PUBLICATIONS

@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{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}

}

@article{pmid34031228,

title = {Tool to monitor tobacco control policy implementation: the Tobacco Control Scale in Latin America. Adaptation process and pilot study},

author = {Feliu A and Martinez C and Peruga A and Joossens L and Bianco E and Cornejo M and Nogueira SO and Fernández E},

doi = {10.1136/tobaccocontrol-2020-056395},

issn = {1468-3318},

year  = {2022},

date = {2022-09-01},

journal = {Tob Control},

volume = {31},

number = {5},

pages = {642--648},

abstract = {BACKGROUND: Monitoring tobacco control policy implementation is one of the keys for tobacco consumption reduction in Latin America (LA). This study reports on the adaptation of the Tobacco Control Scale (TCS) for use in LA countries and the level of tobacco control policy implementation in this region according to the scale.nnMETHODS: Ecological cross-sectional survey. The questionnaire to measure tobacco control policies was a translated (into Spanish and Portuguese) and adapted version of the last TCS as used in Europe. The resulting TCS-LA maintains the same structure as the original TCS, with eight policy domains and 100 points (pts) as maximum score; however, four policy domains were adapted because the exact same rationale could not be applied. At least two non-governmental tobacco control experts were contacted per country to answer the TCS-LA.nnRESULTS: Informants from 17 out of 18 countries completed the questionnaire. Using the TCS-LA, Panama (70 pts), Uruguay (68 pts) and Ecuador (61 pts) exhibited the strongest tobacco control policies, while Guatemala (32 pts), Bolivia (30 pts) and Dominican Republic (29 pts) have implemented a lower number of tobacco control policies. Eight countries reached 50% of the TCS-LA total possible score, indicating a relatively good implementation level of tobacco control policies.nnCONCLUSIONS: Panama, Uruguay and Ecuador are the tobacco control policy leaders in LA; however, tobacco control in the region has room for improvement since nine countries have a total score under 50 pts. The TCS is a feasible and adaptable tool to monitor tobacco control in other WHO regions beyond Europe.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33768256,

title = {Smoking cessation interventions in substance use disorders treatment centers of Catalonia: The abandoned addiction},

author = {Nieva G and Ballbè M and Cano M and Carcolé B and Fernández T and Martínez À and Mondon S and Raich A and Roig P and Serra I and Serrano J and Pinet C},

doi = {10.20882/adicciones.1492},

issn = {0214-4840},

year  = {2022},

date = {2022-07-01},

journal = {Adicciones},

volume = {34},

number = {3},

pages = {227--234},

abstract = {Substance use disorders (SUD) treatment centers are an optimal setting for delivering smoking cessation interventions (SCI). This study aimed to examine the adoption of SCI in SUD treatment centers in Catalonia (Spain) as well as to assess their managers' views on the appropriateness and feasibility of providing SCI. Managers directly in charge of SUD treatment centers (n = 57) answered a 30-item on-line questionnaire. Data was obtained of 50 centers (87.7% response rate). Forty-six per cent of the centers provided some kind of SCI, but only 4.8% of the new patients were treated for smoking cessation. Managers reported that 73.3% of mental health professionals working in SUD centers had not been trained in SCI. Sixty-four per cent of managers agreed that all health professionals should deliver SCI. Those centers offering SCI attended more patients and were more likely to have professionals trained in SCI than those not offering SCI. The implementation of SCI in SUD treatment centers in Catalonia was suboptimal. Continuing education and training should be provided for all health professionals working in SUD centers. Not systematically delivering SCI to patients in treatment for other SUD means missing opportunities to reduce health and economic costs while perpetuating a smoking culture.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35341948,

title = {Methodological guidelines for the estimation of attributable mortality using a prevalence-based method: the STREAMS-P tool},

author = {Pérez-Ríos M and Rey-Brandariz J and Galán I and Fernández E and Montes A and Santiago-Pérez MI and Giraldo-Osorio A and Ruano-Raviña A},

doi = {10.1016/j.jclinepi.2022.03.016},

issn = {1878-5921},

year  = {2022},

date = {2022-07-01},

journal = {J Clin Epidemiol},

volume = {147},

pages = {101--110},

abstract = {BACKGROUND: There is evidence of strong links between exposure to different risk factors and life-threatening diseases. Assessing the burden of a risk factor on the population's mortality due to a given disease provides a clear picture of these links. The estimation of attributable mortality to a risk factor is the most widely used procedure for doing this. Although different methods are available to estimate attributable mortality, the prevalence-based methodology is the most frequent. The main objective of this study is to develop guidelines and checklists to STrengthen the design and REporting of Attributable Mortality Studies using a Prevalence-based method (STREAMS-P) and also to assess the quality of an already published study which uses this methodology.nnMETHODS: The design of the guideline and checklists has been done in two phases. A development phase, where we set recommendations based on the review of the literature, and a validation phase, where we validated our recommendations against other published studies that have estimated attributable mortality using a prevalence-based method.nnRESULTS: We have developed and tested a guideline that includes the information required to perform a prevalence-based attributable mortality study to a given risk factor; a checklist of aspects that should be present when a report or a paper on attributable mortality is written or interpreted and a checklist of quality control criteria for reports or papers estimating attributable mortality.nnCONCLUSION: To our knowledge, the STREAMS-P is the first set of criteria specifically created to assess the quality of such studies and it could be valuable for authors and readers interested in performing attributable mortality studies or interpreting their reliability.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35278807,

title = {Acceptability and participation predictors for a pragmatic randomized controlled trial to test a smoking cessation intervention after discharge from mental health wards},

author = {Martínez C and Feliu A and Torres N and Nieva G and Pinet C and Raich A and Mondon S and Barrio P and Andreu M and Hernández-Ribas R and Vicens J and Costa S and Suelves JM and Vilaplana J and Enríquez M and Alaustre L and Vilalta E and Subirà S and Bruguera E and Castellano Y and Saura J and Guydish J and Fernández E and Ballbè M},

doi = {10.1016/j.drugalcdep.2022.109390},

issn = {1879-0046},

year  = {2022},

date = {2022-05-01},

journal = {Drug Alcohol Depend},

volume = {234},

pages = {109390},

abstract = {BACKGROUND AND AIM: Hospitalization is an ideal time to promote smoking cessation, but interventions are limited for supporting cessation maintenance after discharge. This study aimed to evaluate the acceptability of participating in a trial that tested the efficacy of an intensive telephone-based intervention for smokers after discharge.nnMETHODS: Adult smokers admitted to mental health wards of six hospitals were invited to participate in the trial. We studied the study acceptance/decline rates by analyzing the characteristics of participants (e.g., sex, age, psychiatric disorder, smoking pattern) and hospitals (e.g., size, tobacco control implementation). We calculated adjusted odds ratios (aOR) to assess predictors of non-participation.nnRESULTS: Of 530 smokers that met the study inclusion criteria, 55.5% (n = 294) agreed to participate. Participant and non-participants were not different in sex, age, or psychiatric diagnosis. Compared to non-participants, participants had made more attempts to quit in the past year (66.1% vs 33.9%; p < 0.001) and reported higher abstinence rates during the hospital stay (66.7% vs. 33.3%; p = 0.05). Participation rates by hospital varied from 30.9% to 82.0% (p < 0.001). Predictors of non-participation were not having attempted to quit in the last year (aOR=2.42; 95%CI: 1.66-3.53) and low level of tobacco control in the hospital (aOR range: 1.79-6.39, p < 0.05).nnCONCLUSIONS: A telephone-based intervention to promote smoking cessation after discharge was accepted by half of the smokers with mental health disorders. Smokers that had attempted to quit previously and those that stayed in hospitals with a strong tobacco control policy were more likely to participate in the trial.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34755457,

title = {Factors associated with changes in inpatients' smoking pattern during hospitalization and one month after discharge: A cohort study},

author = {Feliu A and Ravara S and Papadakis S and Enriquez M and Antón L and Saura J and Company A and Romero O and Ripoll R and Ruz A and Precioso J and Pascoal I and Videira L and Correia C and Ferreira S and Fernández E and Martínez C},

