PUBLICACIONS

@article{pmid41072185,

title = {[The Tobacco Market Commission's reports: too opaque, too irrelevant]},

author = {Peruga A and Nerín I and Rodríguez Lozano F and Fernández R and Tigova O and Córdoba R and Martínez C and Fernández E},

doi = {10.1016/j.gaceta.2025.102529},

issn = {1578-1283},

year  = {2025},

date = {2025-10-01},

journal = {Gac Sanit},

volume = {39},

pages = {102529},

abstract = {The monthly reports from the Tobacco Market Commission in Spain (CMT, by its acronym in Spanish), while data-rich, have critical deficiencies that limit their usefulness for public health. A critical analysis reveals three fundamental problems: institutional ambiguity, methodological opacity, and relevant analytical omissions. The authorship of the reports is uncertain, as they are published under the name of an advisory committee with representation from the tobacco industry, which compromises their independence. Methodologically, they lack clear definitions for key variables and use excessively aggregated data categories, preventing rigorous analysis and the replicability of findings. The reports are based on data self-reported by the industry itself, with no evidence of independent audits, which constitutes a serious conflict of interest. Furthermore, they systematically omit crucial information that the CMT derives from its activities, such as breakdowns of tax revenue by product, price-elasticity analyses, estimates of illicit trade, and the sector's advertising and promotion expenditures. For these reports to become an effective tool for formulating evidence-based policies, a reform is essential to ensure transparency in authorship, methodological rigor, data verification, and the inclusion of relevant economic and fiscal analyses.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40957677,

title = {Advertising exposure and the appeal of emerging nicotine-containing products among people who have never used nicotine: findings from the Eurobarometer 2023},

author = {Li CX and Wang PC and Feliu A and Laverty AA and Martinez C and Vardavas CI and Filippidis FT},

doi = {10.1136/tc-2025-059522},

issn = {1468-3318},

year  = {2025},

date = {2025-09-01},

journal = {Tob Control},

abstract = {INTRODUCTION: Emerging nicotine-containing products, including heated tobacco products (HTPs) and nicotine pouches, have been growing in popularity in the European Union (EU). Advertising exposure impacts perceived product appeal and may contribute to product initiation. However, the current EU's Tobacco Products Directive lacks a consistent framework for regulating these advertisements. This study examines how exposure to HTP and nicotine pouch advertisements influences their appeal among people who have never used nicotine.nnMETHODS: Data from the Special Eurobarometer 99.3 survey (May-June 2023) included 13 436 participants who have never used nicotine across 27 EU Member States. We estimated the weighted prevalence of HTP and nicotine pouch advertising exposure and perceived appeal and ran multilevel Poisson regression models adjusting for sociodemographic factors.nnRESULTS: 31.1% of participants reported HTP advertising exposure across the EU, with the highest levels reported in Romania (53.4%) and Slovakia (50.0%) and the lowest in Malta (13.6%). Nicotine pouch advertising exposure averaged 16.6%, peaking in Sweden (46.0%) and lowest in the Netherlands (5.0%) and Lithuania (7.7%). Product appeal remained low, with only 2.0% finding HTPs appealing and 1.3% finding nicotine pouches appealing. Exposed to HTP advertisements were 3.71 times more likely to find them appealing, while exposure to nicotine pouch advertisements increased perceived appeal of nicotine pouches by 5.78 times.nnCONCLUSION: Advertising exposure was associated with higher appeal of nicotine-containing products among people who have never used nicotine. Given the risk of initiation, EU-wide advertising restrictions could protect this group and limit the impact of these products on health.},

keywords = {},

pubstate = {published},

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}

@article{pmid40976422,

title = {Determinants of smoke-free homes adoption among Spanish adults who smoke: A prospective cohort study from the 2016-2021 International Tobacco Control (ITC) EUREST-PLUS Spain Surveys},

author = {Tigova O and Castellano Y and Fu M and Driezen P and Martínez C and Quah ACK and Fong GT and Fernández E},

doi = {10.1016/j.ypmed.2025.108415},

issn = {1096-0260},

year  = {2025},

date = {2025-09-01},

journal = {Prev Med},

volume = {200},

pages = {108415},

abstract = {OBJECTIVE: To assess the prevalence and associated factors of smoke-free homes (SFHs) among Spanish adults who smoke across three cohort waves, and to identify determinants of SFH adoption during follow-up (2016-2021).nnMETHODS: The International Tobacco Control EUREST-PLUS Spain Survey is a nationally representative cohort of ∼1000 adults (≥18 years) who smoke surveyed in 2016, 2018, and 2021. First, we conducted repeated cross-sectional analysis to estimate the prevalence of SFHs at each wave. Second, we estimated incidence and risk ratios (RR) with 95 % confidence intervals (CI) for SFH adoption during the follow-up using adjusted generalised linear models. Independent variables included sociodemographics, smoking characteristics, and beliefs about second-hand smoke harms.nnRESULTS: SFH prevalence was 13.1 % in 2016, 19.0 % in 2018, and 31.5 % in 2021 (p trend <0.001). Quitting smoking (RR = 2.66; 95 % CI: 2.10, 3.36), remaining in any stage other than precontemplation (RR = 1.76; 1.13, 2.73) and progressing beyond precontemplation stage (RR = 2.59; 1.99, 3.37) were determinants of SFH adoption. Maintaining moderate or high nicotine dependence (RR = 0.46; 0.30, 0.69) was inversely associated with SFH adoption.nnCONCLUSIONS: SFH prevalence among Spanish adults who smoke increased in 2016-2021. Initiatives promoting SFHs should encourage progression through the stages of change towards cessation and provide tailored support for individuals with high nicotine dependence.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40971221,

title = {Predictors of Developing Positive Attitudes and Increasing Perceptions of Training in Tobacco Control Among Catalan Nursing Students: A Follow-Up Study},

author = {Laroussy K and Fernández E and Castellano Y and Fu M and Feliu A and Tigova O and Puig M and Galimany J and Moreno C and Martínez C},

doi = {10.1097/JAN.0000000000000664},

issn = {1548-7148},

year  = {2025},

date = {2025-09-01},

journal = {J Addict Nurs},

abstract = {BACKGROUND: The knowledge and attitudes toward tobacco control among nurses are important factors in ensuring appropriate management of the tobacco dependence.nnMETHODS: Observational prospective study of 1,097 Catalan nursing students. Participants completed a paper-and-pencil questionnaire at baseline (2015-2016) and an online survey at follow-up (2018-2019). We examined predictors of developing positive attitudes and increasing perceptions of training using Poisson regression models to compute the adjusted prevalence ratios (aPRs).nnRESULTS: Students in their last years of studies at baseline were less likely than those in the first years to develop a positive attitude towards the exemplary role of nursing students in tobacco control at follow-up (aPR = 0.74). Former smokers were more likely than current smokers to develop positive attitudes towards the exemplary role of health care professionals (aPR = 1.55) and, together with never smokers, to come to recognize the importance of nursing students setting a good example (aPR = 2.23 and aPR = 2.32, respectively). Last year's students were also less likely than those in the first years to increase their perceptions of tobacco-related training received (all aPR < 0.71). Never smokers were less likely than current smokers to increase their perception of training in pharmacological treatments other than nicotine replacement therapy (aPR = 0.81) and to consider themselves capable of helping smokers quit (aPR = 0.78).nnCONCLUSIONS: The year of school and smoking status were strong predictors of developing positive attitudes and increasing perceptions of training in tobacco control.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40975944,

title = {Co-creating a gamified tool for cannabis and tobacco use monitoring: Participant-driven development},

author = {Martínez C and Saura J and Enríquez M and Feliu A and Fu M and Ballbè M and Roca X and Andreu M and Pla M and Maestre-González E and Mondon S and Barrio P and Raich A and Porthé V and Garcia-Pañella O and Colom J and Segura L and Fernández E and Rosa N},

doi = {10.1016/j.drugalcdep.2025.112880},

issn = {1879-0046},

year  = {2025},

date = {2025-09-01},

journal = {Drug Alcohol Depend},

volume = {276},

pages = {112880},

abstract = {INTRODUCTION: The growing use of cannabis, often alongside tobacco, presents challenges for substance use treatment programs (SUTPs), as it intensifies withdrawal symptoms. To address dual dependencies and improve engagement, we developed a gamified web app for individuals in SUTP who use cannabis to monitor their use. This paper describes the tool's co-creation process and and, findings that guided alignment with target needs.nnMETHODS: Seventeen adults with current or past cannabis use were recruited from SUTPs in Catalonia (2021-2023). Using a qualitative, participatory design, the study involved reflexive thematic analysis and co-creation with researchers, clinicians, and gamification experts. Development followed four phases: (1) Discovering, expectations and motivations through interviews; (2) Deepening in Co-design, exploring needs and profiles; (3) Narrative Development, basing stories on real experiences; and (4) Technical Development, adapting features to goals.nnRESULTS: In Phase 1, two archetypes were identified: "socializers" and "explorers", along with core values, such as acceptance, social connection, and life control. Phase 2 revealed expectations for content on autonomy, stigma reduction, empathy, self-confidence, tranquility, and curiosity as key motivators. Phase 3 created three stories. Phase 4 produced a customized tracking app, integrating questionnaires.nnCONCLUSION: This study highlights the value of co-creation in designing interventions for SUTPs and demonstrates usefulness of participatory approaches to create mHealth tools. These approaches informed the app's design to align with individuals' motivations and preferences, grounded in lived experiences. The resulting web app provides personalized support for substance use treatment. Future research should explore clinical and behavioral impacts.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40795943,

title = {Perceptions of e-cigarettes and heated tobacco products among never users of nicotine in the European Union},

author = {Li CX and Wang PC and Feliu A and Laverty AA and Martinez C and Filippidis FT},

doi = {10.1093/ntr/ntaf168},

issn = {1469-994X},

year  = {2025},

date = {2025-08-01},

journal = {Nicotine Tob Res},

abstract = {INTRODUCTION: Emerging tobacco and nicotine products, such as e-cigarettes and heated tobacco products (HTPs), are gaining popularity, particularly among young people. This study examines the perceptions of e-cigarettes and HTPs among nicotine-naive individuals and their variations across sociodemographic subgroups.nnMETHODS: We conducted a cross-sectional analysis of the Special Eurobarometer 99.3 (May-June 2023) among never users of tobacco or nicotine products in the European Union (EU) (n = 13 436). We estimated the weighted prevalence of perceptions of e-cigarettes and HTPs: appeal, perceived effectiveness for smoking cessation, support for them being regulated like cigarettes, and support for keeping them out of sight in points-of-sale. Multi-level Poisson regression models examined associations of sociodemographic factors with these perceptions.nnRESULTS: Among never users in the EU, 2.6% found e-cigarettes appealing, while 2.0% found HTPs appealing. 50.8% and 58.8% of participants supported strict regulations and point-of-sale restrictions for these products, respectively. Younger age groups were more likely to find e-cigarettes (Prevalence Ratio [PR] = 1.70, for ages 15-39 vs. 55+) and HTPs (PR = 1.88, PR = 1.54 for ages 15-24 and 25-39) appealing and view them as effective for smoking cessation. Support for regulations similar to cigarettes was higher among women, individuals with higher education, those living with children, and those without financial difficulties.nnCONCLUSION: While the appeal of these products to never users remained low overall, the study found that young people were more likely to find them appealing, posing a risk for experimentation. Meanwhile, over 50% of respondents supported stricter regulations, which could influence policy changes in this area.nnIMPLICATIONS: Although appeal of e-cigarettes and Heated Tobacco Products (HTPs) was relatively low among people who have never used e-cigarettes, HTPs or smoking tobacco in the European Union, appeal was higher among younger age groups, which are often targeted by the industry. We also found substantial support for stricter regulatory policies for e-cigarettes and HTPs across the EU. These findings might encourage governments to increase restrictions around these emerging nicotine and tobacco products.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40554131,

