2016
Pérez-Ortuño R, Martínez-Sánchez JM, Fu M, Ballbè M, Quirós N, Fernández E, Pascual JA.
Environ Res. 2016;151:635–641.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27619208,
title = {Assessment of tobacco specific nitrosamines (TSNAs) in oral fluid as biomarkers of cancer risk: A population-based study},
author = {Pérez-Ortuño R and Martínez-Sánchez JM and Fu M and Ballbè M and Quirós N and Fernández E and Pascual JA},
doi = {10.1016/j.envres.2016.08.036},
issn = {1096-0953},
year = {2016},
date = {2016-11-01},
journal = {Environ Res},
volume = {151},
pages = {635--641},
abstract = {BACKGROUND: Smoke-free laws are expected to reduce smoking habits and exposure to secondhand smoke. The objective of this study was the measurement of tobacco specific carcinogens (TSNAs) in oral fluid to assess the most suitable biomarker of cancer risk associated with tobacco smoke.nnMETHODS: TSNAs, N'-nitrosonornicotine (NNN), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), as well as nicotine and cotinine were measured in oral fluid samples from 166 smokers and 532 non-smokers of the adult population of Barcelona, Spain. A simple method with an alkaline single liquid-liquid extraction with dichloromethane/isopropanol was used and lower limits of quantification for cotinine, NNN, NNK and NNAL were set at 0.10ng/mL, 1.0, 2.0 and 0.50pg/mL respectively. The NNN/cotinine ratio was also calculated.nnRESULTS: NNN was the most abundant TSNA present in oral fluid with a significant difference between smokers and non-smokers (mean concentrations of 118 and 5.3pg/mL, respectively, p<0.001). NNK and NNAL were detectable in fewer samples. NNN and cotinine concentrations had a moderate correlation within both groups (Spearman's rank correlation coefficient of 0.312, p<0.001 in smokers and 0.279, p=0.022 in non-smokers). NNN/cotinine ratio was significantly higher (p<0.001) in non-smokers than in smokers, in line with equivalent findings for the NNAL/cotinine ratio in urine.nnCONCLUSIONS: TSNAs are detectable in oral fluid of smokers and non-smokers. NNN is the most abundant, in line with its association with esophageal and oral cavity cancers. The NNN/cotinine ratio confirms the relative NNN increase in second hand smoke. Findings provide a new oral fluid biomarker of cancer risk associated with exposure to tobacco smoke.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Smoke-free laws are expected to reduce smoking habits and exposure to secondhand smoke. The objective of this study was the measurement of tobacco specific carcinogens (TSNAs) in oral fluid to assess the most suitable biomarker of cancer risk associated with tobacco smoke.nnMETHODS: TSNAs, N'-nitrosonornicotine (NNN), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), as well as nicotine and cotinine were measured in oral fluid samples from 166 smokers and 532 non-smokers of the adult population of Barcelona, Spain. A simple method with an alkaline single liquid-liquid extraction with dichloromethane/isopropanol was used and lower limits of quantification for cotinine, NNN, NNK and NNAL were set at 0.10ng/mL, 1.0, 2.0 and 0.50pg/mL respectively. The NNN/cotinine ratio was also calculated.nnRESULTS: NNN was the most abundant TSNA present in oral fluid with a significant difference between smokers and non-smokers (mean concentrations of 118 and 5.3pg/mL, respectively, p<0.001). NNK and NNAL were detectable in fewer samples. NNN and cotinine concentrations had a moderate correlation within both groups (Spearman's rank correlation coefficient of 0.312, p<0.001 in smokers and 0.279, p=0.022 in non-smokers). NNN/cotinine ratio was significantly higher (p<0.001) in non-smokers than in smokers, in line with equivalent findings for the NNAL/cotinine ratio in urine.nnCONCLUSIONS: TSNAs are detectable in oral fluid of smokers and non-smokers. NNN is the most abundant, in line with its association with esophageal and oral cavity cancers. The NNN/cotinine ratio confirms the relative NNN increase in second hand smoke. Findings provide a new oral fluid biomarker of cancer risk associated with exposure to tobacco smoke.
Martínez C, Ballbè M, Vilardell M, Fu M, Fernández E.
The role of middle managers in tobacco control after a national smoke-free hospital campus ban. Article
BMC Health Serv Res. 2016;16:517.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27663779,
title = {The role of middle managers in tobacco control after a national smoke-free hospital campus ban},
author = {Martínez C and Ballbè M and Vilardell M and Fu M and Fernández E},
doi = {10.1186/s12913-016-1764-0},
issn = {1472-6963},
year = {2016},
date = {2016-09-01},
journal = {BMC Health Serv Res},
volume = {16},
number = {1},
pages = {517},
abstract = {BACKGROUND: Much of the recent health services research on tobacco control implementation has explored general views and perceptions of health professionals and has rarely taken into account middle management's perspectives. We state that middle managers may facilitate the implementation of smoke-free campus bans and thereby improve their effectiveness. The aim of this study was to assess middle managers' behaviors to enforce a new national smoke-free hospital campus ban, to evaluate their perceptions of the level of compliance of the new regulation, and to explore their attitudes towards how smoking affects the work environment.nnMETHODS: We used a cross-sectional survey, conducted online to evaluate middle managers of a general hospital in Catalonia, Spain. Close-ended and open-ended questions were included. Results were analyzed by using quantitative and qualitative methods. The managers' open opinions to the proposed topics were assessed using UCINET, and a graph was generated in NetDraw.nnRESULTS: Sixty-three of the invited managers (78.7 %) participated in the survey. 87.2 % of them agreed that the hospital complied with the smoke-free campus ban and 79.0 % agreed that managers have an important role in enforcing the ban. They also perceived that smoking disturbs the dynamics of work, is a cause of conflict between smokers and non-smokers, and harms both the professional and the organization images. However, 96.8 % of respondents have never given out fines or similar measures and their active role in reminding others of the policy was limited; in addition, 68.2 % considered that hospitals should provide tobacco cessation treatments. Smoker middle managers were more likely than non-smokers to perceive that smoking has little impact on work.nnCONCLUSIONS: Middle managers play a limited role in controlling tobacco consumption; smokers are less prone to think that smoking disturbs work dynamics than non-smokers. Tailored training and clear proceedings for middle managers could encourage more active roles.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Much of the recent health services research on tobacco control implementation has explored general views and perceptions of health professionals and has rarely taken into account middle management's perspectives. We state that middle managers may facilitate the implementation of smoke-free campus bans and thereby improve their effectiveness. The aim of this study was to assess middle managers' behaviors to enforce a new national smoke-free hospital campus ban, to evaluate their perceptions of the level of compliance of the new regulation, and to explore their attitudes towards how smoking affects the work environment.nnMETHODS: We used a cross-sectional survey, conducted online to evaluate middle managers of a general hospital in Catalonia, Spain. Close-ended and open-ended questions were included. Results were analyzed by using quantitative and qualitative methods. The managers' open opinions to the proposed topics were assessed using UCINET, and a graph was generated in NetDraw.nnRESULTS: Sixty-three of the invited managers (78.7 %) participated in the survey. 87.2 % of them agreed that the hospital complied with the smoke-free campus ban and 79.0 % agreed that managers have an important role in enforcing the ban. They also perceived that smoking disturbs the dynamics of work, is a cause of conflict between smokers and non-smokers, and harms both the professional and the organization images. However, 96.8 % of respondents have never given out fines or similar measures and their active role in reminding others of the policy was limited; in addition, 68.2 % considered that hospitals should provide tobacco cessation treatments. Smoker middle managers were more likely than non-smokers to perceive that smoking has little impact on work.nnCONCLUSIONS: Middle managers play a limited role in controlling tobacco consumption; smokers are less prone to think that smoking disturbs work dynamics than non-smokers. Tailored training and clear proceedings for middle managers could encourage more active roles.