doi = {10.1111/jnu.12735},

issn = {1547-5069},

year  = {2022},

date = {2022-05-01},

journal = {J Nurs Scholarsh},

volume = {54},

number = {3},

pages = {332--344},

abstract = {INTRODUCTION: Smokers are frequent users of healthcare services. Admissions to hospital can serve as a "teachable moment" for quitting smoking. Clinical guidelines recommend initiating smoking cessation services during hospitalization; however, in Southern European countries less than 5% of inpatients receive a brief intervention for smoking cessation.nnOBJECTIVES: The aims of this study were (i) to examine rates of smoking abstinence during and after hospitalization; (ii) to measure changes in smoking patterns among persons who continued smoking after discharge; and (iii) to identify predictors of abstinence during hospitalization and after discharge.nnMETHODS: A cohort study of a representative sample of current adult smokers hospitalized in two Spanish and two Portuguese hospitals. We surveyed smokers during hospitalization and recontacted them one month after discharge. We used a 25-item ad hoc questionnaire regarding their smoking pattern, the smoking cessation intervention they have received during hospitalization, and hospital and sociodemographic characteristics. We performed a descriptive analysis using the chi-square test and a multivariate logistic regression to characterize the participant, hospital, and smoking cessation intervention (5As model) characteristics associated with smoking abstinence.nnRESULTS: Smoking patients from both countries presented high abstinence rates during hospitalization (Spain: 76.4%; Portugal: 70.2%); however, after discharge, their abstinence rates decreased to 55.3% and 46.8%, respectively. In Spain, smokers who tried to quit before hospital admission showed higher abstinence rates, and those who continued smoking reduced a mean of five cigarettes the number of cigarettes per day (p ≤ 0.001). In Portugal, abstinence rates were higher among women (p = 0.030), those not living with a smoker (p = 0.008), those admitted to medical-surgical wards (p = 0.035), who consumed their first cigarette within 60 min after waking (p = 0.006), and those who were trying to quit before hospitalization (p = 0.043).nnCONCLUSIONS: Half of the smokers admitted into the Spanish hospitals are abstinent one month after discharge or have reduced their cigarettes per day. Nevertheless, success rates could be increased by implementing evidence-based tobacco cessation programs at the organizational-level, including post-discharge active quitting smoking support.nnCLINICAL RELEVANCE: Three-quarters of the inpatients who smoke remain abstinent during hospitalization and over half achieve to maintain their abstinence or at least reduce their consumption one month after discharge, proving that admission to hospitals is an excellent teachable moment to quit smoking.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35450905,

title = {COVID-19 among workers of a comprehensive cancer centre between first and second epidemic waves (2020): a seroprevalence study in Catalonia, Spain},

author = {Peremiquel-Trillas P and Saura-Lázaro A and Benavente-Moreno Y and Casabonne D and Loureiro E and Cabrera S and Duran A and Garrote L and Brao I and Trelis J and Galán M and Soler F and Julià J and Cortasa D and Domínguez MÁ and Albasanz-Puig A and Gudiol C and Ramírez-Tarruella D and Muniesa J and Rivas JP and Muñoz-Montplet C and Sedano A and Plans À and Calvo-Cerrada B and Calle C and Clopés A and Carnicer-Pont D and Alemany L and Fernández E},

doi = {10.1136/bmjopen-2021-056637},

issn = {2044-6055},

year  = {2022},

date = {2022-04-01},

journal = {BMJ Open},

volume = {12},

number = {4},

pages = {e056637},

abstract = {OBJECTIVES: Patients with cancer are at higher risk for severe COVID-19 infection. COVID-19 surveillance of workers in oncological centres is crucial to assess infection burden and prevent transmission. We estimate the SARS-CoV-2 seroprevalence among healthcare workers (HCWs) of a comprehensive cancer centre in Catalonia, Spain, and analyse its association with sociodemographic characteristics, exposure factors and behaviours.nnDESIGN: Cross-sectional study (21 May 2020-26 June 2020).nnSETTING: A comprehensive cancer centre (Institut Català d'Oncologia) in Catalonia, Spain.nnPARTICIPANTS: All HCWs (N1969) were invited to complete an online self-administered epidemiological survey and provide a blood sample for SARS-CoV-2 antibodies detection.nnPRIMARY OUTCOME MEASURE: Prevalence (%) and 95% CIs of seropositivity together with adjusted prevalence ratios (aPR) and 95% CI were estimated.nnRESULTS: A total of 1266 HCWs filled the survey (participation rate: 64.0%) and 1238 underwent serological testing (97.8%). The median age was 43.7 years (p25-p75: 34.8-51.0 years), 76.0% were female, 52.0% were nursing or medical staff and 79.0% worked on-site during the pandemic period. SARS-CoV-2 seroprevalence was 8.9% (95% CI 7.44% to 10.63%), with no differences by age and sex. No significant differences in terms of seroprevalence were observed between onsite workers and teleworkers. Seropositivity was associated with living with a person with COVID-19 (aPR 3.86, 95% CI 2.49 to 5.98). Among on-site workers, seropositive participants were twofold more likely to be nursing or medical staff. Nursing and medical staff working in a COVID-19 area showed a higher seroprevalence than other staff (aPR 2.45, 95% CI 1.08 to 5.52).nnCONCLUSIONS: At the end of the first wave of the pandemic in Spain, SARS-CoV-2 seroprevalence among Institut Català d'Oncologia HCW was lower than the reported in other Spanish hospitals. The main risk factors were sharing household with infected people and contact with COVID-19 patients and colleagues. Strengthening preventive measures and health education among HCW is fundamental.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35340748,

title = {The Emergence of COVID-19 as a Cause of Death in 2020 and its Effect on Mortality by Diseases of the Respiratory System in Spain: Trends and Their Determinants Compared to 2019},

author = {Soriano JB and Peláez A and Fernández E and Moreno L and Ancochea J},

doi = {10.1016/j.arbres.2022.03.001},

issn = {1579-2129},

year  = {2022},

date = {2022-04-01},

journal = {Arch Bronconeumol},

volume = {58},

pages = {13--21},

abstract = {OBJECTIVE: To analyze the causes of death by diseases of the respiratory system in Spain in 2020, with special interest in COVID-19; also its trends and determinants, and compare them with 2019.nnMATERIAL AND METHODS: Retrospective cohort study. The coding of all those causes of death by diseases of the respiratory system were regrouped. A descriptive analysis of all deaths and by gender, age, and the 17 Autonomous Communities (CC.AA.) was performed. Also, odds ratios of death in crude and multivariate analysis by logistic regression were estimated.nnRESULTS: In Spain in 2020, 60,358 deaths were attributed to "COVID-19 virus identified" and another 14,481 to "COVID-19 virus not identified (suspicious)". Regrouping the specific causes of death, in 2020 the diseases of the respiratory system caused a total of 139,880 deaths, which corresponds to 28.3% of all deaths in Spain. Compared to 2019, an increase of 68.5% was observed. By gender, deaths by diseases of the respiratory system were higher in men (32.0%) than in women (24.6%), although in specific causes the percentage was higher in women with suspected COVID-19, asthma, respiratory insufficiency and other diseases of the respiratory system. Finally, the variables associated with death from COVID-19 in the multivariate analysis were being male, increasing age (maximum at 80 years), completed studies up to secondary level, employed, and single or widowed marital status, although with a marked variation by CC.AA.nnCONCLUSIONS: In Spain in 2020, COVID-19 produced a large increase (68.5%) in deaths by diseases of the respiratory system compared to the previous year.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35252942,

title = {Reaping what you sow: England's drastic reduction in childhood secondhand smoke exposure in two decades},

author = {Gallus S and Fernandez E},

doi = {10.1016/j.lanepe.2022.100334},

issn = {2666-7762},

year  = {2022},

date = {2022-04-01},

journal = {Lancet Reg Health Eur},

volume = {15},

pages = {100334},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33342937,

title = {Regulation of Electronic Cigarette Use in Public and Private Areas in 48 Countries Within the WHO European Region: A Survey to In-country Informants},

author = {Amalia B and Fu M and Feliu A and Tigova O and Fayokun R and Mauer-Stender K and Fernández E},

doi = {10.2188/jea.JE20200332},

issn = {1349-9092},

year  = {2022},

date = {2022-03-01},

journal = {J Epidemiol},

volume = {32},

number = {3},

pages = {131--138},

abstract = {BACKGROUND: The objective of this study is to describe the legislation regulating the use of electronic cigarettes (e-cigarettes) in various places in European countries.nnMETHODS: A survey among experts from all countries of the World Health Organization (WHO) European Region was conducted in 2018. We collected and described data on legislation regulating e-cigarette use indoors and outdoors in public and private places, the level of difficulties in adopting the legislation, and the public support and compliance. Factors associated with the legislation adoption were identified with Poisson and linear regression analyses.nnRESULTS: Out of 48 countries, 58.3% had legislation on e-cigarette use at the national level. Education facilities were the most regulated place (58.3% of countries), while private areas (eg, homes, cars) were the least regulated ones (39.6%). A third of countries regulated e-cigarette use indoors. Difficulty and support in adopting the national legislation and its compliance were all at a moderate level. Countries' smoking prevalence and income levels were linked to legislation adoption.nnCONCLUSIONS: Although most WHO European Region countries had introduced e-cigarette use legislation at the national level, only a few of the legislation protect bystanders in indoor settings.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35241597,

title = {Smoke-free spaces: a decade of progress, a need for more?},

author = {Semple S and Dobson R and O'Donnell R and Zainal Abidin E and Tigova O and Okello G and Fernández E},