title = {Dimensions and domains to assess secondhand tobacco smoke exposure: insights from a Delphi study},

author = {Blanco-Ferreiro A and Rey-Brandariz J and Ahluwalia JS and Varela-Lema L and Galán I and Santiago-Pérez MI and Sureda X and Fu M and Schiaffino A and José López M and Continente X and Candal-Pedreira C and Mahabee-Gittens M and Pérez-Ríos M},

doi = {10.1016/j.gaceta.2025.102508},

issn = {1578-1283},

year  = {2025},

date = {2025-06-01},

journal = {Gac Sanit},

volume = {39},

pages = {102508},

abstract = {OBJECTIVE: To identify the dimensions and domains to be included in questionnaires when assessing self-reported secondhand tobacco smoke (SHS) exposure in etiological studies and in population health surveys.nnMETHOD: A qualitative study was conducted in two stages. In stage one, based on a Delphi methodology, 16 experts in tobacco epidemiology completed two questionnaires and attended a group session. In stage two, triangulation interviews were conducted with six experts from the Delphi study to provided in-depth reflection on the domains identified in stage one. The recorded transcriptions were analyzed using a thematic approach.nnRESULTS: The experts discussed the importance of assessing SHS exposure in specific scenarios, highlighting the home, workplace, leisure venues, and private transport. They discussed the importance of asking about cohabiting with smokers when assessing exposure at home. The experts stressed the importance of differentiating between leisure venues, by prioritizing closed over open spaces. In population-based health surveys, the experts recommended that the recall time should be recent, referring to the last seven days. In etiological studies, they suggested that lifetime exposures should be explored.nnCONCLUSIONS: This study marks the first step toward identifying the dimensions and domains for assessing self-reported SHS exposure. Question standardization when ascertaining SHS exposure is critical to permit cross study comparisons and to analyze trends in the evolution of SHS exposure.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40135674,

title = {Patterns of Tobacco Use, Dependence, and Motivation to Quit Among Individuals Seeking Treatment for Alcohol and Cannabis Consumption in Catalonia (Spain)},

author = {Martinez C and Saura J and Enriquez M and Feliu A and Roca X and Castellano Y and Cabezas C and Suelves JM and Mondon S and Barrio P and Andreu M and Raich A and Fonseca F and Masferrer L and Bautista P and Fernandez E},

doi = {10.1080/02791072.2025.2479102},

issn = {2159-9777},

year  = {2025},

date = {2025-03-01},

journal = {J Psychoactive Drugs},

pages = {1--15},

abstract = {Understanding smoking behaviors in vulnerable groups is essential for effective cessation services. This study characterizes tobacco consumption and identifies factors associated with nicotine dependence and motivation to quit among individuals entering alcohol and cannabis treatment programs. A multi-center cross-sectional study was conducted in ten centers in Barcelona province. Participants' sociodemographics and tobacco use were assessed, including cigarette consumption and nicotine dependence (Fagerström test). Self-efficacy and motivation to quit were measured on a 0-10 Likert scale. A decision-tree analysis identified factors linked to moderate-to-high nicotine dependence (Fagerström ≥ 5) and high cessation motivation (≥7). Most participants (96.1%) use tobacco daily, with 57.0% using manufactured and 42.2% roll-your-own (RYO) cigarettes. Mean cigarette consumption was 15.2/day (SD = 8.7), with nicotine dependence (4.4, SD = 2.3). Cannabis users started smoking tobacco earlier than those who used alcohol. Over the past year, two-thirds attempted quitting and 60% had high cessation motivation. Self-efficacy for quitting was moderate (mean = 5.1; SD = 3.3). RYO use, age over 45, and alcohol use were associated with moderate-to-high nicotine dependence (probabilities = 0.52, 0.62, and 0.71, respectively). Having a non-tobacco social network was linked to a high motivation to quit (probability = 0.72). Participants had moderate nicotine dependence, low self-efficacy, and high motivation to quit tobacco. Dependence was higher among RYO users, ≥45 years/old, and people with alcohol use disorder. High motivation was more frequent among those with a non-tobacco social network. Integrating cessation support into substance treatment, focusing on RYO and young users, and promoting self-efficacy and tobacco-free socialization may enhance cessation success.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40129551,

title = {Prevalence and determinants of smoke-free homes in 12 European countries: the TackSHS Survey},

author = {Tigova O and Stival C and Castellano Y and Lugo A and Fu M and Mar López A and Martínez C and Soriano JB and O'Donnell R and Semple S and López MJ and Fernández E and Gallus S},

doi = {10.1183/23120541.00950-2024},

issn = {2312-0541},

year  = {2025},

date = {2025-03-01},

journal = {ERJ Open Res},

volume = {11},

number = {2},

abstract = {BACKGROUND: Homes are one of the primary locations where people are exposed to second-hand smoke (SHS) in Europe. We describe the prevalence and identify the main determinants of having home-smoking restrictions in 12 European countries.nnMETHODS: Cross-sectional survey in 12 European countries conducted in 2017-2018 (TackSHS project). Approximately 1000 participants representing the general population aged ≥15 years of each country were interviewed face to face. Individual- and country-level characteristics were explored through adjusted prevalence ratios (PRs) obtained from multilevel Poisson models with random effects.nnRESULTS: Among 11 734 participants, 70.2% (95% confidence interval (CI) 69.4-71.0%) had smoke-free homes and 17.5% (95% CI 16.8-18.2%) had partial home-smoking restrictions in place. Prevalence of smoke-free homes ranged from 44.4% in Greece to 84.5% in England. Having a smoke-free home was significantly inversely associated with current (PR=0.60) or former (PR=0.95) smoking and living in a household with one (PR=0.70) or two or more (PR=0.58) people who smoke. It was also significantly associated with being ≥65 years old (PR=1.05), being female (PR=1.07), having a high educational level (PR=1.09) and living with children (PR=1.09). Having a smoke-free home was associated with living in northern Europe, while partial home-smoking restrictions were more likely among respondents from eastern Europe and countries with lower  gross domestic product.nnCONCLUSIONS: The prevalence of smoke-free homes in Europe is relatively high, but with large variability across countries. European countries with a lower prevalence of smoke-free homes should implement tailored interventions targeting identified determinants and incorporate the success of other countries.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39846443b,

title = {Trends and Association between Smoking and the Socio-Demographic Index Among 11 South American Countries, 1990-2019},

author = {Afolayan OK and Velazquez J and Tundealao S and Fernández E and Martínez C and Leon-Novelo L and Retamales J and Tamí-Maury I},

doi = {10.1080/10826084.2024.2440384},

issn = {1532-2491},

year  = {2025},

date = {2025-01-01},

journal = {Subst Use Misuse},

volume = {60},

number = {4},

pages = {566--576},

abstract = {OBJECTIVES: To examine prevalence trends in the use of smoked tobacco products in 11 South American (SA) countries (i.e., Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Suriname, Uruguay, and Venezuela) and their association with country-specific socio-demographic index (SDI) over 30 years.nnDATA AND METHODS: The estimates of SDI and smoked tobacco prevalence stratified by age, sex, and country were extracted from the Global Burden of Disease Study (1990-2019) on individuals aged 15+. The annual percentage changes (APCs) of trends in country-specific prevalence of smoked tobacco were evaluated using Joinpoint regression. Correlation analysis was also used to explore the association between country-specific prevalence of smoked tobacco and their SDIs, a measure of developmental status considering income per capita, educational attainment, and total fertility rate.nnRESULTS: While all SA countries showed an overall decline in smoked tobacco use prevalence between 1990 and 2019 (APCs between -0.52%-and -4.73%;  < 0.05), Bolivia and Ecuador showed a significant increasing trend (APCs of 0.34% and 0.20%). Country-specific SDI was strongly and significantly correlated (rs = -0.99 to -0.85) with smoking prevalence in SA countries, except for Ecuador and Bolivia (rs = 0.16 and 0.36, respectively).nnCONCLUSION: In recent decades, most SA countries have experienced a significant reduction in the prevalence of smoked tobacco use, except Ecuador and Bolivia, where smoking rates have risen, showing a direct correlation with SDI. These findings can contribute to the design and implementation of strategies and policies for tobacco prevention and control in the SA region especially within the two affected countries - Ecuador and Bolivia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40791264b,

title = {Impact of tobacco control policies on socioeconomic inequalities in smoking prevalence and quit ratios: an ecological study in the European Union (2009-2020)},

author = {Feliu A and Fernandez E and Tamí-Maury I and Martinez C},

doi = {10.1136/bmjph-2024-002418},

issn = {2753-4294},

year  = {2025},

date = {2025-01-01},

journal = {BMJ Public Health},

volume = {3},

number = {2},

pages = {e002418},

abstract = {BACKGROUND: Tobacco control efforts have succeeded in reducing smoking prevalence and increasing smoking cessation rates in the European Union Member States (EU27). However, the impact of these policies has been unequal across different income groups.nnMETHODS: Ecological study with the country as unit of analysis. We used the Tobacco Control Scale (TCS) in EU27 in 2010 and the prevalence of smoking and quit ratios from the Eurobarometer surveys (2009, n=27 788; and 2020, n=28 288). We analysed the relationship between the TCS scores (2010) and smoking indicators and their relative changes (between 2009 and 2020) using scatter plots and multiple linear regression models.nnFINDINGS: In the EU27, high inequalities exist among different income groups. High-income residents had lower smoking prevalence (19 vs 40%) and higher quit ratios (55 vs 32%) compared with the low-income group. Positive changes in smoking indicators from 2009 to 2020 were stronger in the high-income group. There was a stronger negative correlation between TCS scores and smoking prevalence in high-income groups (r=-0.615, p<0.01; r=-0.498; p=0.01) and between its relative changes but only in the high-income group (r=-0.478; p=0.01). A positive correlation was observed between TCS scores and quit ratios (r=0.580, r=0.548, both p<0.01) in high- and moderate-income populations.nnCONCLUSIONS: Declines in smoking prevalence and increases in quit ratios were considerably lower in moderate- and low-income groups. Tailoring tobacco control policies to address financial, social and structural barriers, such as ensuring free access to cessation services, implementing targeted outreach programmes, adopting culturally and linguistically appropriate interventions, among others, is essential for making these measures more equitable, which is key for the EU27 to achieve its tobacco-free goal by 2040.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40756166,

title = {Exposure to secondhand smoke from cigarettes and secondhand aerosol from tobacco and nicotine products in indoor and outdoor public spaces in the European Union: a cross-sectional study},

