PUBLICACIONES

@article{pmid40135674,

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

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

doi = {10.1080/02791072.2025.2479102},

issn = {2159-9777},

year  = {2025},

date = {2025-03-01},

journal = {J Psychoactive Drugs},

pages = {1--15},

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

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}

@article{pmid40129551,

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

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

doi = {10.1183/23120541.00950-2024},

issn = {2312-0541},

year  = {2025},

date = {2025-03-01},

journal = {ERJ Open Res},

volume = {11},

number = {2},

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

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@article{pmid40241742,

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

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

doi = {10.18332/tid/202651},

issn = {1617-9625},

year  = {2025},

date = {2025-01-01},

journal = {Tob Induc Dis},

volume = {23},

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

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pubstate = {published},

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}

@article{pmid39265319,

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

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

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

issn = {1578-1275},

year  = {2025},

date = {2025-01-01},

journal = {Aten Primaria},

volume = {57},

number = {1},

pages = {103077},

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

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pubstate = {published},

tppubtype = {article}

}

@article{pmid39846443,

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

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

doi = {10.1080/10826084.2024.2440384},

issn = {1532-2491},

year  = {2025},

date = {2025-01-01},

journal = {Subst Use Misuse},

volume = {60},

number = {4},

pages = {566--576},

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

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@article{pmid38944617,

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

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

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

issn = {1579-2129},

year  = {2024},

date = {2024-11-01},

journal = {Arch Bronconeumol},

volume = {60},

number = {11},

pages = {690--697},

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

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pubstate = {published},

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@article{pmid39308778,

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

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

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

issn = {2666-7762},

year  = {2024},

date = {2024-10-01},

journal = {Lancet Reg Health Eur},

volume = {45},

pages = {101060},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38288784,

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

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

doi = {10.1111/jpm.13012},

issn = {1365-2850},

year  = {2024},

date = {2024-10-01},

journal = {J Psychiatr Ment Health Nurs},

volume = {31},

number = {5},

pages = {755--766},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38916135,

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

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

doi = {10.1093/tbm/ibae016},

issn = {1613-9860},

year  = {2024},

date = {2024-09-01},

journal = {Transl Behav Med},

volume = {14},

number = {9},

pages = {549--560},

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

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pubstate = {published},

tppubtype = {article}

}

@article{pmid36975072,

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

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

doi = {10.20882/adicciones.1837},

issn = {0214-4840},

year  = {2024},

date = {2024-09-01},

journal = {Adicciones},

volume = {36},

number = {3},

pages = {277--286},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39298750,

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

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

doi = {10.2196/58335},

issn = {1929-0748},

year  = {2024},

date = {2024-09-01},

journal = {JMIR Res Protoc},

volume = {13},

pages = {e58335},

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

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pubstate = {published},

tppubtype = {article}

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@article{pmid38804329,

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

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

issn = {2173-9110},

year  = {2024},

date = {2024-05-01},

journal = {Rev Esp Salud Publica},

volume = {98},

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

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pubstate = {published},

tppubtype = {article}

}

@article{pmid39398343,

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

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

doi = {10.18332/tid/192118},

issn = {1617-9625},

year  = {2024},

date = {2024-01-01},

journal = {Tob Induc Dis},

volume = {22},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38910916,

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

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

doi = {10.18332/tid/189392},

issn = {1617-9625},

year  = {2024},

date = {2024-01-01},

journal = {Tob Induc Dis},

volume = {22},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33879426,

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

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

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

issn = {2531-0437},

year  = {2024},

date = {2024-01-01},

journal = {Pulmonology},

volume = {30},

number = {2},

pages = {137--144},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39293184,

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

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

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

issn = {1578-1283},

year  = {2024},

date = {2024-01-01},

journal = {Gac Sanit},

volume = {38},

pages = {102422},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38978612,

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

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

doi = {10.18332/tid/189484},

issn = {1617-9625},

year  = {2024},

date = {2024-01-01},

journal = {Tob Induc Dis},

volume = {22},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39569388,

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

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

doi = {10.18332/tpc/192088},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39220715,

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

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

doi = {10.18332/tid/191797},

issn = {1617-9625},

year  = {2024},

date = {2024-01-01},

journal = {Tob Induc Dis},

volume = {22},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38638446,

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

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

doi = {10.18332/tpc/186402},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38757008b,

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

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

doi = {10.18332/tpc/188094},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39524201,

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

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

doi = {10.18332/tpc/193977},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39430870,

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

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

doi = {10.18332/tpc/192786},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38757008,

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

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

doi = {10.18332/tpc/188094},

issn = {2459-3087},

year  = {2024},

date = {2024-01-01},

journal = {Tob Prev Cessat},

volume = {10},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36978253,

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

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

doi = {10.1111/jan.15665},

issn = {1365-2648},

year  = {2023},

date = {2023-09-01},

journal = {J Adv Nurs},

volume = {79},

number = {9},

pages = {3456--3472},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36566961,

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

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

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

issn = {1096-0953},

year  = {2023},

date = {2023-02-01},

journal = {Environ Res},

volume = {219},

pages = {115118},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36534716,

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

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

doi = {10.1213/ANE.0000000000006240},

issn = {1526-7598},

year  = {2023},

date = {2023-01-01},

journal = {Anesth Analg},

volume = {136},

number = {1},

pages = {43--50},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35671260,

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

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

doi = {10.1097/CEJ.0000000000000757},

issn = {1473-5709},

year  = {2023},

date = {2023-01-01},

journal = {Eur J Cancer Prev},

volume = {32},

number = {1},

pages = {81--88},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33727255,

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

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

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

issn = {1468-3318},

year  = {2022},

date = {2022-11-01},

journal = {Tob Control},

volume = {31},

number = {6},

pages = {765--769},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35878525,

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

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

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

issn = {1877-783X},

year  = {2022},

date = {2022-10-01},

journal = {Cancer Epidemiol},

volume = {80},

pages = {102226},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@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}

}