doi = {10.1136/tobaccocontrol-2021-056556},

issn = {1468-3318},

year  = {2022},

date = {2022-03-01},

journal = {Tob Control},

volume = {31},

number = {2},

pages = {250--256},

abstract = {Adoption of smoke-free measures has been one of the central elements of tobacco control activity over the past 30 years. The past decade has seen an increasing number of countries and proportion of the global population covered by smoke-free policies to some extent. Despite reductions in global smoking prevalence, population growth means that the number of non-smokers exposed to the harms caused by secondhand smoke remains high. Smoke-free policy measures have been shown to be useful in protecting non-smokers from secondhand smoke, and can additionally increase cessation and reduce smoking initiation. Policies tend to be aimed primarily at enclosed public or workplace settings with very few countries attempting to control exposure in private or semiprivate spaces such as homes and cars, and, as a result, children may be benefiting less from smoke-free measures than adults. Compliance with legislation also varies by country and there is a need for education and empowerment together with guidance and changing social norms to help deliver the full benefits that smoke-free spaces can bring. Restrictions and policies on use of electronic cigarettes (e-cigarettes) in smoke-free settings require more research to determine the benefits and implications of bystanders' exposure to secondhand e-cigarette aerosol, dual use and smoking cessation.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35241582,

title = {Tobacco control in Europe: progress and key challenges},

author = {Willemsen MC and Mons U and Fernández E},

doi = {10.1136/tobaccocontrol-2021-056857},

issn = {1468-3318},

year  = {2022},

date = {2022-03-01},

journal = {Tob Control},

volume = {31},

number = {2},

pages = {160--163},

abstract = {We discuss progress made with respect to reducing the burden of disease caused by tobacco use within the WHO European Region and outline major issues and challenges regarding ongoing implementation of tobacco control policy. Although 50 of 53 countries in the WHO European Region are parties to the WHO Framework Convention for Tobacco Control (FCTC), smoking prevalence varies tremendously between European countries. While smoking rates are decreasing slowly, faster declines among smokers with a higher socioeconomic status are leading to growing inequalities in tobacco use. Governments in Europe increasingly formulate visions of 'tobacco-free' societies and it is encouraging that the European Commission aims to achieve a tobacco-free Europe in 2040 as part of its Europe's Beating Cancer Plan. While core WHO FCTC measures still have to be fully implemented in many European countries, some countries are implementing more advanced measures such as plain packaging, banning of characterising flavours from tobacco products, tobacco retailer licensing and extensions of smoking bans into spaces such as cars, outdoor areas and public streets. Remaining challenges include protecting tobacco control policymaking from tobacco industry interference, insufficient dedicated budget for scientific research and the need for Europe-wide monitoring data on use of tobacco and nicotine products.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34717946,

title = {Non-smokers' and smokers' support for smoke-free legislation in 14 indoor and outdoor settings across 12 European countries},

author = {Nogueira SO and Fu M and Lugo A and Tigova O and Henderson E and López MJ and Clancy L and Semple S and Soriano JB and Fernandez E and Gallus S and TackSHS Project Investigators},

doi = {10.1016/j.envres.2021.112224},

issn = {1096-0953},

year  = {2022},

date = {2022-03-01},

journal = {Environ Res},

volume = {204},

number = {Pt C},

pages = {112224},

abstract = {BACKGROUND: European countries differ considerably in the scope and the extent of their policies to protect people from the harms of secondhand smoke exposure. Public opinion may have a substantial influence on several stages of policy development, implementation, and compliance. For this reason, we aimed to evaluate the population level of support for smoke-free policies and its correlates.nnMETHODS: We used data from the TackSHS Survey (2017-2018), a cross-sectional study with representative samples of the general population aged ≥15 years from 12 European countries. We described the proportion of non-smokers' and smokers' support for the implementation of smoke-free legislation in 14 indoor and outdoor settings and the country-level characteristics associated with it.nnRESULTS: In the total sample (n = 11,902), support for smoke-free legislation were the lowest for restaurants/bar patios (non-smokers = 53.0%; smokers = 29.2%) and the highest for workplaces (non-smokers = 78.5%; smokers = 66.5%). In the country-level analysis, the highest support among non-smokers was for workplaces in Bulgaria (93.1%) and the lowest for restaurants/bars patios in Greece (39.4%). Among smokers, the corresponding estimates were for children's playgrounds in Latvia (88.9%) and for cars in Portugal (21%). For most settings, support for smoke-free legislation was directly related with the countries' prevalence of secondhand smoke presence and reported smoking in each setting.nnDISCUSSION: Our results show that the majority of European adults (including a large proportion of smokers) are supportive of implementing smoke-free legislation in indoor settings and extending it to selected outdoor settings. Such expressive support can be seen as an opportunity to advance legislation and protect the European population from secondhand smoke exposure.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33456019,

title = {Use and Awareness of Heated Tobacco Products in Europe},

author = {Gallus S and Lugo A and Liu X and Borroni E and Clancy L and Gorini G and Lopez MJ and Odone A and Przewozniak K and Tigova O and van den Brandt PA and Vardavas C and Fernandez E and TackSHS Project Investigators},

doi = {10.2188/jea.JE20200248},

issn = {1349-9092},

year  = {2022},

date = {2022-03-01},

journal = {J Epidemiol},

volume = {32},

number = {3},

pages = {139--144},

abstract = {BACKGROUND: Heated tobacco products (HTP) are new forms of tobacco consumption with limited information available on their use among the general population. Our objective was to analyze the prevalence and associations of use of HTP across 11 countries in Europe.nnMETHODS: Within the TackSHS Project, in 2017-2018 we conducted a cross-sectional study with information on HTP use in the following countries: Bulgaria, England, France, Germany, Greece, Italy, Latvia, Poland, Portugal, Romania and Spain. In each country, face-to-face interviews were performed on a representative sample of around 1,000 subjects aged ≥15 years, for a total of 10,839 subjects.nnRESULTS: Overall, 27.8% of study participants were aware of HTPs, 1.8% were ever HTP users (ranging from 0.6% in Spain to 8.3% in Greece), and 0.1% were current users. Men were more frequently HTP ever users than women (adjusted odds ratio [aOR] 1.47; 95% confidence interval [CI], 1.11-1.95). Ever HTP use was inversely related to age (P for trend <0.001) and more frequent in ex-smokers (compared with never smokers, aOR 4.32; 95% CI, 2.69-6.95) and current smokers (aOR 8.35; 95% CI, 5.67-12.28), and in electronic cigarette past users (compared with never users, aOR 5.48; 95% CI, 3.46-8.68) and current users (aOR 5.92; 95% CI, 3.73-9.40).nnCONCLUSIONS: In 2017-2018, HTP use was still limited in Europe among the general population; however, the dual use of these products, their high use among younger generations, and the interest of non-smokers in these products are worrying and indicate the need for close monitoring in terms of prevalence and the characteristics of users.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34651540,

title = {Association between biomarkers of tobacco consumption and lung cancer risk among daily smokers},

author = {González-Marrón A and Martín-Sánchez JC and Pérez-Ortuño R and Fu M and Ballbè M and Cartanyà-Hueso À and Matilla-Santander N and Pascual JA and Fernández E and Martínez-Sánchez JM},

doi = {10.1080/17476348.2022.1993064},

issn = {1747-6356},

year  = {2022},

date = {2022-02-01},

journal = {Expert Rev Respir Med},

volume = {16},

number = {2},

pages = {247--252},

abstract = {BACKGROUND: Biomarkers of tobacco consumption may play a role in the lung cancer risk assessment. However, the role of salivary biomarkers has not been well studied. The aim of this study is to assess the use of salivary biomarkers of tobacco consumption as lung cancer screening criterion.nnRESEARCH DESIGN AND METHODS: Data came from the Determinants of cotinine phase 3 project (Barcelona, 2013-2014). We compared the concentrations of TSNAs, including NNAL, NNN and NNK, and cotinine, in saliva samples of 142 daily smokers from the general population according to their risk of lung cancer. High risk of lung cancer was defined as per the inclusion criteria in the US National Lung Screening Trial (NLST) and in the Dutch-Belgian lung cancer screening trial (NELSON).nnRESULTS: Among daily smokers accomplishing the age criterion for lung cancer screening, salivary concentrations of cotinine, NNAL and NNK adjusted for sex were significantly higher (p-value < 0.05) in daily smokers at high risk of lung cancer compared to smokers not at high risk according to both NELSON and NLST criteria.nnCONCLUSIONS: Saliva concentrations of cotinine, NNAL and NNK may be used as additional criteria for lung cancer screening. Further research on this topic is guaranteed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35803645,

title = {Determinants of participation in an online follow-up survey among nursing students},

author = {Laroussy K and Castellano Y and Fu M and Baena A and Feliu 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 Fernández E and Martínez C},