author = {Li CX and Wang PC and Feliu A and Laverty AA and Martinez C and Peruga A and Girvalaki C and Radu Loghin C and Vardavas CI and Filippidis FT},

doi = {10.1136/bmjph-2025-002903},

issn = {2753-4294},

year  = {2025},

date = {2025-01-01},

journal = {BMJ Public Health},

volume = {3},

number = {2},

pages = {e002903},

abstract = {INTRODUCTION: In December 2024, the Council of the European Union (EU) adopted a recommendation to expand regulations on the use of nicotine-containing products both in indoor settings and specific outdoor areas. This study aimed to examine sociodemographic factors associated with exposure to conventional tobacco smoke and aerosols across the EU and support for relevant regulations.nnMETHODS: We performed a secondary analysis of cross-sectional data from the Special Eurobarometer 99.3 (n=26 358, May-June 2023) across 27 EU Member States (MS). We estimated the weighted prevalence of secondhand exposure to tobacco smoke and aerosols and support for bans on smoking, e-cigarettes and heated tobacco products in public settings. Multilevel Poisson regression models explored associations between sociodemographic factors and these outcomes.nnRESULTS: Exposure to secondhand smoke and aerosols varied across EU MS. Younger individuals, those with higher education, living with children, and current and former tobacco and nicotine users (prevalence ratio (PR) 1.16, 1.01-1.33; and PR 1.22, 1.05-1.41, respectively) were more likely to report exposure to both tobacco smoke and aerosol from emerging products. Women (PR 1.05, 1.02-1.08; and PR 1.03, 1.02-1.05, respectively), those living with children (PR 1.05, 1.02-1.07; and PR 1.04, 1.02-1.07, respectively) and those with higher education levels (PR 1.10, 1.04-1.15; and PR 1.10, 1.06-1.14) were more likely to support bans, whereas those with financial difficulties (PR 0.94, 0.89-0.99 and PR: 0.95, 0.91-0.99, respectively), as well as current and former smokers (PR 0.61, 0.55-0.67; and PR 0.78, 0.73-0.84, respectively) and emerging product users (PR 0.84, 0.76-0.92; and PR 0.69, 0.62-0.76, respectively), were less supportive.nnCONCLUSION: Our analysis found that both exposure to secondhand smoke and aerosol and support for bans in public spaces vary substantially between population subgroups and across countries. Our findings can support EU MS in implementing targeted interventions to increase population support for and implement the recent EU Council recommendations.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40791264,

title = {Impact of tobacco control policies on socioeconomic inequalities in smoking prevalence and quit ratios: an ecological study in the European Union (2009-2020)},

author = {Feliu A and Fernandez E and Tamí-Maury I and Martinez C},

doi = {10.1136/bmjph-2024-002418},

issn = {2753-4294},

year  = {2025},

date = {2025-01-01},

journal = {BMJ Public Health},

volume = {3},

number = {2},

pages = {e002418},

abstract = {BACKGROUND: Tobacco control efforts have succeeded in reducing smoking prevalence and increasing smoking cessation rates in the European Union Member States (EU27). However, the impact of these policies has been unequal across different income groups.nnMETHODS: Ecological study with the country as unit of analysis. We used the Tobacco Control Scale (TCS) in EU27 in 2010 and the prevalence of smoking and quit ratios from the Eurobarometer surveys (2009, n=27 788; and 2020, n=28 288). We analysed the relationship between the TCS scores (2010) and smoking indicators and their relative changes (between 2009 and 2020) using scatter plots and multiple linear regression models.nnFINDINGS: In the EU27, high inequalities exist among different income groups. High-income residents had lower smoking prevalence (19 vs 40%) and higher quit ratios (55 vs 32%) compared with the low-income group. Positive changes in smoking indicators from 2009 to 2020 were stronger in the high-income group. There was a stronger negative correlation between TCS scores and smoking prevalence in high-income groups (r=-0.615, p<0.01; r=-0.498; p=0.01) and between its relative changes but only in the high-income group (r=-0.478; p=0.01). A positive correlation was observed between TCS scores and quit ratios (r=0.580, r=0.548, both p<0.01) in high- and moderate-income populations.nnCONCLUSIONS: Declines in smoking prevalence and increases in quit ratios were considerably lower in moderate- and low-income groups. Tailoring tobacco control policies to address financial, social and structural barriers, such as ensuring free access to cessation services, implementing targeted outreach programmes, adopting culturally and linguistically appropriate interventions, among others, is essential for making these measures more equitable, which is key for the EU27 to achieve its tobacco-free goal by 2040.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39265319b,

title = {[From evidence to practice: The Disemination and Implementation Science in primary care]},

author = {Martínez C and Camarelles Guillem F and González-Viana A and Sánchez Á and Tigova O and Fernández E},

doi = {10.1016/j.aprim.2024.103077},

issn = {1578-1275},

year  = {2025},

date = {2025-01-01},

journal = {Aten Primaria},

volume = {57},

number = {1},

pages = {103077},

abstract = {Dissemination and Implementation Science focuses on bridging the gap between scientific research and its practical application in the real world. By identifying and promoting effective strategies, the Science of Dissemination and Implementation disseminates and implements evidence-based interventions in healthcare settings, taking into account the needs, barriers, context, resources, and end users. This special article introduces and debates the most recent advances in this field, highlighting key approaches, theoretical frameworks, as well as specific challenges and opportunities applied to primary and community care. Additionally, concrete examples tailored to the Spanish context are presented. Given the nascent state of the use of the Dissemination and Implementation Science in Spain, the authors recommend strategically adopting this approach and its principles in primary and community care to expedite the adoption of effective interventions that promote health.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39838401,

title = {Clinician's perceptions and experiences with tobacco treatment in people who use cannabis: a qualitative study},

author = {Martínez C and Pla M and Feliu A and Enríquez M and Saura J and Cabezas C and Colom J and Suelves JM and Mondon S and Barrio P and Andreu M and Raich A and Bernabeu J and Roca X and Narváez M and Fernández E and Group of clinicians of the ACT_ATAC study},

doi = {10.1186/s13011-024-00632-8},

issn = {1747-597X},

year  = {2025},

date = {2025-01-01},

journal = {Subst Abuse Treat Prev Policy},

volume = {20},

number = {1},

pages = {3},

abstract = {INTRODUCTION: Global demand for the treatment of cannabis use disorder has increased significantly, prompting a need to understand effective strategies for addressing concurrent cannabis and tobacco use. This study focuses on clinicians' experiences and perceptions in delivering tobacco cessation services to people who use cannabis.nnMETHODS: Fifteen participants (12 females, 3 males) participated in three homogenous focus groups, including two groups with extensive experience in providing tobacco cessation among the substance use population in Catalonia, Spain, and one group of clinicians without such experience. Thematic analysis was conducted to identify key patterns and insights in their discourse, focusing on shared themes and divergences across groups.nnRESULTS: Five main themes and 17 subthemes emerged: Individual characteristics, Clinician characteristics, Models of intervention, Organizational healthcare models, and Health policies. Clinicians stressed the importance of intervention models and the active role of professionals in addressing tobacco use within routine care, as tobacco cessation could mitigate social and chronic stigma among people who use cannabis, especially those engaged in polydrug use.nnDISCUSSION AND CONCLUSIONS: Recommendations included integrating tobacco cessation into all services, reducing healthcare service fragmentation, improving resource accessibility, enhancing clinical documentation, and advocating for stronger population-level tobacco control policies.nnTRIAL REGISTRATION: The ACT-ATAC project has been successfully registered at Clinicaltrials.gov [NCT04841655].},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40495994,

title = {Tobacco imagery in prime-time television in Spain: A content analysis},

author = {Peruga A and Tigova O and Feliu A and Carnicer-Pont D and Anton L and Bosch F and Rey-Pino JM and Salto E and Fernández E and Martínez C},

doi = {10.18332/tid/204750},

issn = {1617-9625},

year  = {2025},

date = {2025-01-01},

journal = {Tob Induc Dis},

volume = {23},

abstract = {INTRODUCTION: Exposure to tobacco content in media among youth is a well-established risk factor for smoking initiation and continued use. This study assessed the prevalence and nature of tobacco imagery on Spanish prime-time television (TV) programming and its associations with program characteristics: genre, production nationality, and broadcast timing.nnMETHODS: A content analysis of 63959 minutes of TV programming in 2021, excluding advertisements and trailers, across 18 broadcast channels examined the presence of tobacco imagery: actual tobacco use, tobacco cultural cues, smoking ban violations, tobacco brand appearances, or any of these.nnRESULTS: The analysis revealed that 2.4% of the TV programming time contained at least one instance of tobacco imagery, resulting in 8.5 million impressions for viewers aged 4-24 years. Feature films had the highest prevalence of tobacco-related content (adjusted prevalence ratio, APR=11.9; 95% CI: 9.5-14.9). Tobacco-related content appeared more frequently outside designated children's protection hours (PR=0.7; 95% CI: 0.6-0.80). However, its presence within the designated children's protection schedule remains a significant concern, generating 15.6 million tobacco impressions for young viewers.nnCONCLUSIONS: The seemingly modest content level of tobacco imagery (2.4%) translates into a substantial number of impressions for young viewers aged 4-24 years, including during the designated children's protection schedule. Reducing tobacco imagery in films and TV series represents a promising strategy for curbing youth smoking. However, the current reliance on youth protection schedules is inadequate. To better protect children from tobacco imagery, policies should mandate strong anti-tobacco disclaimers preceding programs featuring tobacco and certificates of No Pay-off for tobacco portrayals.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40443706,

title = {Recommendations for updating regulations on advertising, promotion and sponsorship of tobacco and nicotine products in the European Union},

author = {Koprivnikar H and Carnicer-Pont D and López AM and González-Marrón A and Sæbø G and Gallus S and Possenti I and Lambrou A and Papachristou E and Pénzes M and Schoretsaniti S and Arteta N and Fernández E},

doi = {10.18332/tpc/204275},

issn = {2459-3087},

year  = {2025},

date = {2025-01-01},

journal = {Tob Prev Cessat},

volume = {11},

abstract = {INTRODUCTION: Comprehensive bans on advertising, promotion and sponsorship of tobacco and nicotine products (TAPS) have proven effective in reducing their use. The Joint Action on Tobacco Control 2 (JATC2) aims to identify TAPS gaps in the current European Union (EU) regulations and to provide comprehensive recommendations for updating them.nnMETHODS: An online consultation with European TAPS national experts was conducted in 2023. Seventy-seven experts from 27 European countries were contacted and 38 experts from 21 countries participated in the consultation.nnRESULTS: Significant gaps in current TAPS regulations were identified, particularly in entertainment, online media and points of sale. Citizens are not adequately protected from TAPS, the tobacco industry extensively uses loopholes to circumvent regulations. TAPS-related issues currently affect tobacco and particularly non-therapeutic nicotine products, devices, accessories, products imitations and all marketing channels, entertainment, online media and especially, social networks. To address these challenges, regulations should include bans on internet sales and TAPS at points of sale, licensing, decreased retail availability, plain packaging and ban on corporate social responsibility actions, corporate promotion and 'brand stretching'. These measures should be accompanied by effective monitoring and enforcement, dissuasive sanctions, formalized collaboration among countries and international collaboration, civil society involvement, strong public education, and community awareness programs.nnCONCLUSIONS: There is an urgent need to address the current gaps in the EU TAPS regulations through comprehensive and harmonized TAPS bans across all EU countries. Updated regulations must anticipate emerging industry strategies and new products, ensuring continuous adaptation to counteract them effectively.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40241742,

