifier [NCT05512091].},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Cannabis use has increased worldwide, with over 188 million users annually. In Spain, past-year prevalence among people aged 15-64 is 10.6%. Dual use of cannabis and tobacco is common, increasing health risks and complicating cessation. This study examines consumption patterns and cannabis withdrawal severity among dual users undergoing treatment for cannabis use disorder (CUD).nnMETHOD: A cross-sectional study was conducted in substance use treatment programs in Catalonia, Spain. Participants were cannabis users initiating CUD treatment. A questionnaire collected sociodemographic data, cannabis and tobacco use characteristics (e.g., number of spliffs, tobacco amount), nicotine dependence, motivation to quit, and cannabis withdrawal symptoms. Hierarchical cluster analysis using Gower's distance identified behavioral patterns among participants.nnRESULTS: Data from 94 participants seeking CUD treatment were included. Daily tobacco use was reported by 91.5%, with a mean Fagerström score of 4.2/10. Most participants (88.1%) co-used cannabis with tobacco, and 75.8% experienced cannabis withdrawal symptoms, with women reporting greater severity. Cluster analysis revealed two profiles: Cluster 1 (71.0%) included mostly older males with higher motivation to quit and fewer withdrawal symptoms; Cluster 2 (29.0%) was younger, more sex-balanced, and showed higher nicotine dependence, and more severe withdrawal symptoms.nnCONCLUSIONS: Co-use of cannabis and tobacco is highly prevalent among individuals entering CUD treatment. Higher nicotine dependence is associated with more severe withdrawal symptoms. Older males with higher motivation and fewer withdrawal symptoms may have better prognosis, highlighting motivation as cessation predictor. Findings underscore the need to enhance motivation to quit both substances and integrated treatment. The DuCATA project has been registered at Clinicaltrials.gov under the identifier [NCT05512091].
Feliu A, Martinez C, Vardavas C, Fernández E, Filippidis FT.
From vision to action: a framework to assess readiness for the tobacco endgame. Article
Tob Control. 2026.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid42082364,
title = {From vision to action: a framework to assess readiness for the tobacco endgame},
author = {Feliu A and Martinez C and Vardavas C and Fernández E and Filippidis FT},
doi = {10.1136/tc-2025-059920},
issn = {1468-3318},
year = {2026},
date = {2026-05-01},
journal = {Tob Control},
abstract = {BACKGROUND: Tobacco endgame strategies aim to reduce smoking prevalence to minimal levels (<5%) through measures that expand traditional tobacco control approaches. Although some countries have set endgame targets, most still report prevalence rates >15%, and practical guidance on how to assess readiness for endgame implementation remains limited. This study aims to synthetise the key determinants of jurisdictions' readiness for tobacco endgame and proposes a self-assessment tool to evaluate it.nnMETHODS: A narrative review of peer-reviewed and grey literature published between January 2010 and September 2025 was conducted. Publications were identified through targeted searches of academic databases and relevant organisational websites. A thematic synthesis of evidence on political, social and structural determinants of readiness was undertaken to identify recurring domains, which were later used to inform the development of a self-assessment tool.nnRESULTS: Nine readiness domains were identified: relatively low smoking prevalence; advanced implementation of WHO Framework Convention on Tobacco Control measures; robust enforcement infrastructure; social denormalisation of smoking; broad public understanding and support for ending tobacco use; a positive political climate and strong political will and leadership; a cohesive tobacco control community and civil society; minimal tobacco industry interference with strong protective mechanisms; and sufficient resources to implement tobacco endgame action plan. These domains guided the development of an evidence-informed self-assessment tool to help jurisdictions evaluate readiness, identify gaps and prioritise strategic actions.nnCONCLUSION: The Assessment of Readiness for Tobacco Endgame tool offers an evidence-informed framework to assess tobacco endgame readiness, helping jurisdictions assess capacities, identify gaps and guide strategic decision-making.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Tobacco endgame strategies aim to reduce smoking prevalence to minimal levels (<5%) through measures that expand traditional tobacco control approaches. Although some countries have set endgame targets, most still report prevalence rates >15%, and practical guidance on how to assess readiness for endgame implementation remains limited. This study aims to synthetise the key determinants of jurisdictions' readiness for tobacco endgame and proposes a self-assessment tool to evaluate it.nnMETHODS: A narrative review of peer-reviewed and grey literature published between January 2010 and September 2025 was conducted. Publications were identified through targeted searches of academic databases and relevant organisational websites. A thematic synthesis of evidence on political, social and structural determinants of readiness was undertaken to identify recurring domains, which were later used to inform the development of a self-assessment tool.nnRESULTS: Nine readiness domains were identified: relatively low smoking prevalence; advanced implementation of WHO Framework Convention on Tobacco Control measures; robust enforcement infrastructure; social denormalisation of smoking; broad public understanding and support for ending tobacco use; a positive political climate and strong political will and leadership; a cohesive tobacco control community and civil society; minimal tobacco industry interference with strong protective mechanisms; and sufficient resources to implement tobacco endgame action plan. These domains guided the development of an evidence-informed self-assessment tool to help jurisdictions evaluate readiness, identify gaps and prioritise strategic actions.nnCONCLUSION: The Assessment of Readiness for Tobacco Endgame tool offers an evidence-informed framework to assess tobacco endgame readiness, helping jurisdictions assess capacities, identify gaps and guide strategic decision-making.