doi = {10.1016/j.profnurs.2022.04.008},

issn = {1532-8481},

year  = {2022},

date = {2022-01-01},

journal = {J Prof Nurs},

volume = {41},

pages = {108--114},

abstract = {INTRODUCTION: Determinants of participation in longitudinal studies are crucial for prevent attrition.nnAIM: To analyze determinants of participation in a follow-up survey among nursing students.nnMATERIALS AND METHODS: Prospective longitudinal study among nursing students. We examined individual and contextual determinants of participation in an online follow-up survey (2018) among nursing students that had completed the paper-and-pencil questionnaire in baseline (2015-2016), using a multilevel logistic regression models.nnRESULTS: From the 4381 baseline participants, we identified 3440 eligible persons. The number of participants in the follow-up survey was 1252 (28.6%). Determinants of participation at follow-up were being female, aged ≤19 year-old in comparison with those older than 20, and being a never smoker compared with a current smoker.nnCONCLUSIONS: Nursing students' participation at the online follow-up survey was moderate. Being female, aged ≤19 year-old, and being never smoker were determinants of participation. To boost participation in online surveys, some strategies such as adapted communications channels, the use of reminders and incentives should be included.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35515714,

title = {Measuring cigarette dependence: A comparison of two scales in two different groups of smokers},

author = {Fu M and Carnicer-Pont D and Castellano Y and Ballbè M and Sureda X and Raich A and Martínez-Sánchez JM and Martínez C and Baena A and Riccobene A and Enríquez M and Fernández E},

doi = {10.18332/tpc/146714},

issn = {2459-3087},

year  = {2022},

date = {2022-01-01},

journal = {Tob Prev Cessat},

volume = {8},

pages = {15},

abstract = {INTRODUCTION: The Fagerström Test for Cigarette Dependence (FTCD) and the Cigarette Dependence Scale (CDS) are usually used to assess cigarette dependence in clinical- and population-based studies. Our objective was to compare these two scales within groups of smokers from both contexts.nnMETHODS: The study was observational with smokers from a representative sample of the adult general population (n=188) and smokers attending a smoking cessation clinic in Barcelona, Spain (n=759). The FTCD and the CDS-5 (short version of 5 items) were used to assess cigarette dependence. We compared the standardized median scores obtained with both scales within each group of smokers by selected variables. To this aim, we re-scaled the scores of both scales to allow their comparison and assess their correlation within both groups.nnRESULTS: The scores obtained with both scales were highly correlated within both groups of smokers (p<0.001), indicating good agreement in the assessment of cigarette dependence. Nevertheless, higher standardized CDS-5 scores were observed more frequently in the population group overall (3.9 vs FTCD score=3.7, p=0.001), among women (4.5 vs 4.2; p<0.001), in the youngest group of smokers (3.9 vs 3.2; p<0.007) and in light smokers (time to the first cigarette >60 min; 1.7 vs 1.1; p<0.001).nnCONCLUSIONS: While the CDS-5 scored higher more frequently in the population group, the FTCD scored higher more frequently in the clinical group. These differences should be considered when designing either clinical- or population-based studies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35511766,

title = {Serum cotinine cut-points for secondhand smoke exposure assessment in children under 5 years: A systemic review},

author = {Mourino N and Ruano-Raviña A and Varela Lema L and Fernández E and López MJ and Santiago-Pérez MI and Rey-Brandariz J and Giraldo-Osorio A and Pérez-Ríos M},

doi = {10.1371/journal.pone.0267319},

issn = {1932-6203},

year  = {2022},

date = {2022-01-01},

journal = {PLoS One},

volume = {17},

number = {5},

pages = {e0267319},

abstract = {BACKGROUND: Serum cotinine has become the most widely used biomarker of secondhand smoke exposure (SHS) over time in all ages. The aim of this study was to review the serum cotinine cut-points used to classify children under 5 years as exposed to SHS.nnMETHODS: A systematic review performed in the Pubmed (MEDLINE) and EMBASE databases up to April 2021 was conducted using as key words "serum cotinine", "tobacco smoke pollution" (MeSH), "secondhand smoke", "environmental tobacco smoke" and "tobacco smoke exposure". Papers which assessed SHS exposure among children younger than 5 years old were included. The PRISMA 2020 guidelines were followed. Analysis was pre-registered in PROSPERO (registration number: CRD42021251263).nnRESULTS: 247 articles were identified and 51 fulfilled inclusion criteria. The selected studies were published between 1985-2020. Most of them included adolescents and adults. Only three assessed postnatal exposure exclusively among children under 5 years. None of the selected studies proposed age-specific cut-points for children < 5 years old. Cut-point values to assess SHS exposure ranged from 0.015 to 100 ng/ml. The most commonly used cut-point was 0.05 ng/ml, derived from the assay limit of detection used by the National Health and Nutrition Examination Survey (NHANES).nnCONCLUSIONS: No studies have calculated serum cotinine age-specific cut-points to ascertained SHS exposure among children under 5 years old. Children's age-specific cut-points are warranted for health research and public health purposes aimed at accurately estimating the prevalence of SHS exposure and attributable burden of disease to such exposure, and at reinforcing 100% smoke-free policies worldwide, both in homes, private vehicles and public places.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35477507,

title = {[Current use of electronic cigarettes among never smoker high school students]},

author = {Peruga A and Martínez C and Fu M and Ballbè M and Tigova O and Carnicer-Pont D and Fernández E},

doi = {10.1016/j.gaceta.2022.01.004},

issn = {1578-1283},

year  = {2022},

date = {2022-01-01},

journal = {Gac Sanit},

volume = {36},

number = {5},

pages = {433--438},

abstract = {OBJECTIVE: To test whether electronic cigarettes use among secondary school students in Spain is associated with initiating nicotine use.nnMETHOD: Secondary analysis of the ESTUDES 2019 survey, a cross-sectional study conducted on a representative sample of students aged 14-18 years and selected students who had never smoked (n=16,705). We computed the prevalence and estimated the factors associated with current electronic cigarettes use (at least once in the month before the interview), with and without nicotine.nnRESULTS: The prevalence of current electronic cigarettes use among students who have never smoked is 2.5% (95% confidence interval [95%CI]: 2.2-2.9). 0.1% (95%CI: 0.08-0.2) declared using liquids with nicotine at least sometimes and 2.4% (95%CI: 2.1-2.8) using liquids always without nicotine. Being male and under 17 years of age, reporting binge drinking behavior, and having regular friends who use cannabis, increases the probability of current use of electronic cigarettes. The latter two variables seem to act as contextual variables associated with electronic cigarettes use.nnCONCLUSIONS: The percentage of Spanish never smoker students who currently use electronic cigarettes is lower than in neighboring countries, except for the United Kingdom. Only one in every 1000 Spanish students between 14 and 18 years old who have never smoked initiates the current use of nicotine with an electronic cigarette. However, we must monitor the evolution of this indicator.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35330752,

title = {Tobacco products in the European Union Common Entry Gate (EU-CEG): A tool for monitoring the EU tobacco products directive},

author = {Carnicer-Pont D and Tigova O and Havermans A and Remue E and Ferech M and Vejdovszky K and Solimini R and Gallus S and Nunes E and Lange CC and Gomez-Chacon C and Ruiz-Dominguez F and Behrakis P and Vardavas CI and Fernandez E},

doi = {10.18332/tpc/145501},

issn = {2459-3087},

year  = {2022},

date = {2022-01-01},

journal = {Tob Prev Cessat},

volume = {8},

pages = {10},

abstract = {INTRODUCTION: Under the European Union (EU) Tobacco Products Directive (2014/40/EU) (TPD), manufacturers and importers of tobacco products are required to report information to the European Commission (EC) and Member States (MS) on products intended to be placed on the market. We describe the distribution of notifications to the EU Common Entry Gate (EU-CEG) and identify key fields for improvement on reporting cigarettes or roll-your-own (RYO) tobacco.nnMETHODS: A cross-sectional analysis of secondary data reported in the EU-CEG was conducted for tobacco products notified within EU-CEG between June 2016 and October 2019 for 12 EU MS. Analysis of compliance to specific regulations for priority additives that refer to cigarettes and RYO was conducted for 10 EU countries.nnRESULTS: Overall, 39170 tobacco products were notified. This included 16762 (42.8%) notifications of cigars, followed by cigarettes 11242 (28.7 %), waterpipes 3291 (8.4%), cigarillos (n=1783), pipe (n=1715), RYO (n=1635), chewing tobacco (n=1021), novel tobacco products (n=839), herbal products for smoking (n=535), other (n=258), nasal (n=74) and oral tobacco (n=15). In cigarettes and RYO tobacco products, the proportion of ingredients notified in all countries that contained an unknown Chemical Abstract Services (CAS) number was 3.8% and 2.1%, respectively. The proportion of underreporting flagging of priority additives ranged from 15.9% in Malta to 41.3% in Lithuania, the mean proportion of underreporting of the variable 'priority additive' for the 10 countries together was 24.7%.nnCONCLUSIONS: In the EU-CEG data base, for the period of analysis, a significant number of product notifications took place while large variations in the number of types of tobacco products notified across EU countries was noted. The timely monitoring of these data is needed so that products non-compliant within the EU-CEG system are assessed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34419288,

title = {[Lights and shadows for public health: A critical analysis of the tobacco legislation in Spain]},