title = {Mapping indicators of tobacco and related product use: Unveiling challenges and variations in the Eurobarometer surveys over three decades},

author = {Teshima A and Martínez C and Filippidis FT and Laverty AA and Vardavas CI and Feliu A and Peruga A and Fernandez E},

doi = {10.18332/tid/202651},

issn = {1617-9625},

year  = {2025},

date = {2025-01-01},

journal = {Tob Induc Dis},

volume = {23},

abstract = {INTRODUCTION: The European Commission's Special Eurobarometer surveys on tobacco are widely used as comparable and representative data across the European Union for monitoring consumption patterns. Despite their broad use, certain challenges persist, including inconsistencies in survey timelines and variations in the collected information across waves. This study aims to identify available tobacco and related product indicators, and assess their temporal comparability, to support researchers to better understand the potential uses of these data and their alignment with other sources.nnMETHODS: We explored questionnaires and reports in these surveys on tobacco from the Eurobarometer official website since its inception (1992, 2002, 2005, 2006, 2008, 2009, 2012, 2014, 2017, 2020 and 2023 waves). We extracted and compared questions and responses on use of tobacco and related products, as well as on sociodemographic variables. Finally, we compared all indicators, including frequency and wording, and further mapped the consistency of the indicators and type of product used across the different waves.nnRESULTS: Current, daily, former and never use of conventional cigarettes has been consistently assessed across all waves, enabling temporal comparisons. From 2009, the surveys have expanded to include e-cigarette use; since 2012, the surveys include various combusted products such as cigars, pipes, cigarillos, and waterpipes, and from 2020, heated tobacco products. By contrast, detailed data on product-specific use intensity and initiation remain limited. While indicators for secondhand smoke exposure and smoking cessation were present in multiple waves, their comparability is hindered by variations in question-wording and responses.nnCONCLUSIONS: Some challenges exist in using Eurobarometer surveys for temporal estimation of tobacco-related burden. Nonetheless, these surveys remain a valuable and unique tool for monitoring tobacco and related product use across the European Union. To further enhance their utility, periodic re-evaluation by tobacco control experts is recommended to ensure that the surveys maintain comparability with past data while capturing effectively emerging products and trends.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39265319,

title = {[From evidence to practice: The Disemination and Implementation Science in primary care]},

author = {Martínez C and Camarelles Guillem F and González-Viana A and Sánchez Á and Tigova O and Fernández E},

doi = {10.1016/j.aprim.2024.103077},

issn = {1578-1275},

year  = {2025},

date = {2025-01-01},

journal = {Aten Primaria},

volume = {57},

number = {1},

pages = {103077},

abstract = {Dissemination and Implementation Science focuses on bridging the gap between scientific research and its practical application in the real world. By identifying and promoting effective strategies, the Science of Dissemination and Implementation disseminates and implements evidence-based interventions in healthcare settings, taking into account the needs, barriers, context, resources, and end users. This special article introduces and debates the most recent advances in this field, highlighting key approaches, theoretical frameworks, as well as specific challenges and opportunities applied to primary and community care. Additionally, concrete examples tailored to the Spanish context are presented. Given the nascent state of the use of the Dissemination and Implementation Science in Spain, the authors recommend strategically adopting this approach and its principles in primary and community care to expedite the adoption of effective interventions that promote health.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39846443,

title = {Trends and Association between Smoking and the Socio-Demographic Index Among 11 South American Countries, 1990-2019},

author = {Afolayan OK and Velazquez J and Tundealao S and Fernández E and Martínez C and Leon-Novelo L and Retamales J and Tamí-Maury I},

doi = {10.1080/10826084.2024.2440384},

issn = {1532-2491},

year  = {2025},

date = {2025-01-01},

journal = {Subst Use Misuse},

volume = {60},

number = {4},

pages = {566--576},

abstract = {OBJECTIVES: To examine prevalence trends in the use of smoked tobacco products in 11 South American (SA) countries (i.e., Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Suriname, Uruguay, and Venezuela) and their association with country-specific socio-demographic index (SDI) over 30 years.nnDATA AND METHODS: The estimates of SDI and smoked tobacco prevalence stratified by age, sex, and country were extracted from the Global Burden of Disease Study (1990-2019) on individuals aged 15+. The annual percentage changes (APCs) of trends in country-specific prevalence of smoked tobacco were evaluated using Joinpoint regression. Correlation analysis was also used to explore the association between country-specific prevalence of smoked tobacco and their SDIs, a measure of developmental status considering income per capita, educational attainment, and total fertility rate.nnRESULTS: While all SA countries showed an overall decline in smoked tobacco use prevalence between 1990 and 2019 (APCs between -0.52%-and -4.73%;  < 0.05), Bolivia and Ecuador showed a significant increasing trend (APCs of 0.34% and 0.20%). Country-specific SDI was strongly and significantly correlated (rs = -0.99 to -0.85) with smoking prevalence in SA countries, except for Ecuador and Bolivia (rs = 0.16 and 0.36, respectively).nnCONCLUSION: In recent decades, most SA countries have experienced a significant reduction in the prevalence of smoked tobacco use, except Ecuador and Bolivia, where smoking rates have risen, showing a direct correlation with SDI. These findings can contribute to the design and implementation of strategies and policies for tobacco prevention and control in the SA region especially within the two affected countries - Ecuador and Bolivia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38944617,

title = {Incidence and Determinants of COVID-19 Among People Who Smoke (2018-2021): Findings From the ITC EUREST-PLUS Spain Surveys},

author = {Carnicer-Pont D and Fu M and Castellano Y and Tigova O and Driezen P and Quah ACK and Kaai SC and Soriano JB and Vardavas CI and Fong GT and Fernández E},

doi = {10.1016/j.arbres.2024.05.037},

issn = {1579-2129},

year  = {2024},

date = {2024-11-01},

journal = {Arch Bronconeumol},

volume = {60},

number = {11},

pages = {690--697},

abstract = {OBJECTIVE: To estimate the cumulative incidence of COVID-19 and its determinants among a nationally representative sample of adults from Spain who smoke.nnMETHODS: This is a prospective cohort study that uses data from two waves (Wave 2 in 2018 and Wave 3 in 2021) of the ITC EUREST-PLUS Spain Survey. At baseline (Wave 1 in 2016), all respondents were adults (aged ≥18) who smoked. In total, 1008 respondents participated in Wave 2, and 570 out of 888 eligible participants were followed up in Wave 3 (64.2%). We estimated the cumulative incidence and the relative risk of COVID-19 (RR) and 95% confidence intervals (CI) during follow-up using self-reported information on sociodemographic, smoking-related and health-related characteristics and identified associated factors using multivariable Poisson models with robust variance adjusted for the independent variables.nnRESULTS: The overall cumulative incidence of self-reported COVID-19 was 5.9% (95% CI: 3.9-8.0%), with no significant differences between males (6.3%; 95% CI: 3.6-9.0%) and females (5.6%; 95% CI: 3.2-8.0%). After adjusting for age, sex, and educational level, COVID-19 incidence was positively associated with moderate nicotine dependence (RR: 2.37; 95% CI: 1.04-5.40) and negatively associated with having a partner who smoked (RR: 0.12; 95% CI: 0.03-0.42), and having friends but not a partner who smoked (RR: 0.28; 95% CI: 0.14-0.56).nnCONCLUSION: The correlates of having had COVID-19 among people who smoke should be considered when tailoring information and targeted non-pharmacological preventive measures.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39308778,

title = {More or less "modest" versus significant excess mortality due to COVID-19 deaths in Europe},

author = {Soriano JB and Peláez A and Lumbreras S and Fernández E and Ancochea J},

doi = {10.1016/j.lanepe.2024.101060},

issn = {2666-7762},

year  = {2024},

date = {2024-10-01},

journal = {Lancet Reg Health Eur},

volume = {45},

pages = {101060},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38288784,

title = {Quitline nurses' experiences in providing telephone-based smoking cessation help to mental health patients: A mixed methods study},

author = {Rosa N and Feliu A and Ballbè M and Alaustre L and Vilalta E and Torres N and Nieva G and Pla M and Pinet C and Raich A and Mondon S and Barrio P and Andreu M and Suelves JM and Vilaplana J and Enríquez M and Castellano Y and Guydish J and Fernández E and Martínez C},

doi = {10.1111/jpm.13012},

issn = {1365-2850},

year  = {2024},

date = {2024-10-01},

journal = {J Psychiatr Ment Health Nurs},

volume = {31},

number = {5},

pages = {755--766},

abstract = {WHAT IS KNOWN ON THE SUBJECT?: Quitlines are known to be effective in helping people quit smoking, including those with mental health conditions. It is particularly important to address smoking in this population as the prevalence of smoking ranges from 40% to 75%. However, professionals working in quitlines often face barriers due to their limited training and resources to effectively support these smokers quit, especially if they are not mental health professionals. Therefore, training programmes should be developed to enhance their knowledge and skills in providing smoking cessation support to this vulnerable population. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The '061 QUIT-MENTAL study' evaluated the efficacy of a proactive telephone-based intervention for smoking cessation among smokers with severe mental health disorders. Conducted through a quitline service in Catalonia, Spain, the study focused on training non-mental health specialized nurses and other health professionals to provide evidence-based interventions for promoting smoking cessation among individuals with mental health disorders. The objective of this study is to assess the changes in nurses' knowledge and readiness to treat smokers with mental health conditions, while also capturing their insights and perceptions regarding the facilitators and barriers to providing smoking cessation interventions. The training and insights of the nurses were integral to conducting this research and providing valuable information for the future sustainability of such interventions. This is particularly important as quitlines hold the potential to offer cessation support to these patients at the community level. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: While the training programme was successful in improving non-mental health specialized nurses' knowledge and motivation skills to help patients with mental health disorders quit smoking, they encountered obstacles in delivering this intervention over the phone. These difficulties were mainly due to challenges in reaching participants and delivering the intervention as detailed in the protocol. The study highlights the need of reducing barriers for providers in attending to these patients, particularly if they are non-mental health specialized professionals. By minimizing the stigmatization associated with caring for mentally ill individuals and promoting coordination with specialists, innovative approaches may be introduced to alleviate the burden of tobacco-related diseases among this population. ABSTRACT: Introduction The viewpoint of those who implement a programme for the first time is crucial for understanding its impact and ensuring its long-term viability. The 061 QUIT-MENTAL study was a pragmatic randomized controlled trial evaluating a proactive telephone-based intervention addressed to mental health patients conducted by non-psychiatric specialized nurses. Aim We assessed nurses' knowledge of smoking cessation interventions addressed to this population before and after receiving training and their insights after delivering the intervention. Method Mixed methods study: (1) Pre-post evaluation to assess self-reported knowledge, self-efficacy and opinions about smoking cessation. (2) In-depth interviews with key nurses to ascertain their perceptions regarding the impact of the training received in delivering the study intervention. Results The training enhanced nurses' knowledge of psychological and pharmacological resources to aid these patients, as well as their ability to increase their motivation to quit. However, nurses reported difficulties in delivering population-based interventions to individuals with mental health disorders. These challenges primarily arose from participants being hard to reach, exhibiting low motivation to quit, struggling to comprehend instructions or follow recommendations, and nurses feeling unsure about their capacity to assist individuals with mental illnesses in quitting, despite the training they received. Discussion Despite the training and protocol designed to facilitate the delivery of the intervention, nurses faced difficulties in providing population-based interventions to individuals with mental health disorders. Implications for Practice Future quitline programmes aimed at the population with mental health disorders should strive to reduce barriers for providers in attending to these patients, particularly if they are non-mental health specialized professionals. By minimizing the stigmatization associated with caring for mentally ill individuals and promoting coordination with specialists, innovative approaches may be introduced to alleviate the burden of tobacco-related diseases among this population.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38916135,