Lidón-Moyano C, Martínez-Sánchez JM, Fu M, Ballbè M, Martín-Sánchez JC, Martínez C, Saltó E, Fernández E.
Tob Control. 2016;26:557–562.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27625409,
title = {Impact of the Spanish smoking legislations in the adoption of smoke-free rules at home: a longitudinal study in Barcelona (Spain)},
author = {Lidón-Moyano C and Martínez-Sánchez JM and Fu M and Ballbè M and Martín-Sánchez JC and Martínez C and Saltó E and Fernández E},
doi = {10.1136/tobaccocontrol-2016-053114},
issn = {1468-3318},
year = {2016},
date = {2016-09-01},
journal = {Tob Control},
volume = {26},
number = {5},
pages = {557--562},
abstract = {OBJECTIVE: To assess the impact of two Spanish smoking legislations in the adoption of voluntary smoke-free-homes rules in Spain.nnMETHODS: This is a longitudinal study, before and after the implementation of two national smoking bans (in 2005 and 2010), in a representative sample (n=1245) of non-institutionalised adults (≥16 years) from Barcelona (Spain) surveyed in 2004-2005 and followed up in 2013-2014. The final sample analysed was 736 individuals (400 women and 336 men). We defined smoking rules in the houses as complete (when smoking was not allowed in the household), partial (when smoking was allowed in some places inside the house) or absent (when smoking was allowed everywhere). We calculated relative changes in the prevalence of smoking rules in homes before and after 2 national smoking legislations by means of prevalence ratios (PRs) and their 95% CIs.nnRESULTS: The households with voluntary smoke-free rules (complete or partial) relatively increased 31% after Spanish smoking bans (from 55.6% to 72.6%, p<0.001). The houses with complete rules relatively increased 57% (from 23.9% to 37.6%, p<0.001) whereas the houses with partial rules increased 11% (from 31.7% to 35.0%, p=0.148). The increase of any type of rules (complete and partial) was statistically significantly independent of sex (PR between 1.29 and 1.33), age (PR between 1.24 and 1.33), educational level (PR between 1.19 and 1.47) and minimum age in house (PR between 1.12 and 1.40). However, this increase was statistically and significantly higher only among never smokers (PR=1.46) at baseline.nnCONCLUSIONS: The implementation of the smoke-free regulations in public and work places in Spain was associated with an increasing of voluntary adoption of smoke-free rules in homes. According to our data, the Spanish smoking bans did not shift the tobacco consumption from public and work places to private places (homes).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To assess the impact of two Spanish smoking legislations in the adoption of voluntary smoke-free-homes rules in Spain.nnMETHODS: This is a longitudinal study, before and after the implementation of two national smoking bans (in 2005 and 2010), in a representative sample (n=1245) of non-institutionalised adults (≥16 years) from Barcelona (Spain) surveyed in 2004-2005 and followed up in 2013-2014. The final sample analysed was 736 individuals (400 women and 336 men). We defined smoking rules in the houses as complete (when smoking was not allowed in the household), partial (when smoking was allowed in some places inside the house) or absent (when smoking was allowed everywhere). We calculated relative changes in the prevalence of smoking rules in homes before and after 2 national smoking legislations by means of prevalence ratios (PRs) and their 95% CIs.nnRESULTS: The households with voluntary smoke-free rules (complete or partial) relatively increased 31% after Spanish smoking bans (from 55.6% to 72.6%, p<0.001). The houses with complete rules relatively increased 57% (from 23.9% to 37.6%, p<0.001) whereas the houses with partial rules increased 11% (from 31.7% to 35.0%, p=0.148). The increase of any type of rules (complete and partial) was statistically significantly independent of sex (PR between 1.29 and 1.33), age (PR between 1.24 and 1.33), educational level (PR between 1.19 and 1.47) and minimum age in house (PR between 1.12 and 1.40). However, this increase was statistically and significantly higher only among never smokers (PR=1.46) at baseline.nnCONCLUSIONS: The implementation of the smoke-free regulations in public and work places in Spain was associated with an increasing of voluntary adoption of smoke-free rules in homes. According to our data, the Spanish smoking bans did not shift the tobacco consumption from public and work places to private places (homes).
Giraldo P, Sato L, Martínez-Sánchez JM, Comas M, Dwyer K, Sala M, Castells X.
BMJ Open. 2016;6:e011644.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27577585,
title = {Eleven-year descriptive analysis of closed court verdicts on medical errors in Spain and Massachusetts},
author = {Giraldo P and Sato L and Martínez-Sánchez JM and Comas M and Dwyer K and Sala M and Castells X},
doi = {10.1136/bmjopen-2016-011644},
issn = {2044-6055},
year = {2016},
date = {2016-08-01},
journal = {BMJ Open},
volume = {6},
number = {8},
pages = {e011644},
abstract = {OBJECTIVES: To evaluate and compare the characteristics of court verdicts on medical errors allegedly harming patients in Spain and Massachusetts from 2002 to 2012.nnDESIGN, SETTING AND PARTICIPANTS: We reviewed 1041 closed court verdicts obtained from data on litigation in the Thomson Reuters Aranzadi Westlaw databases in Spain (Europe), and 370 closed court verdicts obtained from the Controlled Risk and Risk Management Foundation of Harvard Medical Institutions (CRICO/RMF) in Massachusetts (USA). We included closed court verdicts on medical errors. The definition of medical errors was based on that of the Institute of Medicine (USA). We excluded any agreements between parties before a judgement.nnRESULTS: Medical errors were involved in 25.9% of court verdicts in Spain and in 74% of those in Massachusetts. The most frequent cause of medical errors was a diagnosis-related problem (25.1%; 95% CI 20.7% to 31.1% in Spain; 35%; 95% CI 29.4% to 40.7% in Massachusetts). The proportion of medical errors classified as high severity was 34% higher in Spain than in Massachusetts (p=0.001). The most frequent factors contributing to medical errors in Spain were surgical and medical treatment (p=0.001). In Spain, 98.5% of medical errors resulted in compensation awards compared with only 6.9% in Massachusetts.nnCONCLUSIONS: This study reveals wide differences in litigation rates and the award of indemnity payments in Spain and Massachusetts; however, common features of both locations are the high rates of diagnosis-related problems and the long time interval until resolution.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: To evaluate and compare the characteristics of court verdicts on medical errors allegedly harming patients in Spain and Massachusetts from 2002 to 2012.nnDESIGN, SETTING AND PARTICIPANTS: We reviewed 1041 closed court verdicts obtained from data on litigation in the Thomson Reuters Aranzadi Westlaw databases in Spain (Europe), and 370 closed court verdicts obtained from the Controlled Risk and Risk Management Foundation of Harvard Medical Institutions (CRICO/RMF) in Massachusetts (USA). We included closed court verdicts on medical errors. The definition of medical errors was based on that of the Institute of Medicine (USA). We excluded any agreements between parties before a judgement.nnRESULTS: Medical errors were involved in 25.9% of court verdicts in Spain and in 74% of those in Massachusetts. The most frequent cause of medical errors was a diagnosis-related problem (25.1%; 95% CI 20.7% to 31.1% in Spain; 35%; 95% CI 29.4% to 40.7% in Massachusetts). The proportion of medical errors classified as high severity was 34% higher in Spain than in Massachusetts (p=0.001). The most frequent factors contributing to medical errors in Spain were surgical and medical treatment (p=0.001). In Spain, 98.5% of medical errors resulted in compensation awards compared with only 6.9% in Massachusetts.nnCONCLUSIONS: This study reveals wide differences in litigation rates and the award of indemnity payments in Spain and Massachusetts; however, common features of both locations are the high rates of diagnosis-related problems and the long time interval until resolution.