author = {Feliu A and Martínez C and Fernández E},

doi = {10.1016/j.gaceta.2021.07.001},

issn = {1578-1283},

year  = {2022},

date = {2022-01-01},

journal = {Gac Sanit},

volume = {36},

number = {1},

pages = {48--52},

abstract = {Tobacco smoking is a chronic disease that is the leading preventable cause of death in developed countries. In Spain, the prevalence of tobacco use has decreased driven by the implementation of tobacco control policies; however, current legislation does not establish a harmonized regulation for all tobacco products. The aim of this article is to review the current legislation and critically analyze its limitations in relation to the principles of good administration now defined in the Law 39/2015. Spanish in force tobacco control policies main limitations can be divided into four areas: the lack of specific regulation for new tobacco products; the differences in their regulation; the lack of information to the general population on their harmful effects and the new developments in the regulation of smoke-free spaces; and the lack of adaptation of the regulation to the most recent scientific evidence. All in all, the quality of tobacco control regulations in Spain, despite the successes achieved with the Law 28/2005, has been compromised by the State's laxity in the legislative, regulatory, and administrative spheres, which has led to a regulatory stagnation that runs counter to the principles of good regulation. This review should encourage scientific organizations and civil society associations to call for an actualization of the tobacco legislation, with determined and coordinated prevention and control policies to promote a tobacco-free Spain.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34387341,

title = {Secondhand Smoke Exposure in European Countries With Different Smoke-Free Legislation: Findings From the EUREST-PLUS ITC Europe Surveys},

author = {Nogueira SO and Fernández E and Driezen P and Fu M and Tigova O and Castellano Y and Mons U and Herbeć A and Kyriakos CN and Demjén T and Trofor AC and Przewoźniak K and Katsaounou PA and Vardavas CI and Fong GT and EUREST-PLUS Consortium},

doi = {10.1093/ntr/ntab157},

issn = {1469-994X},

year  = {2022},

date = {2022-01-01},

journal = {Nicotine Tob Res},

volume = {24},

number = {1},

pages = {85--92},

abstract = {INTRODUCTION: Exposure to secondhand smoke (SHS) poses serious and extensive health and economic-related consequences to European society and worldwide. Smoking bans are a key measure to reducing SHS exposure but have been implemented with varying levels of success. We assessed changes in the prevalence of self-reported SHS exposure and smoking behavior in public places among smokers in six European countries and the influence of the country's type of smoking ban (partial or total ban) on such exposure and smoking behavior.nnAIMS AND METHODS: The EUREST-PLUS ITC Europe Surveys were conducted among adult smokers in Germany, Greece, Hungary, Poland, Romania, and Spain in 2016 (Wave 1, n = 6011) and 2018 (Wave 2, n = 6027). We used generalized estimating equations models to assess changes between Waves 1 and 2 and to test the interaction between the type of smoking ban and (1) self-reported SHS exposure, (2) self-reported smoking in several public places.nnRESULTS: A significant decrease in self-reported SHS exposure was observed in workplaces, from 19.1% in 2016 to 14.0% in 2018 (-5.1%; 95% CI: -8.0%; -2.2%). Self-reported smoking did not change significantly inside bars (22.7% in Wave 2), restaurants (13.2% in Wave 2) and discos/nightclubs (34.0% in W2). SHS exposure in public places was significantly less likely (adjusted odds ratio = 0.35; 95% CI: 0.26-0.47) in the countries with total bans as compared to those countries with partial bans.nnCONCLUSION: The inverse association between smoking in public places and smoking bans indicates an opportunity for strengthening smoke-free legislation and protecting bystanders from exposure to SHS in public places.nnIMPLICATIONS: Prevalence of smokers engaging in and being exposed to smoking in public places varied by type of smoke-free legislation across six European Union countries in our study; those with total smoke bans reported significantly less exposure to SHS than those with partial or no bans. Our results indicate room for improvement, not only to decrease the prevalence of exposure to SHS in Europe but also to diminish the variability between countries through common, more restrictive smoke-free legislation, and importantly, strong and sustained enforcement.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34111773,

title = {Tobacco use among substance use disorder (SUD) treatment staff is associated with tobacco-related services received by clients},

author = {Guydish J and Le T and Hosakote S and Straus E and Wong J and Martínez C and Delucchi K},

doi = {10.1016/j.jsat.2021.108496},

issn = {1873-6483},

year  = {2022},

date = {2022-01-01},

journal = {J Subst Abuse Treat},

volume = {132},

pages = {108496},

abstract = {BACKGROUND: Despite disproportionately high rates of smoking among people in residential substance use disorder (SUD) treatment, few receive tobacco cessation services. Little is known about how smoking among treatment staff may impact this disparity. We explored the relationship between staff tobacco use and client tobacco use. Additionally, we examined the relationship between staff tobacco use and tobacco-related services reported by staff and clients.nnMETHODS: Staff (n = 363) and clients (n = 639) in 24 California publicly-funded residential SUD treatment programs were surveyed in 2019-20. Staff self-reported current tobacco use, as well as their beliefs, self-efficacy, and practices regarding smoking cessation. Clients reported their tobacco use and they services received while in treatment. Regression analyses examined the adjusted and unadjusted associations between staff and client tobacco use and other outcomes.nnRESULTS: Use of any tobacco product by staff ranged from 0% to 100% by program, with an average of 32% across programs. Adjusted analyses found that higher rates of staff tobacco use were associated with higher rates of client tobacco use, and with fewer clients receiving tobacco-related counseling. In programs that had higher rates of staff tobacco use, staff were less likely to believe that clients should quit smoking in treatment and had lower self-efficacy to address smoking.nnCONCLUSION: Higher rates of tobacco use among staff are associated with higher rates of client tobacco use and fewer clients receiving cessation counseling. Efforts to reduce tobacco use among SUD clients should be supported by efforts to reduce tobacco use among staff. SUD treatment programs, and agencies that fund and regulate those programs, should aim to reduce the use of tobacco products among staff.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33865630,

title = {[Evaluation of competences in scientific writing after two different types of training courses: SCRIU-B study protocol]},

author = {Serés E and Fernández E and García AM and Vives-Cases C and Bosch F},

doi = {10.1016/j.gaceta.2020.12.036},

issn = {1578-1283},

year  = {2022},

date = {2022-01-01},

journal = {Gac Sanit},

volume = {36},

number = {2},

pages = {188--192},

abstract = {Scientific writing is one of the competences required and requested by health professionals. There are several course formats designed for acquiring these competences, although the improvement after taking part in these courses is not always demonstrated. Through an open and non-randomized experimental design, the SCRIU-B study aims to evaluate the acquisition of competencies in scientific writing after specific training courses (face-to-face and online) as well as the satisfaction of the participants with these courses. A control group with participants from other training workshops not related to scientific writing is included. Through different questionnaires about knowledge, attitudes and skills we will evaluate and compare the improvement of their scientific writing skills. The results of the study will allow us to assess the usefulness of these courses and improve their format and implementation.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33563478,

title = {[Tobacco heated products: a new challenge in tobacco control]},

author = {Peruga A and Rodríguez Lozano F and López MJ and Córdoba García R and Nerín I and Sureda X and Fernández E},

doi = {10.1016/j.gaceta.2020.12.033},

issn = {1578-1283},

year  = {2022},

date = {2022-01-01},

journal = {Gac Sanit},

volume = {36},

number = {1},

pages = {57--59},

abstract = {As cigarette sales decline, the tobacco industry has turned to the sale of heated tobacco products (HTP), which are on the rise. We are concerned with reports erroneously indicating that heated tobacco is associated with a lower risk of cancer and other diseases than conventional cigarettes, citing as a source the Food and Drug Administration (FDA) of the United States. The FDA has indeed authorized the sale of an HTP, but denies that this approval is an endorsement of the product or that it is safe. Philip Morris asked the FDA to approve this product as a "modified risk" tobacco product. However, the Agency denied that the risk to users' health was less than conventional cigarettes, despite emitting less amount of some toxicants. Spain and the European Union should end the regulatory privileges that HTPs have until now. We identified at least five aspects to improve: 1) compliance with the prohibition of HTPs use where smoking is prohibited; 2) control of the prohibition of advertising, promotion, and sponsorship of HTPs; 3) that HTPs carry the same type of labeling as cigarettes; 4) limit that HTPs have characteristic aromas; and 5) treat HTPs fiscally at the same level as cigarettes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32441557,

title = {Lung function changes in patients with chronic obstructive pulmonary disease (COPD) and asthma exposed to secondhand smoke in outdoor areas},

author = {Keogan S and Alonso T and Sunday S and Tigova O and Fernández E and López MJ and Gallus S and Semple S and Tzortzi A and Boffi R and Gorini G and López-Nicolás Á and Radu-Loghin C and Soriano JB and Clancy L and TackSHS Project Investigators (all listed in Appendix)},