title = {Improving tobacco cessation interventions in hospitals: Pre-post evaluation of an innovative health systems intervention in Catalonia (Spain)},

author = {Martínez C and Feliu A and Enriquez M and Antón L and Castellano Y and Company A and Romero O and Ripoll R and Ruz A and Papadakis S and Fernández E},

doi = {10.1093/tbm/ibae016},

issn = {1613-9860},

year  = {2024},

date = {2024-09-01},

journal = {Transl Behav Med},

volume = {14},

number = {9},

pages = {549--560},

abstract = {This study measured changes in healthcare professionals' (HCPs) performance in tobacco cessation intervention before and 6 months after a health system intervention. The intervention involved exposure to online training for staff and the implementation of a structured organizational change-level practice model that included some strategies, comprising establishing tobacco cessation steering groups with champions in each hospital, developing tailored protocols and guidelines within each organization, conducting on-site workshops for clinicians, and creating posters and pocket materials summarizing the intervention. Pre-post evaluation in four hospitals in Barcelona province (Catalonia, Spain). We assessed the knowledge, attitudes, behaviors, and organizational factors (KABO) and the performance of each of the components of the 5As Model for Treating Tobacco Use according to a scale from 0 ("Never") to 10 ("Always") among HCPs. We performed Wilcoxon signed-rank tests for paired samples and assessed changes in performance by performing linear regression. A total of 255 HCPs completed the pre-post evaluation. All components of the 5As Model increased, with "Assist" and "Arrange a follow-up" showing the greatest improvement. Several KABO dimensions significantly increased, including individual skills (mean score: 3.3-5.7, P < .001), attitudes and beliefs (4.8-5.4, P < .001), individual commitment (5.9-6.6, P < .001), and perception of having positive organizational support (4.3-4.7, P < .001). An increase in each point in individual skills and support of the organization was associated with increased rates of 5As delivery, with the greatest associations found for "Assist" (0.60 and 0.17, respectively) and "Arrange a follow-up" (0.71 and 0.18, respectively). The intervention was successful in increasing HCPs individual skills, attitudes and beliefs, individual commitment, and perception of having positive organizational support and the performance of all components of the 5As. Future research should focus on strategies that promote organizational support, a dimension that is essential to increasing Assist and Arrange, which were less implemented at baseline.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36975072,

title = {Training mental health residents in tobacco and alcohol: Relationship with their clinical intervention},

author = {Mondon S and Raich A and Martí C and Fernández E and Ballbè M and La Red Catalana de Hospitales Sin Humo GTTYSM},

doi = {10.20882/adicciones.1837},

issn = {0214-4840},

year  = {2024},

date = {2024-09-01},

journal = {Adicciones},

volume = {36},

number = {3},

pages = {277--286},

abstract = {The objective of this study is to describe how mental health professionals in training (residents) apply the brief intervention (5As) on the tobacco and alcohol consumption to their patients, and if this is related to the training received and/or their own consumption. This is a cross-sectional study in which a self-reported questionnaire was administered to first-year residents of mental health professionals in Catalonia (2016-2019) (psychiatrists, psychologists and nurses). We performed a descriptive analysis of the variables and we applied a chi-square test for the comparison of proportions. 154 professionals completed the questionnaire. Half of them had not received any university training on intervention in smoking (46.8%) or in alcohol consumption (53.2%). Those who had received it, advised, assessed and helped their patients to quit smoking more frequently (p = 0.008, p = 0.037 and p = 0.039; respectively). Those who had received training in alcohol intervention gave advice, performed assessments and offered help to quit/reduce alcohol among their patients more frequently (p < 0,001; p = 0,001; y p < 0,001; respectively). Residents usually helped more to quit or reduce alcohol than to quit tobacco (p < 0,001). 60.1% of them never or rarely helped their patients to stop smoking and 34.6% rarely helped in the case of alcohol. In general, nurses did more intervention for tobacco than alcohol use, regardless of the training received. The lack of training of professionals in tobacco and alcohol intervention at university is related to a lack of intervention on patients in their professional practice, regardless of their own consumption.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39298750,

title = {Patterns of Use and Withdrawal Syndrome in Dual Cannabis and Tobacco Users (DuCATA_GAM-CAT): Protocol for a Mixed Methods Study},

author = {Saura J and Feliu A and Enríquez-Mestre M and Fu M and Ballbè M and Castellano Y and Pla M and Rosa N and Radeva P and Maestre-González E and Cabezas C and Colom J and Suelves JM and Mondon S and Barrio P and Andreu M and Raich A and Bernabeu J and Vilaplana J and Roca Tutusaus X and Guydish J and Fernández E and Martínez C},

doi = {10.2196/58335},

issn = {1929-0748},

year  = {2024},

date = {2024-09-01},

journal = {JMIR Res Protoc},

volume = {13},

pages = {e58335},

abstract = {BACKGROUND: Approximately 1 in 6 cannabis users develop a cannabis use disorder (CUD) and the odds increase to 1 in 2 for daily users.nnOBJECTIVE: The Dual use of Cannabis and Tobacco Monitoreing through a Gamified Web app (DuCATA_GAM-CaT) project aims to identify cannabis-tobacco patterns of use and withdrawal symptoms among individuals with CUD who are attending substance abuse programs.nnMETHODS: The project uses a mixed methods approach consisting of 3 studies. First, a participatory qualitative study involves focus groups comprising individuals with CUD, clinicians, project researchers, and an expert gamification company to co-design a gamified web app. Second, a longitudinal prospective study to follow up individuals over 6 weeks with CUD attending substance abuse programs . Participants report their cannabis-tobacco usage patterns, type and frequency of tobacco use, nicotine dependence, withdrawal symptoms, psychoemotional factors, and motivation to quit both substances. Predictive analysis techniques are used to analyze clinical, demographic, psychological, and environmental data to predict the probability of achieving abstinence. Third, homogeneous focus groups to explore participants' experiences during their CUD treatment.nnRESULTS: By June 2024, the project had completed the first study, defining eligible cannabis user profiles, developed the initial web app prototype, and initiated recruitment across 10 centers, with 74 participants enrolled, aiming to reach 150 participants in total.nnCONCLUSIONS: All participants are required to provide informed consent, and their information is kept confidential and anonymized following confidentiality rules. The research team is committed to disseminating the results obtained to professional and patient groups, as well as informing public health agents, to positively influence political and social decision makers and design programmers. Additionally, we aim to prioritize the publication of the results in high-impact journals specialized in drug abuse, public health, and health care services research.nnTRIAL REGISTRATION: ClinicalTrials.gov NCT05512091; https://clinicaltrials.gov/study/NCT05512091.nnINTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58335.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38804329,

title = {[What does Harm Reduction in Tobacco Use means to Public Health]},

author = {Ayesta J and Peruga A and Rebollar A and Rey N and Zamorano A and Verdejo S and Panero J and Doncel JC and Martín A and Pérez-Sacristán EM},

issn = {2173-9110},

year  = {2024},

date = {2024-05-01},

journal = {Rev Esp Salud Publica},

volume = {98},

abstract = {Harm reduction is a classic Public Health concept to refer to the reduction of the negative effect of drug use/abuse with a focus on justice and human rights, but the tobacco industry has been perverting this concept for years and using it as a tool for its own marketing. This publication details what real harm reduction action on tobacco use would be, when it should be implemented, and what pillars it should be based on. Different methods of reducing the harmful effects of tobacco and nicotine have been tried and tested over time, but the results have been poor; therefore, smoking cessation by the various officially recognised methods is recommended as a priority objective, using the tools that are truly supported by science. In contrast, it also explains the strategies developed by the industry to manipulate consumers and make them dependent on products that can eventually kill them: from the development of filtered cigarettes to light cigarettes, and from menthol to flavoured vapes. In all cases, they have falsely led people to believe that they were developing less toxic products when they were not. Nowadays, both light and menthol cigarettes are banned in Spain, filters have not reduced risk but increased the use, and vapes try to replace cigarettes with their attractive flavours and their false legend of healthier products when what they are really doing is maintaining the same addiction by changing the object, encouraging dual use, and attracting younger and younger non-smokers. At the same time, a strategy of dividing the opinion of health professionals has been developed, using medical doctors and researchers with recognised conflicts of interest but who manage to confuse consumers. In conclusion, we consider that, although nicotine releasing devices may be useful elements in some particular cases, they are not recommended at the population level as they can promote onset, prevent cessation, as well as maintaining the addictive capacity. The only nicotine products that are recommended are those of pharmacological use approved for the case and provided they are used as a transitional tool to complete cessation.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40936741,

title = {EFFECTIVENESS OF A POST-DISCHARGE PHONE-BASED SMOKING CESSATION INTERVENTION FOR PATIENTS WITH SEVERE MENTAL HEALTH DISORDERS: THE 061 QUITMENTAL RANDOMIZED CONTROLLED CLINICAL TRIAL},

author = {Martínez C and Feliu A and Saura J and Nieva G and Pinet C and Raich A and Mondon S and Barrio P and Andreu M and Hernández-Ribas R and Costa S and Suelves JM and Vilaplana J and Enríquez M and Alaustre L and Vilalta E and Alvarez JB and Guydish J and 061 Quitmental Group and Fernández E and Ballbè M},

doi = {10.1007/s11469-024-01254-8},

issn = {1557-1874},

year  = {2024},

date = {2024-02-01},

journal = {Int J Ment Health Addict},

abstract = {A pragmatic double-blind randomized controlled trial was conducted in Barcelona to assess a telephone-based smoking cessation intervention's effectiveness for individuals with mental health disorders post-discharge. Participants were divided into an Intervention Group (IG) and Control Group (CG) with a 2:1 allocation ratio. The IG received proactive motivational assistance, while the CG received brief advice. Biochemically validated past 7-day abstinence was the main outcome measure. Of 530 screened individuals, 294 were enrolled (200 IG, 94 CG). During follow-up, participants reported 97 episodes of ≥7-day abstinence (IG: 51, CG: 26). Overall abstinence probability was 30-35%, with no difference between groups at one-year follow-up. However, intervention participants were more likely to report abstinence if they quit during hospitalization or were considering quitting. The intervention effectively supported smoking abstinence in motivated individuals. Combining this with clinical and community-based interventions holds promise for aiding smoking cessation in those with mental disorders.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39398343,

title = {Assessment of exposure to secondhand tobacco smoke in Spain: A scoping review},