Teshima A, Feliu A, Gallus S, Martinez C, Fernandez E.
Lancet Reg Health Eur. 2026;60:101511.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid41216474,
title = {Impact of cigarette prices and age-of-sale policies on smoking prevalence among youth in 26 European Member States (2012-2023): a longitudinal ecological study using repeated cross-sectional data},
author = {Teshima A and Feliu A and Gallus S and Martinez C and Fernandez E},
doi = {10.1016/j.lanepe.2025.101511},
issn = {2666-7762},
year = {2026},
date = {2026-01-01},
journal = {Lancet Reg Health Eur},
volume = {60},
pages = {101511},
abstract = {BACKGROUND: Reducing tobacco and nicotine use and preventing smoking initiation among youth are key public health priorities. We evaluated the impact of cigarette prices and age-of-sale laws on youth smoking prevalence in the European Union (EU).nnMETHODS: In this ecological study with 26 EU Member States as the unit of analysis, we estimated smoking prevalence among individuals aged 15-24, using five Eurobarometer waves (2012-2023, n = 12,087). We used fixed-effects panel regression models to assess the association between cigarette prices, the introduction of 18+ age-of-sale laws for tobacco products and changes in youth smoking prevalence, controlling for time and tobacco control policy implementation.nnFINDINGS: Weighted youth smoking prevalence decreased from 28.4% (841/2818) in 2012 to 22.2% (490/2222) in 2023, although the trend was not consistently downward. A €1 increase in inflation-adjusted cigarette prices per pack was associated with a 3.4 percentage point reduction in male youth prevalence (95% CI: -6.40 to -0.45), while there was no significant association for females or at the EU level. Regional variation was observed, with price increases associated with substantial reductions in youth smoking among both sexes in Southern Europe and among males in Northern Europe. In contrast, no such associations were found in Western or Eastern Europe. Age-of-sale laws were not significantly associated with youth smoking prevalence at the EU level.nnINTERPRETATION: Current taxation and age-of-sale policies remain insufficient, with impacts varying by sex and region. Achieving the tobacco endgame requires harmonised EU-level measures and stronger enforcement, particularly of these two policies, to prevent the ongoing influx of new youth smoking initiates. This study suggests that their potential impact has been constrained by inadequate enforcement to date rather than by policy ineffectiveness.nnFUNDING: None.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Reducing tobacco and nicotine use and preventing smoking initiation among youth are key public health priorities. We evaluated the impact of cigarette prices and age-of-sale laws on youth smoking prevalence in the European Union (EU).nnMETHODS: In this ecological study with 26 EU Member States as the unit of analysis, we estimated smoking prevalence among individuals aged 15-24, using five Eurobarometer waves (2012-2023, n = 12,087). We used fixed-effects panel regression models to assess the association between cigarette prices, the introduction of 18+ age-of-sale laws for tobacco products and changes in youth smoking prevalence, controlling for time and tobacco control policy implementation.nnFINDINGS: Weighted youth smoking prevalence decreased from 28.4% (841/2818) in 2012 to 22.2% (490/2222) in 2023, although the trend was not consistently downward. A €1 increase in inflation-adjusted cigarette prices per pack was associated with a 3.4 percentage point reduction in male youth prevalence (95% CI: -6.40 to -0.45), while there was no significant association for females or at the EU level. Regional variation was observed, with price increases associated with substantial reductions in youth smoking among both sexes in Southern Europe and among males in Northern Europe. In contrast, no such associations were found in Western or Eastern Europe. Age-of-sale laws were not significantly associated with youth smoking prevalence at the EU level.nnINTERPRETATION: Current taxation and age-of-sale policies remain insufficient, with impacts varying by sex and region. Achieving the tobacco endgame requires harmonised EU-level measures and stronger enforcement, particularly of these two policies, to prevent the ongoing influx of new youth smoking initiates. This study suggests that their potential impact has been constrained by inadequate enforcement to date rather than by policy ineffectiveness.nnFUNDING: None.
Sæbø G, Carnicer-Pont D, Lopez AM, Koprivnikar H, Pénzes M, González-Marrón A, Arteta N, Fernández E.