doi = {10.1080/02770903.2020.1766062},

issn = {1532-4303},

year  = {2021},

date = {2021-09-01},

journal = {J Asthma},

volume = {58},

number = {9},

pages = {1169--1175},

abstract = {BACKGROUND: Further evidence is needed on the effects that short- and long-term exposure to secondhand smoke (SHS) have on the respiratory health of patients with lung disease. Within the TackSHS project we aimed to assess the acute respiratory effects in lung function that result from short-term SHS exposure among patients with asthma and chronic obstructive pulmonary disease (COPD).nnMETHODS: The study design was an intervention trial with measurements before/after exposure to SHS in legal outdoor smoking areas. We studied patients with asthma or COPD from Czechia, Ireland, and Spain. Forced spirometry, peak flow and carbon monoxide (CO) measurements were performed pre- and 24 h post- exposure.nnRESULTS: Overall, 60 patients were studied, 30 with asthma, and 30 with COPD; 35 (58.3%) were female. There were no significant differences observed in exhaled CO between pre- and 24 h post-exposure neither in women ( = 0.210), nor in men ( = 0.169).A statistically significant decrease in forced vital capacity (FVC) was seen, overall, in asthma participants ( = 0.02) and in forced expiratory volume in the first second (FEV), ( = 0.02), FVC ( = 0.04) and peak expiratory flow rate (PEFR) ( = 0.04) in female asthmatic participants. The observed decreases in respiratory measurements in COPD were not significant. There were no reported increases in symptoms, respiratory medication, or use of health services 24 h after the exposure.nnCONCLUSION: We conclude that acute, short-term SHS exposure had a statistically significant effect on spirometry in female asthma patients but did not significantly modify spirometric indices 24 h later in COPD patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33905602,

title = {Environmental and individual exposure to secondhand aerosol of electronic cigarettes in confined spaces: Results from the TackSHS Project},

author = {Amalia B and Fu M and Tigova O and Ballbè M and Castellano Y and Semple S and Clancy L and Vardavas C and López MJ and Cortés N and Pérez-Ortuño R and Pascual JA and Fernández E},

doi = {10.1111/ina.12841},

issn = {1600-0668},

year  = {2021},

date = {2021-09-01},

journal = {Indoor Air},

volume = {31},

number = {5},

pages = {1601--1613},

abstract = {Secondhand electronic cigarette (e-cigarette) aerosol (SHA) might impair indoor air quality and expose bystanders. This study aims to investigate exposure to SHA in controlled conditions of enclosed settings simulating real-world scenario. An experiment was performed in a car and in a room, in which SHA was generated during a 30-minute ad libitum use of an e-cigarette. The experiment was replicated on five consecutive days in each setting. We measured PM , airborne nicotine concentrations, and biomarkers of exposure to SHA, such as nicotine metabolites, tobacco-specific nitrosamines, propylene glycol, and glycerol in bystanders' saliva samples before, during, and after the exposure period. Self-reported health symptoms related to exposure to SHA were also recorded. The results showed that the highest median PM concentration was recorded during the exposure period, being 21 µg/m in the room setting and 16 µg/m in the car setting-about twofold increase compared to the baseline. Most concentrations of the airborne nicotine and all biomarkers were below the limit of quantification in both settings. Bystanders in both settings experienced some short-term irritation symptoms, expressed as dry throat, nose, eyes, and phlegm. In conclusion, short-term use of an e-cigarette in confined spaces increased indoor PM level and caused some irritation symptoms in bystanders.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33149260,

title = {Burden of disease from exposure to secondhand smoke in children in Europe},

author = {Carreras G and Lachi A and Cortini B and Gallus S and López MJ and López-Nicolás Á and Lugo A and Pastor MT and Soriano JB and Fernandez E and Gorini G and TackSHS Project Investigators},

doi = {10.1038/s41390-020-01223-6},

issn = {1530-0447},

year  = {2021},

date = {2021-07-01},

journal = {Pediatr Res},

volume = {90},

number = {1},

pages = {216--222},

abstract = {BACKGROUND: Secondhand smoke (SHS) exposure at home and fetal SHS exposure during pregnancy are a major cause of disease among children. The aim of this study is quantifying the burden of disease due to SHS exposure in children and in pregnancy in 2006-2017 for the 28 European Union (EU) countries.nnMETHODS: Exposure to SHS was estimated using a multiple imputation procedure based on the Eurobarometer surveys, and SHS exposure burden was estimated with the comparative risk assessment method using meta-analytical relative risks. Data on deaths and disability-adjusted life years (DALYs) were collected from National statistics and from the Global Burden of Disease Study.nnRESULTS: Exposure to SHS and its attributable burden stalled in 2006-2017; in pregnant women, SHS exposure was 19.8% in 2006, 19.1% in 2010, and 21.0% in 2017; in children it was 10.1% in 2006, 9.6% in 2010, and 12.1% in 2017. In 2017, 35,633 DALYs among children were attributable to SHS exposure in the EU, mainly due to low birth weight.nnCONCLUSIONS: Comprehensive smoking bans up to 2010 contributed to reduce SHS exposure and its burden in children immediately after their implementation; however, SHS exposure still occurs, and in 2017, its burden in children was still relevant.nnIMPACT: Exposure to secondhand smoke at home and in pregnancy is a major cause of disease among children. Smoking legislation produced the adoption of voluntary smoking bans in homes; however, secondhand smoke exposure at home still occurs and its burden is substantial. In 2017, the number of deaths and disability-adjusted life years in children attributable to exposure to secondhand smoke in the European Union countries were, respectively, 335 and 35,633. Low birth weight caused by secondhand smoke exposure in pregnancy showed the largest burden. Eastern European Union countries showed the highest burden.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33129855,

title = {Third-hand exposure at homes: Assessment using salivary cotinine},

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

doi = {10.1016/j.envres.2020.110393},

issn = {1096-0953},

year  = {2021},

date = {2021-05-01},

journal = {Environ Res},

volume = {196},

pages = {110393},

abstract = {BACKGROUND/OBJECTIVES: While exposure to secondhand smoke (SHS) is a well-established problem, exposure to third-hand smoke (THS) is scanty known and needs to be studied. The objective of this work is to characterize salivary cotinine concentrations among people who self-reported exposure to SHS and THS at home.nnMETHODS: Cross-sectional study of a representative sample (n = 736) of the adult population (≥16 years) from the city of Barcelona carried out in 2013-2014. A questionnaire on tobacco use and passive exposure was administered, and a saliva sample was collected for cotinine determination. For this study, the information of the non-smoker participants who provided saliva sample (n = 519) was used. The geometric means (GM) and geometric standard deviations (GSD) of the cotinine concentration were compared according to the type of self-reported exposure at home: (1) Not exposed to SHS or THS; (2) Exposed to SHS and THS; and (3) Only exposed to THS. We used log-linear models to compare the cotinine concentration of each exposed group with respect to the unexposed group, adjusting for sex, age, educational level, and tobacco exposure in other settings.nnRESULTS: The GM of the salivary cotinine concentration was 0.34 ng/ml (GSD = 0.16) among individuals reporting SHS and THS exposure, 0.22 ng/ml (GSD = 0.15) among those reporting only THS exposure and 0.11 ng/ml (GSD = 0.04) among those who declared not to be exposed to SHS nor THS (p-value for trend <0.001). The regression model showed a statistically significant increase in cotinine concentration among those exposed to SHS and THS (188% higher, 95% CI: 153%; 223%), and only exposed to THS (106% higher, IC95. %: 74.5%; 137.0%) when comparing with the unexposed group. No statistically significant differences in cotinine concentration were observed between those exposed to SHS and THS compared to the THS group (-25.8%, 95% CI: -69.5%; 17.9%).nnCONCLUSIONS/RECOMMENDATIONS: People exposed to third-hand smoke at home had quantifiable cotinine levels in saliva. No differences in cotinine levels were found between those exposed to second-hand and third-hand smoke at home. The reduction of exposure to third-hand smoke at home should be put into the agenda of tobacco control.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32594125,

title = {Gaining insight into the implementation of an e-learning smoking cessation course in Latin American countries},

author = {Vides-Porras A and Cáceres P and Company A and Guillen O and Arrien MA and Castellano Y and Margalef M and Yantuche W and Fernández E and Martínez C and Group of Hospital Coordinators in the Fruitful Project},

doi = {10.1093/heapro/daaa054},

issn = {1460-2245},

year  = {2021},

date = {2021-04-01},

journal = {Health Promot Int},

volume = {36},

number = {2},

pages = {349--362},

abstract = {Continuous medical education focused on health problems emerging in low- and middle-income countries (LMICs) is scarce. Although tobacco consumption is increasing in LMICs, there is a lack of tobacco cessation training programs in these countries. To promote smoking cessation interventions in Bolivia, Guatemala and Paraguay, we adapted an e-learning program developed in Catalonia (Spain). This process evaluation study reports on reach, dose and satisfaction of participants with the course, as well as the contextual factors of its application. We conducted a multiple method evaluation, which included a survey and several focus groups, each one specific to the same type of healthcare professional (nurses, doctors, other professionals). Two hundred and ninety-two participants registered into the online course. The motivation for undertaking the course was different between doctors and nurses. The main sources of difficulty in enrolling and finishing the course were the technical problems experienced when accessing the platform, and lack of acquaintance with computers and the Internet in general. Our results show that implementing e-learning education in hospitals from LMICs is feasible, especially when there are similarities between participating countries and the country in which the original program was developed. However, several elements such as strong organizational commitment, technical support and resources and adequate communication channels should be provided to facilitate enrollment and training completion. Efforts to improve Internet access should be made to avoid jeopardizing students' motivation to enroll and complete online training.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33858559,