author = {Blanco-Ferreiro A and Teijeiro A and Varela-Lema L and Rey-Brandariz J and Candal-Pedreira C and Martin-Gisbert L and García G and Galán I and Fernández E and Mourino N and Pérez-Ríos M},

doi = {10.18332/tid/192118},

issn = {1617-9625},

year  = {2024},

date = {2024-01-01},

journal = {Tob Induc Dis},

volume = {22},

abstract = {INTRODUCTION: There is no consensus on the questions that should be included in questionnaires to properly ascertain exposure to secondhand tobacco smoke (SHS). The objective of this study is to analyze the questions included in studies which have assessed SHS exposure in Spain.nnMETHODS: A scoping review was performed, using PubMed, Embase and Web of Science databases, selecting original articles published in English and Spanish, across the period 2012-2021. We extracted data from each study regarding its design, target population, sample size or geographical scope; we also collected data regarding how studies dealt with exposure to SHS including assessment and intensity of SHS, exposure setting, geographical scope, and the verbatim questions used.nnRESULTS: Finally, 75 studies were identified. In the 23 studies carried out in children, verbatim questions were included in 8 studies, and the setting most studied was the home. SHS exposure was assessed during pregnancy and postnatally by 8 studies, the verbatim questions used were described in 2 studies, being exposure ascertained at home and workplace. In the adult population, 14 of 44 studies described the verbatim questions; the setting most studied was the home. Verbatim questions varied among studies.nnCONCLUSIONS: Questionnaire-based assessment of SHS exposure is highly heterogeneous, hindering comparability between studies. Therefore, it is necessary to set a standard questionnaire to assess exposure to SHS.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38910916,

title = {Changes in prevalence and socioeconomic inequalities in secondhand smoke exposure in Spanish children, 2016-2019},

author = {Sanz-Mas M and Continente X and Henderson E and Fernández E and Schiaffino A and Pérez-Ríos M and Espelt A and Guxens M and López MJ},

doi = {10.18332/tid/189392},

issn = {1617-9625},

year  = {2024},

date = {2024-01-01},

journal = {Tob Induc Dis},

volume = {22},

abstract = {INTRODUCTION: Children are vulnerable to secondhand smoke (SHS) exposure, especially those with lower socioeconomic status. This study assesses the changes in prevalence and socioeconomic inequalities in SHS exposure in children younger than 12 years old in Spain between 2016 and 2019.nnMETHODS: We conducted two cross-sectional studies among representative samples of households with children aged <12 years in Spain, in 2016 (n=2411) and 2019 (n=2412). Families were interviewed to assess children's SHS exposure in private settings and outdoor public venues and their adoption of home and car smoke-free rules. We used the education level of the home main earner as a proxy for socioeconomic position. Changes over time in the prevalence and socioeconomic inequalities of SHS exposure and smoke-free rules were estimated through adjusted Poisson regression models with robust variance according to sociodemographic covariates (adjusted prevalence ratios, APRs).nnRESULTS: In 2019, 70.5% of children were exposed to SHS in Spain. No changes between 2016 and 2019 were found for overall SHS exposure, exposure at home, and at school entrances. SHS exposure increased at public transport stations (APR=1.24; 95% CI: 1.03-1.49) and outdoor hospitality venues (APR=1.17; 95% CI: 1.07-1.29) while it decreased in cars (APR=0.74; 95% CI: 0.56-0.98) and parks (APR=0.87; 95% CI: 0.77-0.98). Households with lower education level had higher prevalence of SHS exposure at home in 2019 compared with those with university studies (primary: APR=1.30; 95% CI: 1.11-1.51; secondary: APR=1.12; 95% CI: 1.00-1.25) and were less likely to adopt home indoor smoke-free rules (primary: APR=0.88; 95% CI: 0.79-0.99; secondary: APR=0.95; 95% CI: 0.89-1.02). Socioeconomic inequalities in SHS exposure at home persisted between 2016 and 2019 (p>0.05), while decreased in smoke-free rules in cars (p=0.039).nnCONCLUSIONS: Reported SHS exposure among children in Spain remained high between 2016 and 2019. Inequalities persisted at home, highlighting the need for measures to reduce such exposure with an equity perspective.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33879426,

title = {Particulate matter in aerosols produced by two last generation electronic cigarettes: a comparison in a real-world environment},

author = {Borgini A and Veronese C and De Marco C and Boffi R and Tittarelli A and Bertoldi M and Fern Ndez E and Tigova O and Gallus S and Lugo A and Gorini G and Carreras G and L Pez MJ and Continente X and Semple S and Dobson R and Clancy L and Keogan S and Tzortzi A and Vardavas C and Nicol S LP and Starchenko P and Soriano JB and Ruprecht AA and TackSHS Project Investigators},

doi = {10.1016/j.pulmoe.2021.03.005},

issn = {2531-0437},

year  = {2024},

date = {2024-01-01},

journal = {Pulmonology},

volume = {30},

number = {2},

pages = {137--144},

abstract = {The design of e-cigarettes (e-cigs) is constantly evolving and the latest models can aerosolize using high-power sub-ohm resistance and hence may produce specific particle concentrations. The aim of this study was to evaluate the aerosol characteristics generated by two different types of electronic cigarette in real-world conditions, such as a sitting room or a small office, in number of particles (particles/cm). We compared the real time and time-integrated measurements of the aerosol generated by the e-cigarette types Just Fog and JUUL. Real time (10s average) number of particles (particles/cm) in 8 different aerodynamic sizes was measured using an optical particle counter (OPC) model Profiler 212-2. Tests were conducted with and without a Heating, Ventilating Air Conditioning System (HVACS) in operation, in order to evaluate the efficiency of air filtration. During the vaping sessions the OPC recorded quite significant increases in number of particles/cm. The JUUL e-cig produced significantly lower emissions than Just Fog with and without the HVACS in operation. The study demonstrates the rapid volatility or change from liquid or semi-liquid to gaseous status of the e-cig aerosols, with half-life in the order of a few seconds (min. 4.6, max 23.9), even without the HVACS in operation. The e-cig aerosol generated by the JUUL proved significantly lower than that generated by the Just Fog, but this reduction may not be sufficient to eliminate or consistently reduce the health risk for vulnerable non e-cig users exposed to it.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39293184,

title = {[How is the compliance with the tobacco control law in hospitaty terraces?]},

author = {López MJ and Fu M and Fernández E and Henderson E and Continente X},

doi = {10.1016/j.gaceta.2024.102422},

issn = {1578-1283},

year  = {2024},

date = {2024-01-01},

journal = {Gac Sanit},

volume = {38},

pages = {102422},

abstract = {OBJECTIVE: To describe tobacco consumption and the compliance with the law on hospitality terraces in Barcelona.nnMETHOD: Cross-sectional study by observation in a sample of 120 hospitality terraces in Barcelona. 30-minute observations were made using a standardized record sheet. The study variables were number of people smoking, number of cigarettes smoked, cigarette butts, socioeconomic status of the neighborhood, time of observation, consumption regulation, number of chairs and number of persons.nnRESULTS: There were people smoking at the time of the observation in 97.5% of the terraces, with no differences according to socioeconomic level of the neighborhood or the regulation of the terrace. There was no compliance with the law in 100% of the terraces where smoking was banned.nnCONCLUSIONS: The widespread non-compliance with the current law indicates the need to implement a smoking ban without exceptions on hospitality terraces.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38978612,

title = {Determinants of tobacco use transitions in smoker nursing students in Catalonia: A prospective longitudinal study},

author = {Laroussy K and Fernández E and Castellano Y and Fu M and Baena A and Feliu A and Peruga A and Margalef M and Tigova O and Galimany J and Puig M and Moreno C and Bueno A and López A and Roca J and Saura J and Martínez C},

doi = {10.18332/tid/189484},

issn = {1617-9625},

year  = {2024},

date = {2024-01-01},

journal = {Tob Induc Dis},

volume = {22},

abstract = {INTRODUCTION: The use of emerging tobacco and nicotine products affects tobacco use behaviors among college students. Thus, we aimed to examine transitions in tobacco use patterns and identify their predictors among smokers in a cohort of nursing students in Catalonia (Spain).nnMETHODS: We conducted a prospective longitudinal study of Catalan nursing students between 2015-2016 and 2018-2019. We examined transitions in tobacco use patterns between baseline and follow-up among smokers from: 1) daily to non-daily smoking, 2) non-daily to daily smoking, 3) cigarette-only use to poly-tobacco use, 4) poly-tobacco use to cigarette-only use, 5) between products, 6) reducing consumption by ≥5 cigarettes per day (CPD); and 7) quitting smoking. We applied a Generalized Linear Model with a log link (Poisson regression) and robust variance to identify predictors of reducing cigarette consumption by ≥5 CPD and quitting smoking, obtaining both crude and adjusted (APR) prevalence ratios and their 95% confidence intervals (CIs).nnRESULTS: Among daily smokers at baseline, 12.1% transitioned to non-daily smoking at follow-up, while 36.2% of non-daily smokers shifted to daily smoking. Among cigarette-only users, 14.2% transitioned to poly-tobacco use, while 48.4% of poly-tobacco users switched to exclusive cigarette use. Among all smokers (daily and non-daily smokers), 60.8% reduced their cigarette consumption by ≥5 CPD and 28.3% quit smoking. Being a non-daily smoker (APR=0.33; 95% CI 0.19-0.55) and having lower nicotine dependence (APR=0.78; 95% CI 0.64-0.96) were inversely associated with reducing cigarette consumption, while being a non-daily smoker (APR=1.19; 95% CI: 1.08-1.31) was directly associated with quitting smoking.nnCONCLUSIONS: Nursing students who smoked experienced diverse transitions in tobacco use patterns over time. Evidence-based tobacco use preventive and cessation interventions are needed to tackle tobacco use among future nurses.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39569388,

title = {Factors and reasons for planning to quit smoking among a nationally representative sample of adults who smoke: Findings from the 2021 ITC EUREST-PLUS Spain Survey},

author = {Kaai SC and Fu M and Driezen P and Quah ACK and Yan M and Castellano Y and Tigova O and Fong GT and Fernández E},

doi = {10.18332/tpc/192088},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

abstract = {INTRODUCTION: Intentions to quit are the strongest predictor of successful smoking cessation and future quit attempts. This study assesses factors associated with quit intentions among adults who smoke in Spain.nnMETHODS: Data are from the 2021 International Tobacco Control (ITC) EUREST-PLUS Spain Wave 3 Survey, a nationally representative survey of adults aged ≥18 years who smoke (n=1006). Analysis was restricted to 867 adults who provided information about quit intentions. Multivariable Poisson regression was used to examine several correlates of quit intentions. Adjusted prevalence ratios (APR) were estimated.nnRESULTS: Less than half (45.6%) of adults who smoke reported intending to quit, with only 13.0% intending to quit in the next 6 months; 11.3% reported at least one quit attempt in the past year. Factors associated with quit intentions were having a high income (APR=1.39; 95% CI: 1.01-1.92), having at least one quit attempt in the previous year (APR=1.41; 95% CI: 1.16-1.71), worrying that smoking will damage one's health (APR=1.52; 95% CI: 1.05-2.20), regretting starting to smoke (agree, APR=1.25; 95% CI: 1.03-1.52; disagree, APR=0.66; 95% CI: 0.46-0.95), health concerns (APR=1.46; 95% CI: 1.17-1.82), and smoking restrictions in public places (APR=1.28; 95% CI: 1.06-1.54).nnCONCLUSIONS: Only13% of adults from Spain who smoke intend to quit in the next 6 months. Factors associated with quitting were high income, at least one quit attempt in the past year, worrying about health damage from smoking, regretting starting to smoke, having health concerns, and smoking restrictions in public places. There is a need for comprehensive measures that encourage and support people to quit.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39220715,