Lhachimi SK, Nusselder WJ, Smit HA, Baili P, Bennett K, Fernández E, Kulik MC, Lobstein T, Pomerleau J, Boshuizen HC, Mackenbach JP.
BMC Public Health. 2016;16:734.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27495151,
title = {Potential health gains and health losses in eleven EU countries attainable through feasible prevalences of the life-style related risk factors alcohol, BMI, and smoking: a quantitative health impact assessment},
author = {Lhachimi SK and Nusselder WJ and Smit HA and Baili P and Bennett K and Fernández E and Kulik MC and Lobstein T and Pomerleau J and Boshuizen HC and Mackenbach JP},
doi = {10.1186/s12889-016-3299-z},
issn = {1471-2458},
year = {2016},
date = {2016-08-01},
journal = {BMC Public Health},
volume = {16},
pages = {734},
abstract = {BACKGROUND: Influencing the life-style risk-factors alcohol, body mass index (BMI), and smoking is an European Union (EU) wide objective of public health policy. The population-level health effects of these risk-factors depend on population specific characteristics and are difficult to quantify without dynamic population health models.nnMETHODS: For eleven countries-approx. 80 % of the EU-27 population-we used evidence from the publicly available DYNAMO-HIA data-set. For each country the age- and sex-specific risk-factor prevalence and the incidence, prevalence, and excess mortality of nine chronic diseases are utilized; including the corresponding relative risks linking risk-factor exposure causally to disease incidence and all-cause mortality. Applying the DYNAMO-HIA tool, we dynamically project the country-wise potential health gains and losses using feasible, i.e. observed elsewhere, risk-factor prevalence rates as benchmarks. The effects of the "worst practice", "best practice", and the currently observed risk-factor prevalence on population health are quantified and expected changes in life expectancy, morbidity-free life years, disease cases, and cumulative mortality are reported.nnRESULTS: Applying the best practice smoking prevalence yields the largest gains in life expectancy with 0.4 years for males and 0.3 year for females (approx. 332,950 and 274,200 deaths postponed, respectively) while the worst practice smoking prevalence also leads to the largest losses with 0.7 years for males and 0.9 year for females (approx. 609,400 and 710,550 lives lost, respectively). Comparing morbidity-free life years, the best practice smoking prevalence shows the highest gains for males with 0.4 years (342,800 less disease cases), whereas for females the best practice BMI prevalence yields the largest gains with 0.7 years (1,075,200 less disease cases).nnCONCLUSION: Smoking is still the risk-factor with the largest potential health gains. BMI, however, has comparatively large effects on morbidity. Future research should aim to improve knowledge of how policies can influence and shape individual and aggregated life-style-related risk-factor behavior.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Influencing the life-style risk-factors alcohol, body mass index (BMI), and smoking is an European Union (EU) wide objective of public health policy. The population-level health effects of these risk-factors depend on population specific characteristics and are difficult to quantify without dynamic population health models.nnMETHODS: For eleven countries-approx. 80 % of the EU-27 population-we used evidence from the publicly available DYNAMO-HIA data-set. For each country the age- and sex-specific risk-factor prevalence and the incidence, prevalence, and excess mortality of nine chronic diseases are utilized; including the corresponding relative risks linking risk-factor exposure causally to disease incidence and all-cause mortality. Applying the DYNAMO-HIA tool, we dynamically project the country-wise potential health gains and losses using feasible, i.e. observed elsewhere, risk-factor prevalence rates as benchmarks. The effects of the "worst practice", "best practice", and the currently observed risk-factor prevalence on population health are quantified and expected changes in life expectancy, morbidity-free life years, disease cases, and cumulative mortality are reported.nnRESULTS: Applying the best practice smoking prevalence yields the largest gains in life expectancy with 0.4 years for males and 0.3 year for females (approx. 332,950 and 274,200 deaths postponed, respectively) while the worst practice smoking prevalence also leads to the largest losses with 0.7 years for males and 0.9 year for females (approx. 609,400 and 710,550 lives lost, respectively). Comparing morbidity-free life years, the best practice smoking prevalence shows the highest gains for males with 0.4 years (342,800 less disease cases), whereas for females the best practice BMI prevalence yields the largest gains with 0.7 years (1,075,200 less disease cases).nnCONCLUSION: Smoking is still the risk-factor with the largest potential health gains. BMI, however, has comparatively large effects on morbidity. Future research should aim to improve knowledge of how policies can influence and shape individual and aggregated life-style-related risk-factor behavior.
Martín-Sánchez JC, Clèries R, Lidón C, González-de Paz L, Lunet N, Martínez-Sánchez JM.
Bayesian prediction of lung and breast cancer mortality among women in Spain (2014-2020). Article
Cancer Epidemiol. 2016;43:22–29.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27318304,
title = {Bayesian prediction of lung and breast cancer mortality among women in Spain (2014-2020)},
author = {Martín-Sánchez JC and Clèries R and Lidón C and González-de Paz L and Lunet N and Martínez-Sánchez JM},
doi = {10.1016/j.canep.2016.05.009},
issn = {1877-783X},
year = {2016},
date = {2016-08-01},
journal = {Cancer Epidemiol},
volume = {43},
pages = {22--29},
abstract = {BACKGROUND: Breast cancer (BC) is the main cause of cancer mortality among women, and mortality from lung cancer (LC) is increasing among women. The purpose of the present study was to project the mortality rates of both cancers and predict when LC mortality will exceed BC mortality.nnMETHODS: The cancer mortality data and female population distribution were obtained from the Spanish National Statistics Institute. Crude rate (CR), age-standardized rate (ASR), and age-specific rate were calculated for the period 1980-2013 and projected for the period 2014-2020 using a Bayesian log-linear Poisson model.nnRESULTS: All calculated rates were greater for BC than for LC in 2013 (CR, 27.3 versus 17.3; ASR, 13.5 versus 9.3), and the CR was not projected to change by 2020 (29.2 versus 27.6). The ASR for LC is expected to surpass that of BC in 2019 (12.9 versus 12.7).nnCONCLUSIONS: By 2020 the LC mortality rates may exceed those of BC for ages 55-74 years, possibly because of the prevalence of smoking among women, and the screening for and more effective treatment of BC. BC screening could be a good opportunity to help smokers quit by offering counseling and behavioral intervention.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Breast cancer (BC) is the main cause of cancer mortality among women, and mortality from lung cancer (LC) is increasing among women. The purpose of the present study was to project the mortality rates of both cancers and predict when LC mortality will exceed BC mortality.nnMETHODS: The cancer mortality data and female population distribution were obtained from the Spanish National Statistics Institute. Crude rate (CR), age-standardized rate (ASR), and age-specific rate were calculated for the period 1980-2013 and projected for the period 2014-2020 using a Bayesian log-linear Poisson model.nnRESULTS: All calculated rates were greater for BC than for LC in 2013 (CR, 27.3 versus 17.3; ASR, 13.5 versus 9.3), and the CR was not projected to change by 2020 (29.2 versus 27.6). The ASR for LC is expected to surpass that of BC in 2019 (12.9 versus 12.7).nnCONCLUSIONS: By 2020 the LC mortality rates may exceed those of BC for ages 55-74 years, possibly because of the prevalence of smoking among women, and the screening for and more effective treatment of BC. BC screening could be a good opportunity to help smokers quit by offering counseling and behavioral intervention.