title = {The right to smoke and the right to smoke-free surroundings: international comparison of smoke-free psychiatric clinic implementation experiences},

author = {Freiburghaus T and Raffing R and Ballbè M and Gual A and Tönnesen H},

doi = {10.1192/bjo.2021.35},

issn = {2056-4724},

year  = {2021},

date = {2021-04-01},

journal = {BJPsych Open},

volume = {7},

number = {3},

pages = {e81},

abstract = {BACKGROUND: In Scandinavia, people with a severe mental disorder have a reduced life expectancy of 15-20 years compared with the general public. Smoking is a major contributor, and smoke-free policies are increasingly adopted in psychiatric clinics around the world. We compared potential facilitators and barriers among staff and management, for the implementation of smoke-free psychiatric clinics.nnAIMS: To investigate the attitudes and experiences regarding smoke-free policies among managers and staff involved in the implementation processes of smoke-free psychiatric clinics at hospitals in Malmö (Sweden) and Barcelona (Spain).nnMETHOD: We used a qualitative methodology, with 15 semi-structured interviews. The interviews were conducted with each participant individually, and were subsequently transcribed. The data were analysed with systematic text condensation.nnRESULTS: There were notable differences in how the smoke-free policies were carried out and experienced, and attitudes regarding the policy changes differed in the two settings. Key differences were the views on the right to smoke in compulsory care and to stay in smoke-free surroundings supported by smoking cessation intervention; the prioritisation of staff facilitation of smoking breaks; and views on smoking and smoke-free psychiatry. In contrast, participants agreed on the importance of staff education and management support. A smoking ban by law and belonging to a network of smoke-free hospitals were also relevant.nnCONCLUSIONS: Staff education, and support from staff and management for the patients' right to stay in smoke-free surroundings, facilitated successful implementation of smoke-free policies in the psychiatric clinics, whereas supporting the right to smoke was a barrier.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33903637,

title = {The association between tobacco control policy implementation and country-level socioeconomic factors in 31 European countries},

author = {Feliu A and Filippidis FT and Joossens L and Amalia B and Tigova O and Martínez C and Fernández E},

doi = {10.1038/s41598-021-88194-8},

issn = {2045-2322},

year  = {2021},

date = {2021-04-01},

journal = {Sci Rep},

volume = {11},

number = {1},

pages = {8912},

abstract = {European countries have made significant progress in implementing tobacco control policies to reduce tobacco use; however, whether socioeconomic status (SES) of a country may influence the implementation of such policies is unknown. The aim of this study is to assess the association between country-level SES and the implementation level of tobacco control policies in 31 European countries. An ecological study using data from Eurostat, Human Development Reports on several SES indicators and the Tobacco Control Scale (TCS) of 2016 was conducted to measure country-level tobacco control policies. We analysed the relationship between SES indicators and the TCS by means of scatter-plots and Spearman's rank correlation coefficients (r) and multivariable linear regression analysis. In Europe, no statistically significant association was found between SES factors and the level of implementation of tobacco control policies. Only public spending on tobacco control was associated with all SES factors, except for Gini Index (an income inequality index). The strongest associations of TCS scores for this policy domain were found with the Human Development Index (r = 0.586; p < 0.001) and the Gross Domestic Product per capita (in Euros) (r = 0.562; p = 0.001). The adjusted linear regression model showed an association of tobacco control policy implementation with countries' geographical location (Western Europe, β = - 15.7; p = 0.009, compared to Northern Europe). In conclusion, no association was found between SES factors and the level of implementation of tobacco control policies in 31 European countries; policymakers should be aware that tobacco control policies could be successfully implemented despite socioeconomic constraints, especially when these policies are of low cost and cost-effective (i.e., smoke-free bans and taxation).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33388324,

title = {Burden of disease from second-hand tobacco smoke exposure at home among adults from European Union countries in 2017: an analysis using a review of recent meta-analyses},

author = {Carreras G and Lachi A and Cortini B and Gallus S and López MJ and López-Nicolás Á and Soriano JB and Fernandez E and Tigova O and Gorini G and TackSHS Project Investigators},

doi = {10.1016/j.ypmed.2020.106412},

issn = {1096-0260},

year  = {2021},

date = {2021-04-01},

journal = {Prev Med},

volume = {145},

pages = {106412},

abstract = {Smoke-free legislation reduced second-hand smoke (SHS) exposure in public places, and indirectly promoted private smoke-free settings. Nevertheless, a large proportion of adults is still exposed to SHS at home. The aim of this paper is to quantify the burden of disease due to home SHS exposure among adults in the 28-European Union (EU) countries for year 2017. The burdens by gender from lung cancer, chronic obstructive pulmonary disease (COPD), breast cancer, ischemic heart disease (IHD), stroke, asthma, and diabetes were estimated in an original research analysis using the comparative risk assessment method. Relative risks of death/diseases by gender for adults exposed to SHS at home compared to not exposed ones were estimated updating existing meta-analyses. Prevalence of home SHS exposure by gender was estimated using a multiple imputation procedure based on Eurobarometer surveys. Data on mortality and disability adjusted life years (DALYs) were obtained from the Global Burden of Disease, Injuries and Risk Factors Study. In 2017, 526,000 DALYs (0.36% of total DALYs) and 24,000 deaths (0.46% of total deaths) were attributable to home SHS exposure in the 28-EU countries, mainly from COPD and IHD. South-Eastern EU countries showed the highest burden, with proportion of DALYs/deaths attributable to SHS exposure on total higher than 0.50%/0.70%, whereas northern EU-countries showed the lowest burden, with proportions of DALYs/deaths lower than 0.25%/0.34%. The burden from SHS exposure is still significant in EU countries. More could be done to raise awareness of the health risks associated with SHS exposure at home.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33385392,

title = {Toward a correct measure of third-hand exposure},

author = {Lidón-Moyano C and Fu M and Perez-Ortuño R and Ballbè M and Garcia E and Martín-Sánchez JC and Pascual JA and Fernández E and Martínez-Sánchez JM},

doi = {10.1016/j.envres.2020.110686},

issn = {1096-0953},

year  = {2021},

date = {2021-03-01},

journal = {Environ Res},

volume = {194},

pages = {110686},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33533185,

title = {Tobacco control policies in the 21st century: achievements and open challenges},

author = {Peruga A and López MJ and Martinez C and Fernández E},

doi = {10.1002/1878-0261.12918},

issn = {1878-0261},

year  = {2021},

date = {2021-03-01},

journal = {Mol Oncol},

volume = {15},

number = {3},

pages = {744--752},

abstract = {Noncommunicable diseases (NCDs), including cancer, are responsible for almost 70% of all deaths worldwide. Tobacco use is a risk factor common to most NCDs. This article discusses tobacco control policies and highlights major achievements and open challenges to reduce smoking prevalence and attributable morbidity and mortality in the 21st century. The introduction of the WHO Framework Convention on Tobacco Control in 2005 has been a key achievement in the field and has already facilitated a drop in both smoking prevalence and exposure to secondhand smoke. Indicatively, the size of the worldwide population benefiting from at least one cost-effective tobacco control policy has quadrupled since 2007. In addition, plain cigarette packaging has been successfully introduced as a tobacco control policy, surmounting efforts of the tobacco industry to challenge this based on trade and investment law. Nevertheless, tobacco control still faces major challenges. Smoking prevalence needs to be further reduced in a rather expedited manner. Smoke-free environments should be extended, and the use of plain tobacco packaging with large pictorial health warnings for all tobacco products should be further promoted in some parts of the world. Some of these measures will require prompt determination and diligence. For example, bold political decisions are needed to significantly increase real prices of tobacco products through excise taxes, ban added ingredients that are currently used to increase the attractiveness of tobacco products and ban the tobacco industry's corporate social responsibility initiatives. Finally, the debate on harm reduction strategies for tobacco control still needs to be resolved.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33278471,

title = {How widespread is electronic cigarette use in outdoor settings? A field check from the TackSHS project in 11 European countries},

author = {Amalia B and Rodríguez A and Henderson E and Fu M and Continente X and Tigova O and Semple S and Clancy L and Gallus S and Fernández E and López MJ and TackSHS Project Investigators},