title = {Support for regulating smoking in private and public places by adults who currently smoke and recently quit smoking in Spain},

author = {Fu M and Castellano Y and Tigova O and Pérez-Ríos M and Driezen P and Kaai SC and Quah ACK and Vardavas CI and Fong GT and Fernández E},

doi = {10.18332/tid/191797},

issn = {1617-9625},

year  = {2024},

date = {2024-01-01},

journal = {Tob Induc Dis},

volume = {22},

abstract = {INTRODUCTION: While indoor smoking restrictions are common, outdoor restrictions are still rare. We explored opinions and support for regulating smoking in different indoor and outdoor environments among adults who smoke and those who recently quit smoking, in Spain.nnMETHODS: The 2021 ITC EUREST-PLUS Spain Survey is a cross-sectional study conducted among a nationally representative sample of 1006 adults aged ≥18 years who smoked cigarettes (n=867) or had recently quit smoking (n=139). Using Poisson regression with robust variance, we estimated adjusted prevalence and prevalence ratios of favorable opinions on regulating smoking in different indoor and outdoor environments and support for regulation in unregulated outdoor environments, by sociodemographic and smoking-related characteristics.nnRESULTS: There were highly favorable opinions for regulating smoking in places with minors (>95% in primary and secondary playgrounds, and cars with pre-school children and minors) and outdoor transportation (60-80%). There were less favorable opinions for regulating smoking in outdoor terraces of bars/pubs and restaurants (15-20%). Support for further total outdoor regulations on smoking was moderate for markets/shopping centers, public building entrances and swimming pools (40-60%), and low for restaurants/bars/pubs (29.2%). Having quit smoking, having no significant others who smoke and/or believing that cigarette smoke is harmful to others, were factors positively associated with favorable opinions and support for regulating smoking.nnCONCLUSIONS: The settings in Spain with the most favorable opinions for regulation among adults who smoke and have recently quit smoking are places with minors, private cars with others and outdoor areas of public transportation, while the settings with the least favorable opinions were outdoor terraces of bars, pubs, and restaurants. Support for further total outdoor smoking bans is generally moderate, but low for restaurants, bars, and pubs. Overall, these findings suggest the feasibility of extending smoke-free policies to other public and private settings to protect others from tobacco smoke exposure.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38638446,

title = {Tobacco endgame measures and their adaptation in selected European countries: A narrative review synthesis},

author = {Ruokolainen O and Ollila H and Laatikainen T and Pätsi SM and Carreras G and Gorini G and Carnicer-Pont D and Cselkó Z and Guignard R and Karekla M and Kilibarda B and Koprivnikar H and Lambrou A and Nguyen-Thanh V and Papachristou E and Schoretsaniti S and Vasic M},

doi = {10.18332/tpc/186402},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

abstract = {Due to the continued detrimental effects of tobacco use, a growing number of countries are embracing the idea of tobacco endgame, meaning ending the tobacco epidemic instead of controlling it. This narrative review aims to synthesize and update the evidence from earlier scientific reviews on effective tobacco endgame measures, as well as to assess their integration to current national strategies among European countries with official tobacco endgame goals. The synthesis of the prior scientific literature found most evidence on product-focused and some evidence for supply-focused policies. Little evidence was detected for user- and institutional-focused measures. An update for the tobacco-free generation measure showed uncertainty in reducing smoking prevalence, especially for adolescents' reactions to age-restrictive laws. All the countries that established a tobacco endgame strategy have included product standards in their measures, predominantly based on European Union regulations on conventional tobacco products, yet standards above this level and considering other products were also common. Cessation measures were given strong emphasis in strategies, yet none of the countries linked these to specific endgame measures. Despite commonly mentioning vulnerable groups, such as youth and pregnant women, adoption of measures to reduce tobacco use among these groups was scarce. Lastly, the decline in tobacco use seems to be modest, implying challenges in meeting the endgame goals. To meet these goals, European countries should reinforce the implementation of known effective tobacco control measures such as tax increases. Furthermore, new innovative strategies and measures to meet the objective of an endgame should be explored.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38757008b,

title = {Preventing and countering the interference of tobacco industry: Recommendations from the Joint Action on Tobacco Control 2},

author = {Solimini R and Ollila H and Gallus S and Havermans A and Talhout R and Kilibarda B and Vasic M and Fernández E and Carnicer-Pont D and Lopez AM and Pérez-Sacristán EM and Cselko Z and Mulcahy M and O'Donovan-Sadat F},

doi = {10.18332/tpc/188094},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39524201,

title = {Barriers and opportunities for the expansion of smoke- and aerosol-free environment policies in Europe},

author = {Pénzes M and Carnicer-Pont D and Luque AML and Koprivnikar H and Kilibarda B and Vasic M and González-Marrón A and Possenti I and Gallus S and Lambrou A and Papachristou E and Schoretsaniti S and Carreras G and Gorini G and Fernández E and JATC-2 WP8 Partners},

doi = {10.18332/tpc/193977},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

abstract = {INTRODUCTION: Comprehensive legislation covering the use of all types of tobacco and nicotine products to provide a smoke- and aerosol-free environment (SAFE) should be part of strategies aimed at phasing out tobacco use. There is a need to identify challenges and opportunities for advancing SAFE policies and their implementation. This study aims to identify barriers and opportunities to extend, enforce, and comply with SAFE policies in Europe.nnMETHODS: Within the Joint Action on Tobacco Control 2, a cross-sectional expert consultation was launched in 2022. Data obtained through an online questionnaire including closed and open-ended questions on barriers, opportunities, and interference by the tobacco and/or nicotine industry (TNI) on the extension, and compliance with/enforcement of SAFE policies, were analyzed thematically and descriptively.nnRESULTS: From 29 European countries, 61 experts (response rate: 55.5%) were included in our sample. The most commonly identified barriers for the extension of SAFE policies were tobacco industry lobbying and funding activities, while the most commonly reported opportunity was extending SAFE policies to specific outdoor public or private places, especially where children are present. In terms of compliance with/enforcement of SAFE policies, the lack of human and financial resources and capacity to monitor/enforce compliance were the most commonly identified barriers, while opportunities included more powerful enforcement authorities with increased capacity. The experts identified greater TNI interference on the extension than on the enforcement of SAFE policies.nnCONCLUSIONS: Comprehensive regulation of TNI interference and allocation of human/financial resources for policy enforcement, should be a priority for the extension of SAFE policies in Europe.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39430870,

title = {Best practices for expansion of smoke-free and aerosol-free environments in Europe: Protocol for the consultation to experts},

author = {Carnicer-Pont D and Luque AML and Kilibarda B and Vasic M and Penzes M and Stival C and Gonzalez A and Koprivnikar H and Carreras G and Gorini G and Possenti I and Lugo A and Gallus S and Fernández E},

doi = {10.18332/tpc/192786},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

abstract = {Smoke-free legislation has been shown to positively impact reducing secondhand smoke (SHS) exposure, especially in countries that have implemented comprehensive legislation rather than partial bans. Also, secondhand aerosols (SHA) that come from the heating of tobacco or liquids, with or without nicotine, in electronic nicotine delivery systems (ENDS) have been proven to increase levels of harmful substances in the air. Therefore, protection against SHS and SHA exposure and expansion of smoke- and aerosol-free environments (SAFE) should be taken into account when creating or trying to expand or enforce clean air policies. This article aims to present the protocol for a consultation with experts on tobacco and nicotine control in order to identify best practices, barriers, and opportunities for the expansion of SAFE in Europe. We identified experts among policymakers, researchers, and tobacco regulators in European countries and invited them to participate in the consultation by completing an online survey designed, programmed, and pilot-tested using Survey Monkey. The responses to the questionnaire contained quantitative and qualitative information that was thematically analyzed. The experts' consultation allowed us to produce a report on barriers and opportunities for SAFE, a report and a position paper on SAFE best practices, a web-based repository of best practices, and a weight of evidence paper that assembles evidence supporting the expansion of SAFE on indoor and outdoor spaces.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38757008,

title = {Preventing and countering the interference of tobacco industry: Recommendations from the Joint Action on Tobacco Control 2},

author = {Solimini R and Ollila H and Gallus S and Havermans A and Talhout R and Kilibarda B and Vasic M and Fernández E and Carnicer-Pont D and Lopez AM and Pérez-Sacristán EM and Cselko Z and Mulcahy M and O'Donovan-Sadat F},

doi = {10.18332/tpc/188094},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36978253,

title = {Transitions in smoking status in nursing students: A prospective longitudinal study},

author = {Laroussy K and Castellano Y and Fu M and Baena A and Feliu A and Peruga A and Margalef M and Aldazabal J and Tigova O and Galimany J and Puig M and Moreno C and Bueno A and López A and Roca J and Saura J and Fernández E and Martínez C},

doi = {10.1111/jan.15665},

issn = {1365-2648},

year  = {2023},

date = {2023-09-01},

journal = {J Adv Nurs},

volume = {79},

number = {9},

pages = {3456--3472},

abstract = {AIM: To describe transitions in smoking status and their determining factors among nursing students between baseline (2015-2016) and follow-up (2018-2019).nnDESIGN: Observational prospective longitudinal study of 4381 nursing students in Catalonia (Spain).nnMETHODS: We examined transitions in smoking status from: (i) current smokers to recent quitters, (ii) never smokers to new smokers and (iii) former smokers to quitters who relapsed. We fitted logistic regression models to assess the predictors of quitting smoking.nnRESULTS: The proportion of current smokers decreased from 29.7% at baseline to 23.6% at follow-up, with a cumulative incidence rate of quitting of 28.3% during follow-up. Nondaily smokers were more likely to quit than daily smokers. Of those who were never smokers at baseline, 4.6% were smokers at follow-up, and 23.2% of former smokers at baseline had relapsed at follow-up.nnCONCLUSIONS: Nondaily smokers were more likely to have quit smoking at follow-up among this cohort of nursing students. The early implementation of a comprehensive tobacco control program that includes tobacco-free campus policies, tobacco prevention interventions and cessation support during college years may decrease tobacco use among nursing students.nnIMPACT: Nursing students' tobacco use is concerning, as they are the future workforce of nurses who have a key role in tobacco product use prevention and cessation. During college years, nursing students have a greater likelihood of experimenting with several smoking status changes as well as to consolidate smoking behaviors. This is the first longitudinal study to highlight the factors associated with quitting smoking among a cohort of Spanish nursing students. Being a nondaily smoker at baseline predicted quitting at follow-up. Our findings support the early implementation of a comprehensive tobacco control program that includes tobacco-free campus policies, tobacco prevention interventions and tobacco cessation support during college years to decrease tobacco product use prevalence among nursing students.nnREPORTING METHOD: We have adhered to STROBE guidelines. No Patient or Public Contribution. This observational study has not been registered.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36566961,