Fu M, Fernández E, Martínez-Sánchez JM, San Emeterio N, Quirós N, Sureda X, Ballbè M, Muñoz G, Riccobene A, Centrich F, Saltó E, López MJ.
Environ Res. 2016;148:421–428.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27131796,
title = {Second-hand smoke exposure in indoor and outdoor areas of cafés and restaurants: Need for extending smoking regulation outdoors?},
author = {Fu M and Fernández E and Martínez-Sánchez JM and San Emeterio N and Quirós N and Sureda X and Ballbè M and Muñoz G and Riccobene A and Centrich F and Saltó E and López MJ},
doi = {10.1016/j.envres.2016.04.024},
issn = {1096-0953},
year = {2016},
date = {2016-07-01},
journal = {Environ Res},
volume = {148},
pages = {421--428},
abstract = {Smoke-free legislation in indoor public places has concentrated smokers in the areas outside building entrances or other outdoor areas. This study assessed the drift of second-hand smoke between outdoor and indoor areas of cafés and restaurants in Barcelona, Spain, and characterized the exposure on outdoor terraces. Using a cross-sectional design, we monitored vapor-phase nicotine in indoor areas and outside entrances simultaneously (n=47), and on some outdoor terraces (n=51). We computed the median nicotine concentration and interquartile range (IQR) to describe the data and performed multivariate analysis to describe nicotine concentration and its determinants. The overall median nicotine concentration indoors was 0.65µg/m(3) (IQR: 0.29-1.17µg/m(3)), with significant differences based on the number of smokers at the entrance (p=0.039). At outside entrances, the overall median nicotine concentration was 0.41µg/m(3) (IQR: 0.21-1.17µg/m(3)). The nicotine concentrations indoors and at the corresponding outside entrances were not significantly different, and the multivariate analysis confirmed the relationship between these variables. On terraces, the overall median nicotine concentration was 0.54µg/m(3) (IQR: 0.25-1.14µg/m(3)), but it increased to 0.60µg/m(3) when a tobacco smell was perceived, 0.72µg/m(3) on closed terraces, 1.24µg/m(3) when there were >6 smokers, and 1.24µg/m(3) when someone smoked >20min. Multivariate analysis confirmed the outdoor terrace area, the season, the type of enclosure, and the number of smokers as the most relevant variables explaining nicotine concentration (R(2)=0.396). These findings show that second-hand smoke exposure exists in indoor areas due to smokers smoking at the outside entrances. In addition, exposure may occur on outdoor terraces when smokers are present and the terrace is enclosed to some extent. Thus, the current Spanish law does not fully protect non-smokers from second-hand smoke and supports extending regulation to some outdoor areas.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Smoke-free legislation in indoor public places has concentrated smokers in the areas outside building entrances or other outdoor areas. This study assessed the drift of second-hand smoke between outdoor and indoor areas of cafés and restaurants in Barcelona, Spain, and characterized the exposure on outdoor terraces. Using a cross-sectional design, we monitored vapor-phase nicotine in indoor areas and outside entrances simultaneously (n=47), and on some outdoor terraces (n=51). We computed the median nicotine concentration and interquartile range (IQR) to describe the data and performed multivariate analysis to describe nicotine concentration and its determinants. The overall median nicotine concentration indoors was 0.65µg/m(3) (IQR: 0.29-1.17µg/m(3)), with significant differences based on the number of smokers at the entrance (p=0.039). At outside entrances, the overall median nicotine concentration was 0.41µg/m(3) (IQR: 0.21-1.17µg/m(3)). The nicotine concentrations indoors and at the corresponding outside entrances were not significantly different, and the multivariate analysis confirmed the relationship between these variables. On terraces, the overall median nicotine concentration was 0.54µg/m(3) (IQR: 0.25-1.14µg/m(3)), but it increased to 0.60µg/m(3) when a tobacco smell was perceived, 0.72µg/m(3) on closed terraces, 1.24µg/m(3) when there were >6 smokers, and 1.24µg/m(3) when someone smoked >20min. Multivariate analysis confirmed the outdoor terrace area, the season, the type of enclosure, and the number of smokers as the most relevant variables explaining nicotine concentration (R(2)=0.396). These findings show that second-hand smoke exposure exists in indoor areas due to smokers smoking at the outside entrances. In addition, exposure may occur on outdoor terraces when smokers are present and the terrace is enclosed to some extent. Thus, the current Spanish law does not fully protect non-smokers from second-hand smoke and supports extending regulation to some outdoor areas.
González-de Paz L, Real J, Borrás-Santos A, Martínez-Sánchez JM, Rodrigo-Baños V, Dolores Navarro-Rubio M.
J Public Health Policy. 2016;37:173–189.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid26865318,
title = {Associations between informal care, disease, and risk factors: A Spanish country-wide population-based study},
author = {González-de Paz L and Real J and Borrás-Santos A and Martínez-Sánchez JM and Rodrigo-Baños V and Dolores Navarro-Rubio M},
doi = {10.1057/jphp.2016.3},
issn = {1745-655X},
year = {2016},
date = {2016-05-01},
journal = {J Public Health Policy},
volume = {37},
number = {2},
pages = {173--189},
abstract = {This population-based study using 2011-2012 Spanish National Health Survey data aimed to measure the impact of disease, health-related habits, and risk factors associated with informal caregiving. We included and matched self-reported informal caregivers [ICs] with controls (1:4) from the same survey. For each outcome, we analyzed associations between ICs and controls using linear regression or logistic regression models. ICs had 3.4 per cent more depression (OR: 1.33, 95 per cent confidence intervals [CI]:1.06, 1.68). ICs had lower social support (95 per cent CI: 1.64, 3.28), they did more housework alone (OR:3.6, 95 per cent CI:2.65, 4.89), and had greater stress (95 per cent CI:0.13, 0.83). Women ICs caring alone had more anxiety than other groups. We found no statistical association between caregivers and worse health-related habits or increased risk factors (less physical activity, smoking, drinking, and cholesterol). Our results provide evidence that health-care professionals and organizations should recognize the importance of caring for those who care.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This population-based study using 2011-2012 Spanish National Health Survey data aimed to measure the impact of disease, health-related habits, and risk factors associated with informal caregiving. We included and matched self-reported informal caregivers [ICs] with controls (1:4) from the same survey. For each outcome, we analyzed associations between ICs and controls using linear regression or logistic regression models. ICs had 3.4 per cent more depression (OR: 1.33, 95 per cent confidence intervals [CI]:1.06, 1.68). ICs had lower social support (95 per cent CI: 1.64, 3.28), they did more housework alone (OR:3.6, 95 per cent CI:2.65, 4.89), and had greater stress (95 per cent CI:0.13, 0.83). Women ICs caring alone had more anxiety than other groups. We found no statistical association between caregivers and worse health-related habits or increased risk factors (less physical activity, smoking, drinking, and cholesterol). Our results provide evidence that health-care professionals and organizations should recognize the importance of caring for those who care.