doi = {10.1016/j.envres.2020.110571},

issn = {1096-0953},

year  = {2021},

date = {2021-02-01},

journal = {Environ Res},

volume = {193},

pages = {110571},

abstract = {Exposure to secondhand aerosol from electronic cigarettes (e-cigarettes) may pose harms to bystanders, but they are used in many indoor settings. Less evidence exists on e-cigarette use in outdoor settings. This study aims to assess the use of e-cigarettes in outdoor settings in Europe. A cross-sectional study was conducted at the entrances of primary schools (N = 200), children's playgrounds (N = 200), and outdoor hospitality venues (N = 220) during 2017-2018 in major cities of 11 European countries. We performed 30-min observations and recorded e-cigarette use at three-time points: at 0 min, 15 min, and 30 min. We described the number and proportion of settings with e-cigarette use observed at any of the three-time points according to country and other contextual variables. Results showed that there were 22 (11.0%) school entrances, eight (4.0%) playgrounds, and 47 (21.3%) outdoor hospitality venues where e-cigarette use was observed at any time point. School entrances and outdoor hospitality venues with observed e-cigarette use were more frequently found in countries with a higher prevalence (≥1.4%) of e-cigarette use (school entrances: 18.0% vs. 4.0%; p = 0.002, outdoor hospitality venues: 26.7% vs. 15.0%, p = 0.036). In conclusion, the outdoor setting with the highest visibility of e-cigarette use was outdoor areas of hospitality venues. Although still limited, e-cigarettes were also used in outdoor settings frequented by children. Governments should consider measures to restrict e-cigarette use outdoors to protect the health of bystanders, particularly in areas where children may be present.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32173050,

title = {[Informed choice in breast cancer screening: the role of education]},

author = {Pons-Rodríguez A and Martínez-Alonso M and Perestelo-Pérez L and Garcia M and Sala M and Rué M and en nombre del grupo InforMa and El grupo InforMa está formado por},

doi = {10.1016/j.gaceta.2020.01.002},

issn = {1578-1283},

year  = {2021},

date = {2021-01-01},

journal = {Gac Sanit},

volume = {35},

number = {3},

pages = {243--249},

abstract = {OBJECTIVE: To evaluate the effect of receiving information about the benefits and harms of breast cancer screening in informed choice, according to educational level.nnMETHOD: Secondary analysis of a randomized, controlled study, in four screening programs, in Catalonia and the Canary Islands (Spain). We analyzed 400 women who were going to be invited to participate for the first time. The intervention group received a decision aid that showed the benefits and harms of screening. The control group received a standard brochure that recommended participating in the screening program. Educational level was grouped into two categories, low and high. The primary outcome was informed choice defined as adequate knowledge and consistency between attitudes and intentions.nnRESULTS: The intervention produced a greater increase in knowledge in women with a high educational level compared to those with a lower educational level. Among women who received the intervention, informed choice was almost three times higher in those with a high educational level (27% versus 11%). No differences were observed between educational levels in decisional conflict, confidence in the decision, anxiety and worry about breast cancer, in the intervention and control groups.nnCONCLUSIONS: A decision aid for breast cancer screening had much more impact on informed choice among women with a high educational level. In women with low educational level, the attitude towards screening improved and there was an increase in the intention to be screened.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32123139,

title = {Exposure to secondhand aerosol of electronic cigarettes in indoor settings in 12 European countries: data from the TackSHS survey},

author = {Amalia B and Liu X and Lugo A and Fu M and Odone A and van den Brandt PA and Semple S and Clancy L and Soriano JB and Fernández E and Gallus S and TackSHS Project Investigators},

doi = {10.1136/tobaccocontrol-2019-055376},

issn = {1468-3318},

year  = {2021},

date = {2021-01-01},

journal = {Tob Control},

volume = {30},

number = {1},

pages = {49--56},

abstract = {INTRODUCTION: Exposure to secondhand aerosol from e-cigarette (SHA) may pose harmful effects to bystanders. This study aims to investigate the prevalence, duration and determinants of SHA exposure in various indoor settings in 12 European countries.nnMETHODS: In 2017-2018, we conducted a cross-sectional study, the TackSHS survey, on a representative sample of the population aged ≥15 years in 12 European countries (Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania and Spain). We described the prevalence and duration of exposure to SHA in several indoor settings among 11 604 e-cigarette non-users. Individual-level and country-level characteristics associated with SHA exposure were also explored using multilevel logistic regression analyses.nnRESULTS: Overall, 16.0% of e-cigarette non-users were exposed to SHA in any indoor setting at least weekly, ranging from 4.3% in Spain to 29.6% in England. The median duration of SHA exposure among those who were exposed was 43 min/day. 'Other indoor settings' (eg, bar and restaurant) was reported as the place where most of e-cigarette non-users were exposed (8.3%), followed by workplace/educational venues (6.4%), home (5.8%), public transportation (3.5%) and private transportation (2.7%). SHA exposure was more likely to occur in certain groups of non-users: men, younger age groups, those with higher level of education, e-cigarette past users, current smokers, those perceiving SHA harmless and living in countries with a higher e-cigarette use prevalence.nnCONCLUSIONS: We found inequalities of SHA exposure across and within European countries. Governments should consider extending their tobacco smoke-free legislation to e-cigarettes to protect bystanders, particularly vulnerable populations such as young people.nnTRIAL REGISTRATION NUMBER: NCT02928536.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32151468,

title = {Outreach HIV testing using oral fluid and online consultation of the results: Pilot intervention in Catalonia},

author = {Agustí C and Muñoz R and González V and Villegas L and Fibla J and Meroño M and Capitán A and Fernàndez-López L and Platteau T and Casabona J},

doi = {10.1016/j.eimc.2020.01.020},

issn = {2529-993X},

year  = {2021},

date = {2021-01-01},

journal = {Enferm Infecc Microbiol Clin (Engl Ed)},

volume = {39},

number = {1},

pages = {3--8},

abstract = {INTRODUCTION: The aim of the intervention was to describe the feasibility and cost-effectiveness of offering HIV testing in outreach interventions and subsequent consultation of the results through a secure web page.nnMETHODS: The HIV test was offered "in situ" to men who have sex with men (MSM), migrant sex workers and trans women recruited in places of leisure and sex. Four collaborating NGOs recruited the participants and assisted them to register on the study website (www.swab2know.eu) through a tablet or the smartphone of the same participant. The samples were sent to the reference laboratory and the results were published on the website.nnRESULTS: 834 participants (612 MSMs, 203 women sex workers and 19 trans women) were recruited. In total 22 reagent results (2.6%) were detected: 21 among MSMs (3.4%) and 1 in a trans women (5.3%). While 82.6% of MSMs consulted their outcome, only 39.9% and 26.3% of women sex workers and trans women respectively consulted their outcome CONCLUSIONS: Providing self-sampling in outreach activities, dispatch and analysis in a reference laboratory as well as online communication of test results is feasible. A high proportion of participants with a HIV reactive result were detected among MSMs and trans women.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33023825,

title = {Differences in breast cancer risk after benign breast disease by type of screening diagnosis},

author = {Louro J and Román M and Posso M and Comerma L and Vidal C and Saladié F and Alcantara R and Sanchez M and Quintana MJ and Del Riego J and Ferrer J and Peñalva L and Bargalló X and Prieto M and Sala M and Castells X},

doi = {10.1016/j.breast.2020.09.005},

issn = {1532-3080},

year  = {2020},

date = {2020-12-01},

journal = {Breast},

volume = {54},

pages = {343--348},

abstract = {INTRODUCTION: We aimed to assess differences in breast cancer risk across benign breast disease diagnosed at prevalent or incident screens.nnMATERIALS AND METHODS: We conducted a retrospective cohort study with data from 629,087 women participating in a long-standing population-based breast cancer screening program in Spain. Each benign breast disease was classified as non-proliferative, proliferative without atypia, or proliferative with atypia, and whether it was diagnosed in a prevalent or incident screen. We used partly conditional Cox hazard regression to estimate the adjusted hazard ratios of the risk of breast cancer.nnRESULTS: Compared with women without benign breast disease, the risk of breast cancer was significantly higher (p-value = 0.005) in women with benign breast disease diagnosed in an incident screen (aHR, 2.67; 95%CI: 2.24-3.19) than in those with benign breast disease diagnosed in a prevalent screen (aHR, 1.87; 95%CI: 1.57-2.24). The highest risk was found in women with a proliferative benign breast disease with atypia (aHR, 4.35; 95%CI: 2.09-9.08, and 3.35; 95%CI: 1.51-7.40 for those diagnosed at incident and prevalent screens, respectively), while the lowest was found in women with non-proliferative benign breast disease (aHR, 2.39; 95%CI: 1.95-2.93, and 1.63; 95%CI: 1.32-2.02 for those diagnosed at incident and prevalent screens, respectively).nnCONCLUSION: Our study showed that the risk of breast cancer conferred by a benign breast disease differed according to type of screen (prevalent or incident). To our knowledge, this is the first study to analyse the impact of the screening type on benign breast disease prognosis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}