Tob Control. 2026.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid41530058,
title = {Mapping loopholes in the current regulation of tobacco advertising, promotion, and sponsorship in Europe: a scoping review},
author = {Sæbø G and Carnicer-Pont D and Lopez AM and Koprivnikar H and Pénzes M and González-Marrón A and Arteta N and Fernández E},
doi = {10.1136/tc-2025-059329},
issn = {1468-3318},
year = {2026},
date = {2026-01-01},
journal = {Tob Control},
abstract = {OBJECTIVE: To review and synthesise European evidence identifying loopholes in 'Tobacco Advertising, Promotion and Sponsorship' (TAPS) regulations and actions undertaken by European countries to curb TAPS.nnDATA SOURCES: We conducted a comprehensive search across seven databases (Medline/PubMed, Embase, Web of Science, Sociological abstracts, Global health, CINAHL and PsycInfo) along with grey literature from relevant tobacco control organisation websites. Searches were restricted by publication date (2005-2023), geographical setting (EU & European Free Trade Association countries) and language (English).nnSTUDY SELECTION: All reviewers independently screened titles and abstracts using a purpose-designed Excel spreadsheet to identify sources addressing loopholes in national or supranational settings, deciding on inclusion accordingly.nnDATA EXTRACTION: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist, we extracted data based on the 'Population, Concept and Context' framework, covering tobacco product type, media communication channel and findings indicating TAPS loopholes. Two reviewers used an Excel sheet to extract data.nnDATA SYNTHESIS: Of 1477 sources, 140 were included in the review. Analysis identified five key loopholes: (a) smoking depictions and tobacco advertising in traditional mass media (films and television), (b) cross-border branding and sponsorships, (c) point-of-sale marketing, (d) e-cigarette and tobacco advertising and promotion on the internet and (e) promotion and advertising of tobacco and novel nicotine products on social media.nnCONCLUSIONS: Curbing TAPS through comprehensive national bans and cross-border cooperation remains challenging because of the permeability of mass media, social media and other digital tools. Further research is necessary to develop strategies for effective implementation and enforcement to ensure compliance with TAPS regulations.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To review and synthesise European evidence identifying loopholes in 'Tobacco Advertising, Promotion and Sponsorship' (TAPS) regulations and actions undertaken by European countries to curb TAPS.nnDATA SOURCES: We conducted a comprehensive search across seven databases (Medline/PubMed, Embase, Web of Science, Sociological abstracts, Global health, CINAHL and PsycInfo) along with grey literature from relevant tobacco control organisation websites. Searches were restricted by publication date (2005-2023), geographical setting (EU & European Free Trade Association countries) and language (English).nnSTUDY SELECTION: All reviewers independently screened titles and abstracts using a purpose-designed Excel spreadsheet to identify sources addressing loopholes in national or supranational settings, deciding on inclusion accordingly.nnDATA EXTRACTION: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist, we extracted data based on the 'Population, Concept and Context' framework, covering tobacco product type, media communication channel and findings indicating TAPS loopholes. Two reviewers used an Excel sheet to extract data.nnDATA SYNTHESIS: Of 1477 sources, 140 were included in the review. Analysis identified five key loopholes: (a) smoking depictions and tobacco advertising in traditional mass media (films and television), (b) cross-border branding and sponsorships, (c) point-of-sale marketing, (d) e-cigarette and tobacco advertising and promotion on the internet and (e) promotion and advertising of tobacco and novel nicotine products on social media.nnCONCLUSIONS: Curbing TAPS through comprehensive national bans and cross-border cooperation remains challenging because of the permeability of mass media, social media and other digital tools. Further research is necessary to develop strategies for effective implementation and enforcement to ensure compliance with TAPS regulations.
Liang R, Laverty AA, Feliu A, Martinez C, Peruga A, Vardavas C, Filippidis FT.
Eur J Public Health. 2026.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid41603344,
title = {Public support for standardised packaging and policy implementation: an analysis of European survey data},
author = {Liang R and Laverty AA and Feliu A and Martinez C and Peruga A and Vardavas C and Filippidis FT},
doi = {10.1093/eurpub/ckag001},
issn = {1464-360X},
year = {2026},
date = {2026-01-01},
journal = {Eur J Public Health},
abstract = {We conducted a secondary analysis of Eurobarometer survey data from 27 European countries, collected in 2017 (n = 28 300) and 2023 (n = 26 358), to assess changes in public support for standardised tobacco packaging. In the pooled analysis, support remained unchanged in the 19 MS without relevant legislation (adjusted Prevalence Ratio [aPR]=0.94, 95% Confidence Interval: 0.86-1.03), whereas the 8 MS that had implemented the policy by 2023 were significantly more likely to experience an increase in support (interaction term: aPR = 1.28, 1.17-1.41). The increase in support offers reassurance to policymakers advocating for tobacco packaging regulations and encourages MS to consider the adoption of similar policies.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
We conducted a secondary analysis of Eurobarometer survey data from 27 European countries, collected in 2017 (n = 28 300) and 2023 (n = 26 358), to assess changes in public support for standardised tobacco packaging. In the pooled analysis, support remained unchanged in the 19 MS without relevant legislation (adjusted Prevalence Ratio [aPR]=0.94, 95% Confidence Interval: 0.86-1.03), whereas the 8 MS that had implemented the policy by 2023 were significantly more likely to experience an increase in support (interaction term: aPR = 1.28, 1.17-1.41). The increase in support offers reassurance to policymakers advocating for tobacco packaging regulations and encourages MS to consider the adoption of similar policies.