López MJ, Pérez-Ríos M, Schiaffino A, Fernández E.
Mortality Attributable to Secondhand Smoke Exposure in Spain (2011). Article
Nicotine Tob Res. 2016;18:1307–1310.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid26079574,
title = {Mortality Attributable to Secondhand Smoke Exposure in Spain (2011)},
author = {López MJ and Pérez-Ríos M and Schiaffino A and Fernández E},
doi = {10.1093/ntr/ntv130},
issn = {1469-994X},
year = {2016},
date = {2016-05-01},
journal = {Nicotine Tob Res},
volume = {18},
number = {5},
pages = {1307--1310},
abstract = {INTRODUCTION: The objective of this study was to assess the mortality attributable to secondhand smoke (SHS) exposure among never-smokers in Spain in 2011, after the implementation of the Spanish smoking law.nnMETHODS: Data on SHS exposure were obtained from a computer-assisted telephone survey carried out in a representative sample of the adult Spanish population. We included the two main diseases widely associated with SHS exposure: lung cancer and ischaemic heart disease. The relative risks for these diseases were selected from previously published meta-analyses. The number of deaths attributable to SHS was calculated by applying the population attributable fraction to mortality not attributable to active smoking in 2011. The analyses were stratified by sex, age and setting of exposure (home, workplace, and both combined). In addition, a sensitivity analysis was performed for distinct scenarios.nnRESULTS: In 2011, a total of 586 deaths in men and 442 deaths in women would be attributable to SHS exposure. The total number of deaths from lung cancer attributable to SHS exposure would be 124, while the total number of deaths from ischaemic heart disease would be 904. The inclusion of ex-smokers or SHS exposure in leisure time in the study would considerably increase the total number of attributable deaths (by 20% and 130%, respectively).nnCONCLUSIONS: The total number of deaths attributable to SHS exposure at home and at work in Spain would be 1028 in 2011. Efforts are still needed to reduce the current prevalence of exposure-mainly due to exposure in nonregulated settings such as homes or cars and some outdoor spaces-and the associated morbidity and mortality.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: The objective of this study was to assess the mortality attributable to secondhand smoke (SHS) exposure among never-smokers in Spain in 2011, after the implementation of the Spanish smoking law.nnMETHODS: Data on SHS exposure were obtained from a computer-assisted telephone survey carried out in a representative sample of the adult Spanish population. We included the two main diseases widely associated with SHS exposure: lung cancer and ischaemic heart disease. The relative risks for these diseases were selected from previously published meta-analyses. The number of deaths attributable to SHS was calculated by applying the population attributable fraction to mortality not attributable to active smoking in 2011. The analyses were stratified by sex, age and setting of exposure (home, workplace, and both combined). In addition, a sensitivity analysis was performed for distinct scenarios.nnRESULTS: In 2011, a total of 586 deaths in men and 442 deaths in women would be attributable to SHS exposure. The total number of deaths from lung cancer attributable to SHS exposure would be 124, while the total number of deaths from ischaemic heart disease would be 904. The inclusion of ex-smokers or SHS exposure in leisure time in the study would considerably increase the total number of attributable deaths (by 20% and 130%, respectively).nnCONCLUSIONS: The total number of deaths attributable to SHS exposure at home and at work in Spain would be 1028 in 2011. Efforts are still needed to reduce the current prevalence of exposure-mainly due to exposure in nonregulated settings such as homes or cars and some outdoor spaces-and the associated morbidity and mortality.
Padrón A, Galán I, García-Esquinas E, Fernández E, Ballbè M, Rodríguez-Artalejo F.
Exposure to secondhand smoke in the home and mental health in children: a population-based study. Article
Tob Control. 2016;25:307–312.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid25808665,
title = {Exposure to secondhand smoke in the home and mental health in children: a population-based study},
author = {Padrón A and Galán I and García-Esquinas E and Fernández E and Ballbè M and Rodríguez-Artalejo F},
doi = {10.1136/tobaccocontrol-2014-052077},
issn = {1468-3318},
year = {2016},
date = {2016-05-01},
journal = {Tob Control},
volume = {25},
number = {3},
pages = {307--312},
abstract = {OBJECTIVES: To examine the association between exposure to secondhand smoke (SHS) in the home and mental health among children.nnMETHODS: Cross-sectional study of 2357 children representative of the Spanish population aged 4-12 years in 2011-2012. Duration of SHS exposure in children was reported by parents. Probable mental disorder was defined as a score>90th centile in the parental version of the Strengths and Difficulties Questionnaire (SDQ). Statistical analysis was performed with logistic regression and adjusted for sociodemographic variables, lifestyle, neighbourhood environment and family characteristics, including parental mental health.nnRESULTS: Among study participants, 6.9% (95% CI 5.7% to 8.0%) were exposed to SHS in the home for <1 h/day and 4.5% (95% CI 3.5% to 5.5%) for ≥1 h/day. Compared to children not habitually exposed to SHS, the multivariate ORs for probable mental disorder were 1.49 (95% CI 0.85 to 2.62) for SHS exposure<1 h/day and 2.73 (95% CI 1.38 to 5.41) for SHS exposure≥1 h/day (p for linear trend=0.002). The corresponding ORs for attention-deficit and hyperactivity disorder (ADHD) were 2.18 (95% CI 1.30 to 3.64) for <1 h/day exposure and 3.14 (95% CI 1.63 to 6.04) for ≥1 h/day exposure (p for linear trend<0.001). No association was found between SHS and the rest of the components of the SDQ.nnCONCLUSIONS: Among children, SHS exposure in the home during ≥1 h/day is associated with a higher frequency of mental disorder. This association was mostly due to the impact of SHS on ADHD.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: To examine the association between exposure to secondhand smoke (SHS) in the home and mental health among children.nnMETHODS: Cross-sectional study of 2357 children representative of the Spanish population aged 4-12 years in 2011-2012. Duration of SHS exposure in children was reported by parents. Probable mental disorder was defined as a score>90th centile in the parental version of the Strengths and Difficulties Questionnaire (SDQ). Statistical analysis was performed with logistic regression and adjusted for sociodemographic variables, lifestyle, neighbourhood environment and family characteristics, including parental mental health.nnRESULTS: Among study participants, 6.9% (95% CI 5.7% to 8.0%) were exposed to SHS in the home for <1 h/day and 4.5% (95% CI 3.5% to 5.5%) for ≥1 h/day. Compared to children not habitually exposed to SHS, the multivariate ORs for probable mental disorder were 1.49 (95% CI 0.85 to 2.62) for SHS exposure<1 h/day and 2.73 (95% CI 1.38 to 5.41) for SHS exposure≥1 h/day (p for linear trend=0.002). The corresponding ORs for attention-deficit and hyperactivity disorder (ADHD) were 2.18 (95% CI 1.30 to 3.64) for <1 h/day exposure and 3.14 (95% CI 1.63 to 6.04) for ≥1 h/day exposure (p for linear trend<0.001). No association was found between SHS and the rest of the components of the SDQ.nnCONCLUSIONS: Among children, SHS exposure in the home during ≥1 h/day is associated with a higher frequency of mental disorder. This association was mostly due to the impact of SHS on ADHD.