title = {Measurement of airborne nicotine, as a marker of secondhand smoke exposure, in homes with residents who smoke in 9 European countries},

author = {Henderson E and Rodriguez Guerrero LA and Continente X and Fernández E and Tigova O and Cortés-Francisco N and Semple S and Dobson R and Tzortzi A and Vyzikidou VK and Gorini G and Geshanova G and Mons U and Przewozniak K and Precioso J and Brad R and López MJ and TackSHS project Investigators},

doi = {10.1016/j.envres.2022.115118},

issn = {1096-0953},

year  = {2023},

date = {2023-02-01},

journal = {Environ Res},

volume = {219},

pages = {115118},

abstract = {OBJECTIVE: Smoke-free policies are effective in preventing secondhand smoke (SHS) exposure, but their adoption at home remains largely voluntary. This study aimed to quantify SHS exposure in homes with residents who smoke in Europe according to households' characteristics, tobacco consumption habits, and national contextual factors.nnMETHODS: Cross-sectional study (March 2017-September 2018) based on measurements of air nicotine inside 162 homes with residents who smoke from nine European countries. We installed passive samplers for seven consecutive days to monitor nicotine concentrations. Through self-administered questionnaires, we collected sociodemographic information and the number of individuals who smoke, smoking rules, frequency, location, and quantity of tobacco use in households. Country-level factors included the overall score in the Tobacco Control Scale 2016, the smoking prevalence, and self-reported SHS exposure prevalence. Nicotine concentrations were analyzed as continuous and dichotomous variables, categorized based on the limit of quantification of 0.02 μg/m.nnRESULTS: Overall, median nicotine concentration was 0.85 μg/m (interquartile range (IQR):0.15-4.42), and there was nicotine presence in 93% of homes. Participants reported that smoking was not permitted in approximately 20% of households, 40% had two or more residents who smoked, and in 79% residents had smoked inside during the week of sampling. We found higher nicotine concentrations in homes: with smell of tobacco smoke inside (1.45 μg/m IQR: 0.32-6.34), where smoking was allowed (1.60 μg/m IQR: 0.68-7.63), with two or more residents who smoked (2.42 μg/m IQR: 0.58-11.0), with more than 40 cigarettes smoked (2.92 μg/m IQR: 0.97-10.61), and where two or more residents smoked inside (4.02 μg/m IQR: 1.58-11.74). Household nicotine concentrations were significantly higher in countries with higher national smoking prevalence and self-reported SHS exposure prevalence (p < 0.05).nnCONCLUSIONS: SHS concentrations in homes with individuals who smoke were approximately twenty times higher in homes that allowed smoking compared to those reporting smoke-free household rules. Evidence-based interventions promoting smoke-free homes should be implemented in combination with strengthening other MPOWER measures.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36534716,

title = {Efficacy of Presurgical Interventions to Promote Smoking Cessation: A Systematic Review},

author = {Gavilan E and Fernández E and Minguell J and Trilla E and Zuriguel-Pérez E and Martínez C},

doi = {10.1213/ANE.0000000000006240},

issn = {1526-7598},

year  = {2023},

date = {2023-01-01},

journal = {Anesth Analg},

volume = {136},

number = {1},

pages = {43--50},

abstract = {The aim of this study was to evaluate the efficacy of presurgical interventions for promoting smoking cessation in terms of achieving smoking abstinence and reducing surgical complication rates. A systematic review of randomized clinical trials (RCTs) published from March 2009 to April 2021 was performed following the PRISMA guidelines. References were found in MEDLINE (via PubMed), Web of Science (WOS), and Cumulative Index to Nursing and Allied Health Literature (CINAHL). RCTs comparing the efficacy of a smoking cessation program directed at an intervention group (IG) versus the usual intervention or another directed at a control group (CG) were included. No language restrictions were applied in the search. All approaches to smoking cessation were admitted (face-to-face, telephone, group, individual, multicomponent, etc.), as were all methods for assessing abstinence, follow-up times, surgical specialties, definitions of smokers, and all types of surgical complications. Four hundred forty-four references were pulled out, and 79 duplicates were discarded. We excluded 346 records that were after application of the inclusion/exclusion criteria. In addition to the remaining 19 articles, 1 article obtained from citation searches was also assessed. We finally included 11 original articles in this systematic review, corresponding to 9 studies, because 2 of the RCTs had 2 different articles referring to different aspects of the same study. The results showed long-term postoperative (6 to 12 months) abstinence rates between 25.0% and 36.4% in RCTs with intensive multicomponent interventions, versus rates about 13.0% in brief interventions. Two multicomponent interventions obtained significant improvements regarding the reduction of short-term postoperative surgical complications. In conclusion, presurgical multicomponent smoking cessation interventions are more effective than brief interventions in terms of achieving abstinence and reducing surgical complications. The follow-up time and the intensity of the interventions were predictors of dropout.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35671260,

title = {Compliance with the smoke-free policy in hospitals in Spain: the patients' perspective},

author = {Fu M and Castellano Y and Feliu A and Saura J and Estrada J and Galimany-Masclans J and Moreno C and Fernández E and Martínez C},

doi = {10.1097/CEJ.0000000000000757},

issn = {1473-5709},

year  = {2023},

date = {2023-01-01},

journal = {Eur J Cancer Prev},

volume = {32},

number = {1},

pages = {81--88},

abstract = {OBJECTIVE: To explore compliance with the smoke-free policy in hospitals in Catalonia, Spain, by exploring inpatients' perceptions.nnMETHODS: We conducted a cross-sectional study of a random sample of 1047 inpatients from 13 public hospitals. We collected data about: (a) type of information about the smoke-free policy provided by the hospital, (b) patients' knowledge about the policy, (c) general appreciation of the compliance with the policy, and (d) specific appreciation of such compliance by noticing any sign of tobacco consumption. We described the data by several patients' and hospitals' characteristics and assessed their association with the perceived noncompliance using prevalence ratios (PR) and their 95% confidence intervals (CIs).nnRESULTS: Few patients were informed about the smoke-free policy (4.8% orally, 6.1% in writing, and 55.6% through sign postings). About 64% were aware of the regulation and 73.5% believed that it was properly obeyed. While 0.7% had never or rarely observed smoking indoors, 36.2% had seen someone smoking outdoors sometimes or many times. Signs of tobacco consumption were observed indoors and outdoors. Factors associated with the perception of noncompliance were: being less than 45 years old versus being more than 64 years old (adjusted PR, 2.33; 95% CI, 1.09-4.98) and currently smoking versus have never smoked (adjusted PR, 1.84; 95% CI, 1.02-3.34).nnCONCLUSION: Compliance with the smoke-free policy in hospitals according to the patients' view is notable, although several infringements were reported, mainly outdoors. The smoke-free policy in hospitals should be reinforced by prompting continuous awareness campaigns and the exemplary role of hospital workers.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33727255,

title = {Beyond the European Union Tobacco Products Directive: smokers' and recent quitters' support for further tobacco control measures (2016-2018)},

author = {Nogueira SO and Driezen P and Fu M and Hitchman SC and Tigova O and Castellano Y and Kyriakos CN and Zatoński MZ and Mons U and Quah ACK and Demjén T and Trofor AC and Przewozniak K and Katsaounou P and Fong G and Vardavas CI and Fernández E and EUREST-PLUS Consortium},

doi = {10.1136/tobaccocontrol-2020-056177},

issn = {1468-3318},

year  = {2022},

date = {2022-11-01},

journal = {Tob Control},

volume = {31},

number = {6},

pages = {765--769},

abstract = {BACKGROUND: Several measures recommended by the WHO Framework Convention on Tobacco Control have not been implemented in the European Union, despite changes in the legislation such as the Tobacco Products Directive (TPD). This study aims to understand smokers' and recent quitters' levels of support for tobacco control measures that go beyond the TPD during and after its implementation.nnMETHODS: Data from wave 1 (2016, n=6011) and wave 2 (2018, n=6027) of the EUREST-PLUS International Tobacco Control Policy Evaluation Project Six European Countries Survey, a cohort of adult smokers in Germany, Greece, Hungary, Poland, Romania, Spain were used to estimate the level of support for seven different tobacco control measures, overall and by country.nnRESULTS: In 2018, the highest support was for implementing measures to further regulate tobacco products (50.5%) and for holding tobacco companies accountable for the harm caused by smoking (48.8%). Additionally, in 2018, 40% of smokers and recent quitters supported a total ban on cigarettes and other tobacco products within ten years, if assistance to quit smoking is provided. Overall, support for tobacco control measures among smokers and recent quitters after the implementation of the TPD remained stable over time.nnCONCLUSION: There is considerable support among smokers and recent quitters for tobacco control measures that go beyond the current measures implemented. A significant percentage of smokers would support a ban on tobacco products in the future if the government provided assistance to quit smoking. This highlights the importance of implementing measures to increase smoking cessation in conjunction with other policies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35878525,

title = {Changes in the salivary cotinine cut-offs to discriminate smokers and non-smokers before and after Spanish smoke-free legislation},

author = {Pérez-Martín H and Lidón-Moyano C and González-Marrón A and Fu M and Pérez-Ortuño R and Ballbè M and Martín-Sánchez JC and Pascual JA and Fernández E and Martínez-Sánchez JM},

doi = {10.1016/j.canep.2022.102226},

issn = {1877-783X},

year  = {2022},

date = {2022-10-01},

journal = {Cancer Epidemiol},

volume = {80},

pages = {102226},

abstract = {INTRODUCTION: High levels of cotinine in non-smokers indicate passive exposure to tobacco smoke. This study aims to evaluate variations in salivary cotinine cut-offs to discriminate smokers and non-smokers before and after the implementation of smoke-free legislation (Law 28/2005 and Law 42/2010) in a sample of the adult population of Barcelona, Spain.nnMETHODS: This longitudinal study analyzes salivary cotinine samples and self-reported information from a representative sample (n = 676) of the adult population from Barcelona before and after the approval of smoke-free legislation. We calculated the receiver operating characteristic (ROC) curves, to obtain optimal cotinine cut-off points to discriminate between smokers and non-smokers overall, by sex and age, and their corresponding sensitivity, specificity, and area under the curve. We used linear mixed-effects models, with individuals as random effects, to model the percentage change of cotinine concentration before and after the implementation of both laws.nnRESULTS: The mean salivary cotinine concentration was significantly lower post-2010 law (-85.8%, p < 0.001). The ROC curves determined that the optimal cotinine cut-off points for discriminating non-smokers and smokers were 10.8 ng/mL (pre-2005 law) and 5.6 ng/mL (post-2010 law), with a post-2010 law sensitivity of 92.6%, specificity of 98.4%, and an area under the curve of 97.0%. The post-2010 law cotinine cut-off points were 5.6 ng/mL for males and 1.9 ng/mL for females.nnCONCLUSION: The implementation of Spanish smoke-free legislation was effective in reducing secondhand smoke exposure and, therefore, also in reducing the cut-off point for salivary cotinine concentration. This value should be used to better assess tobacco smoke exposure in this population.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}