Bilal U, Beltrán P, Fernández E, Navas-Acien A, Bolumar F, Franco M.
Gender equality and smoking: a theory-driven approach to smoking gender differences in Spain. Article
Tob Control. 2016;25:295–300.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid25701858,
title = {Gender equality and smoking: a theory-driven approach to smoking gender differences in Spain},
author = {Bilal U and Beltrán P and Fernández E and Navas-Acien A and Bolumar F and Franco M},
doi = {10.1136/tobaccocontrol-2014-051892},
issn = {1468-3318},
year = {2016},
date = {2016-05-01},
journal = {Tob Control},
volume = {25},
number = {3},
pages = {295--300},
abstract = {BACKGROUND: The intersection between gender and class can aid in understanding gender differences in smoking.nnAIM: To analyse how changes in gender inequality relate to differences in smoking prevalence by gender, education and birth cohort in Spain over the past five decades (1960-2010).nnMETHODS: The Gender Inequality Index (GII) was calculated in 5-year intervals from 1960 to 2010. GII ranges from 0 to 1 (1=highest inequality) and encompasses three dimensions: reproductive health, empowerment and labour market. Estimates of female and male smoking prevalence were reconstructed from representative National Health Surveys and stratified by birth cohort and level of education. We calculated female-to-male smoking ratios from 1960 to 2010 stratified by education and birth cohort.nnRESULTS: Gender inequality in Spain decreased from 0.65 to 0.09 over the past 50 years. This rapid decline was inversely correlated (r=-0.99) to a rising female-to-male smoking ratio. The youngest birth cohort of the study (born 1980-1990) and women with high education levels had similar smoking prevalences compared with men. Women with high levels of education were also the first to show a reduction in smoking prevalence, compared with less educated women.nnCONCLUSIONS: Gender inequality fell significantly in Spain over the past 50 years. This process was accompanied by converging trends in smoking prevalence for men and women. Smoking prevalence patterns varied greatly by birth cohort and education levels. Countries in earlier stages of the tobacco epidemic should consider gender-sensitive tobacco control measures and policies.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: The intersection between gender and class can aid in understanding gender differences in smoking.nnAIM: To analyse how changes in gender inequality relate to differences in smoking prevalence by gender, education and birth cohort in Spain over the past five decades (1960-2010).nnMETHODS: The Gender Inequality Index (GII) was calculated in 5-year intervals from 1960 to 2010. GII ranges from 0 to 1 (1=highest inequality) and encompasses three dimensions: reproductive health, empowerment and labour market. Estimates of female and male smoking prevalence were reconstructed from representative National Health Surveys and stratified by birth cohort and level of education. We calculated female-to-male smoking ratios from 1960 to 2010 stratified by education and birth cohort.nnRESULTS: Gender inequality in Spain decreased from 0.65 to 0.09 over the past 50 years. This rapid decline was inversely correlated (r=-0.99) to a rising female-to-male smoking ratio. The youngest birth cohort of the study (born 1980-1990) and women with high education levels had similar smoking prevalences compared with men. Women with high levels of education were also the first to show a reduction in smoking prevalence, compared with less educated women.nnCONCLUSIONS: Gender inequality fell significantly in Spain over the past 50 years. This process was accompanied by converging trends in smoking prevalence for men and women. Smoking prevalence patterns varied greatly by birth cohort and education levels. Countries in earlier stages of the tobacco epidemic should consider gender-sensitive tobacco control measures and policies.
Pérez-Ortuño R, Martínez-Sánchez JM, Fu M, Fernández E, Pascual JA.
Sci Rep. 2016;6:25043.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27112239,
title = {Evaluation of tobacco specific nitrosamines exposure by quantification of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in human hair of non-smokers},
author = {Pérez-Ortuño R and Martínez-Sánchez JM and Fu M and Fernández E and Pascual JA},
doi = {10.1038/srep25043},
issn = {2045-2322},
year = {2016},
date = {2016-04-01},
journal = {Sci Rep},
volume = {6},
pages = {25043},
abstract = {Chronic exposure to specific carcinogens present in secondhand smoke has been associated with different types of cancers. Hair is an ideal matrix to develop a proper biomarker as it absorbs substances in circulation and allows measuring their average concentration over long periods of time. A method was developed for the simultaneous quantification of nicotine, cotinine, NNN, NNK and NNAL in 20 mg human hair samples. Concentrations were significantly different depending on the declared exposure. This study shows for the first time that NNK is present in hair samples from non-smokers in concentrations much higher than any other tobacco specific nitrosamine. NNN could also be detected in samples from the most exposed non-smokers while, as previously reported, NNAL was undetectable. NNK correlates well with nicotine and cotinine (rsp = 0.774 and rsp = 0.792 respectively, p < 0.001 in both cases). However, NNN concentrations did not correlate with any of the other analytes. Ratios between NNK and nicotine show variability with different concentrations of NNK present in samples with similar nicotine values. NNK has proven to be the best marker of tobacco specific nitrosamines in hair. Monitoring NNK may provide a good estimation of cancer risk associated with exposure to secondhand smoke.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Chronic exposure to specific carcinogens present in secondhand smoke has been associated with different types of cancers. Hair is an ideal matrix to develop a proper biomarker as it absorbs substances in circulation and allows measuring their average concentration over long periods of time. A method was developed for the simultaneous quantification of nicotine, cotinine, NNN, NNK and NNAL in 20 mg human hair samples. Concentrations were significantly different depending on the declared exposure. This study shows for the first time that NNK is present in hair samples from non-smokers in concentrations much higher than any other tobacco specific nitrosamine. NNN could also be detected in samples from the most exposed non-smokers while, as previously reported, NNAL was undetectable. NNK correlates well with nicotine and cotinine (rsp = 0.774 and rsp = 0.792 respectively, p < 0.001 in both cases). However, NNN concentrations did not correlate with any of the other analytes. Ratios between NNK and nicotine show variability with different concentrations of NNK present in samples with similar nicotine values. NNK has proven to be the best marker of tobacco specific nitrosamines in hair. Monitoring NNK may provide a good estimation of cancer risk associated with exposure to secondhand smoke.
Guydish J, Passalacqua E, Pagano A, Martínez C, Le T, Chun J, Tajima B, Docto L, Garina D, Delucchi K.
An international systematic review of smoking prevalence in addiction treatment. Article
Addiction. 2016;111:220–230.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid26392127,
title = {An international systematic review of smoking prevalence in addiction treatment},
author = {Guydish J and Passalacqua E and Pagano A and Martínez C and Le T and Chun J and Tajima B and Docto L and Garina D and Delucchi K},
doi = {10.1111/add.13099},
issn = {1360-0443},
year = {2016},
date = {2016-02-01},
journal = {Addiction},
volume = {111},
number = {2},
pages = {220--230},
abstract = {AIMS: Smoking prevalence is higher among people enrolled in addiction treatment compared with the general population, and very high rates of smoking are associated with opiate drug use and receipt of opiate replacement therapy (ORT). We assessed whether these findings are observed internationally.nnMETHODS: PubMed, PsycINFO and the Alcohol and Alcohol Problems Science Database were searched for papers reporting smoking prevalence among addiction treatment samples, published in English, from 1987 to 2013. Search terms included tobacco use, cessation and substance use disorders using and/or Boolean connectors. For 4549 papers identified, abstracts were reviewed by multiple raters; 239 abstracts met inclusion criteria and these full papers were reviewed for exclusion. Fifty-four studies, collectively comprising 37,364 participants, were included. For each paper we extracted country, author, year, sample size and gender, treatment modality, primary drug treated and smoking prevalence.nnRESULTS: The random-effect pooled estimate of smoking across people in addiction treatment was 84% [confidence interval (CI) = 79, 88%], while the pooled estimate of smoking prevalence across matched population samples was 31% (CI = 29, 33%). The difference in the pooled estimates was 52% (CI = 48%, 57%, P < .0001). Smoking rates were higher in programs treating opiate use compared with alcohol use [odds ratio (OR) = 2.52, CI = 2.00, 3.17], and higher in ORT compared to out-patient programs (OR = 1.42, CI = 1.19, 1.68).nnCONCLUSIONS: Smoking rates among people in addiction treatment are more than double those of people with similar demographic characteristics. Smoking rates are also higher in people being treated for opiate dependence compared with people being treated for alcohol use disorder.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
AIMS: Smoking prevalence is higher among people enrolled in addiction treatment compared with the general population, and very high rates of smoking are associated with opiate drug use and receipt of opiate replacement therapy (ORT). We assessed whether these findings are observed internationally.nnMETHODS: PubMed, PsycINFO and the Alcohol and Alcohol Problems Science Database were searched for papers reporting smoking prevalence among addiction treatment samples, published in English, from 1987 to 2013. Search terms included tobacco use, cessation and substance use disorders using and/or Boolean connectors. For 4549 papers identified, abstracts were reviewed by multiple raters; 239 abstracts met inclusion criteria and these full papers were reviewed for exclusion. Fifty-four studies, collectively comprising 37,364 participants, were included. For each paper we extracted country, author, year, sample size and gender, treatment modality, primary drug treated and smoking prevalence.nnRESULTS: The random-effect pooled estimate of smoking across people in addiction treatment was 84% [confidence interval (CI) = 79, 88%], while the pooled estimate of smoking prevalence across matched population samples was 31% (CI = 29, 33%). The difference in the pooled estimates was 52% (CI = 48%, 57%, P < .0001). Smoking rates were higher in programs treating opiate use compared with alcohol use [odds ratio (OR) = 2.52, CI = 2.00, 3.17], and higher in ORT compared to out-patient programs (OR = 1.42, CI = 1.19, 1.68).nnCONCLUSIONS: Smoking rates among people in addiction treatment are more than double those of people with similar demographic characteristics. Smoking rates are also higher in people being treated for opiate dependence compared with people being treated for alcohol use disorder.
Martínez-Sánchez JM, Balaguer A.
Arch Prev Riesgos Labor. 2016;19:175–177.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27378503,
title = {[Healthy university: a health promotion strategy and health for all policies for the creation of a healthy workplace]},
author = {Martínez-Sánchez JM and Balaguer A},
doi = {10.12961/aprl.2016.19.3.04},
issn = {1138-9672},
year = {2016},
date = {2016-01-01},
journal = {Arch Prev Riesgos Labor},
volume = {19},
number = {3},
pages = {175--177},
abstract = {The objective of this study is to describe a model of healthy university and the experience of the International University of Catalonia in creating a healthy workplace. The model focuses on interventions and programs for changing the population distribution of the main risk factors for non-communicable diseases. The three pillars of the model are: a) interventions and programs, b) surveillance and evaluation, and c) education and research in health for all policies. The university as a place of work and knowledge-linked entity is an ideal institution for health promotion. The proposed model may be useful for incorporating the concept of health promotion into the university culture, and in its institutional policies and study plans.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The objective of this study is to describe a model of healthy university and the experience of the International University of Catalonia in creating a healthy workplace. The model focuses on interventions and programs for changing the population distribution of the main risk factors for non-communicable diseases. The three pillars of the model are: a) interventions and programs, b) surveillance and evaluation, and c) education and research in health for all policies. The university as a place of work and knowledge-linked entity is an ideal institution for health promotion. The proposed model may be useful for incorporating the concept of health promotion into the university culture, and in its institutional policies and study plans.
Ballbè M, Gual A, Nieva G, Saltó E, Fernández E, Tobacco, Mental Health Working Group.
Gac Sanit. 2016;30:389–392.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27325123,
title = {Deconstructing myths, building alliances: a networking model to enhance tobacco control in hospital mental health settings},
author = {Ballbè M and Gual A and Nieva G and Saltó E and Fernández E and Tobacco and Mental Health Working Group},
doi = {10.1016/j.gaceta.2016.04.017},
issn = {1578-1283},
year = {2016},
date = {2016-01-01},
journal = {Gac Sanit},
volume = {30},
number = {5},
pages = {389--392},
abstract = {Life expectancy for people with severe mental disorders is up to 25 years less in comparison to the general population, mainly due to diseases caused or worsened by smoking. However, smoking is usually a neglected issue in mental healthcare settings. The aim of this article is to describe a strategy to improve tobacco control in the hospital mental healthcare services of Catalonia (Spain). To bridge this gap, the Catalan Network of Smoke-free Hospitals launched a nationwide bottom-up strategy in Catalonia in 2007. The strategy relied on the creation of a working group of key professionals from various hospitals -the early adopters- based on Rogers' theory of the Diffusion of Innovations. In 2016, the working group is composed of professionals from 17 hospitals (70.8% of all hospitals in the region with mental health inpatient units). Since 2007, tobacco control has improved in different areas such as increasing mental health professionals' awareness of smoking, training professionals on smoking cessation interventions and achieving good compliance with the national smoking ban. The working group has produced and disseminated various materials, including clinical practice and best practice guidelines, implemented smoking cessation programmes and organised seminars and training sessions on smoking cessation measures in patients with mental illnesses. The next challenge is to ensure effective follow-up for smoking cessation after discharge. While some areas of tobacco control within these services still require significant improvement, the aforementioned initiative promotes successful tobacco control in these settings.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Life expectancy for people with severe mental disorders is up to 25 years less in comparison to the general population, mainly due to diseases caused or worsened by smoking. However, smoking is usually a neglected issue in mental healthcare settings. The aim of this article is to describe a strategy to improve tobacco control in the hospital mental healthcare services of Catalonia (Spain). To bridge this gap, the Catalan Network of Smoke-free Hospitals launched a nationwide bottom-up strategy in Catalonia in 2007. The strategy relied on the creation of a working group of key professionals from various hospitals -the early adopters- based on Rogers' theory of the Diffusion of Innovations. In 2016, the working group is composed of professionals from 17 hospitals (70.8% of all hospitals in the region with mental health inpatient units). Since 2007, tobacco control has improved in different areas such as increasing mental health professionals' awareness of smoking, training professionals on smoking cessation interventions and achieving good compliance with the national smoking ban. The working group has produced and disseminated various materials, including clinical practice and best practice guidelines, implemented smoking cessation programmes and organised seminars and training sessions on smoking cessation measures in patients with mental illnesses. The next challenge is to ensure effective follow-up for smoking cessation after discharge. While some areas of tobacco control within these services still require significant improvement, the aforementioned initiative promotes successful tobacco control in these settings.
Lidón-Moyano C, Martínez-Sánchez JM, Fu M, Ballbè M, Martín-Sánchez JC, Fernández E.
[Prevalence and user profile of electronic cigarettes in Spain (2014)]. Article
Gac Sanit. 2016;30:432–437.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27198921,
title = {[Prevalence and user profile of electronic cigarettes in Spain (2014)]},
author = {Lidón-Moyano C and Martínez-Sánchez JM and Fu M and Ballbè M and Martín-Sánchez JC and Fernández E},
doi = {10.1016/j.gaceta.2016.03.010},
issn = {1578-1283},
year = {2016},
date = {2016-01-01},
journal = {Gac Sanit},
volume = {30},
number = {6},
pages = {432--437},
abstract = {OBJECTIVE: To describe the prevalence and user profile of electronic cigarettes among Spanish adults and evaluate the potential dual use of these devices with combustible or conventional tobacco in 2014 in Spain.nnMETHODS: Cross-sectional study of a representative sample of the Spanish adult (16-75 years old) population (n=1,016). A computer-assisted telephone survey was conducted in 2014. The prevalence and 95% confidence intervals (95% CI) for the use of electronic cigarettes stratified by gender, age, tobacco consumption and social status were calculated. The sample was weighted and a logistic regression model adjusted to obtain the crude odds ratios (OR) adjusted by gender, age and social status.nnRESULTS: 10.3% (95% CI: 8.6-12.4) of the Spanish adult population stated being ever users of electronic cigarettes (2% current users, 3.2% past users and 5.1% experimental users). Among current electronic cigarette users, 57.2% also smoked combustible or conventional tobacco, 28% had never smoked and 14.8% were former smokers. The prevalence of electronic cigarette use was higher in the younger population (adjusted OR=23.8; 95% CI: 2.5-227.7) and smokers of combustible tobacco (adjusted OR=10.1; 95% CI: 5.8-17.5).nnCONCLUSIONS: The use of electronic cigarettes in Spain is scarce and is most prevalent among young people and tobacco smokers. Nevertheless, one out of four current electronic cigarette users have never smoked. Hence, the regulation of these devices should be reinforced to avoid a possible gateway to nicotine products among never smokers.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To describe the prevalence and user profile of electronic cigarettes among Spanish adults and evaluate the potential dual use of these devices with combustible or conventional tobacco in 2014 in Spain.nnMETHODS: Cross-sectional study of a representative sample of the Spanish adult (16-75 years old) population (n=1,016). A computer-assisted telephone survey was conducted in 2014. The prevalence and 95% confidence intervals (95% CI) for the use of electronic cigarettes stratified by gender, age, tobacco consumption and social status were calculated. The sample was weighted and a logistic regression model adjusted to obtain the crude odds ratios (OR) adjusted by gender, age and social status.nnRESULTS: 10.3% (95% CI: 8.6-12.4) of the Spanish adult population stated being ever users of electronic cigarettes (2% current users, 3.2% past users and 5.1% experimental users). Among current electronic cigarette users, 57.2% also smoked combustible or conventional tobacco, 28% had never smoked and 14.8% were former smokers. The prevalence of electronic cigarette use was higher in the younger population (adjusted OR=23.8; 95% CI: 2.5-227.7) and smokers of combustible tobacco (adjusted OR=10.1; 95% CI: 5.8-17.5).nnCONCLUSIONS: The use of electronic cigarettes in Spain is scarce and is most prevalent among young people and tobacco smokers. Nevertheless, one out of four current electronic cigarette users have never smoked. Hence, the regulation of these devices should be reinforced to avoid a possible gateway to nicotine products among never smokers.
Raich A, Ballbè M, Nieva G, Cano M, Fernández T, Bruguera E, Fernández E.
Safety of Varenicline for Smoking Cessation in Psychiatric and Addicts Patients. Article
Subst Use Misuse. 2016;51:649–657.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid27050328,
title = {Safety of Varenicline for Smoking Cessation in Psychiatric and Addicts Patients},
author = {Raich A and Ballbè M and Nieva G and Cano M and Fernández T and Bruguera E and Fernández E},
doi = {10.3109/10826084.2015.1133646},
issn = {1532-2491},
year = {2016},
date = {2016-01-01},
journal = {Subst Use Misuse},
volume = {51},
number = {5},
pages = {649--657},
abstract = {The safety of varenicline in the treatment of tobacco dependence has been questioned, in psychiatric patients. However, most published studies have not included psychiatric patients.nnOBJECTIVE: Assess the safety of varenicline for smoking cessation in patients with psychiatric disorders.nnMETHODS: This is a prospective, longitudinal, multicenter study. The sample is composed of three groups (patients with psychotic disorder, patients with alcohol dependence disorder and patients addicts in methadone maintenance treatment). Patients were recruited consecutively between September 2008 and June 2009 from 11 centers. All patients received a standardized smoking cessation program with varenicline and psychological support. Adverse events of the drug were monitored at weeks 1, 2, 4, 6, 8, and 12 of treatment. Bivariate analysis has been used.nnRESULTS: None of the 90 patients included, presented a serious adverse event. The most frequent adverse effect was dry mouth (28.9%), followed by the presence of flatulence (27.8%), abnormal dreams (27.8%), and nausea (22%), especially between weeks 2 and 6 of treatment. None of the patients referred intense suicidal ideation, although two referred to moderate suicidal ideation, which was solved in one case and in the other, treatment was discontinued. Four participants (4.4%) abandoned treatment because of gastrointestinal symptoms. The initial dose of varenicline was reduced in 25% of patients during the study.nnCONCLUSIONS: Gastrointestinal adverse events are the most incident in this sample of psychiatric patients and no exacerbation of psychiatric symptoms was detected, thus indicating a good safety record for varenicline use for smoking cessation in psychiatric patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The safety of varenicline in the treatment of tobacco dependence has been questioned, in psychiatric patients. However, most published studies have not included psychiatric patients.nnOBJECTIVE: Assess the safety of varenicline for smoking cessation in patients with psychiatric disorders.nnMETHODS: This is a prospective, longitudinal, multicenter study. The sample is composed of three groups (patients with psychotic disorder, patients with alcohol dependence disorder and patients addicts in methadone maintenance treatment). Patients were recruited consecutively between September 2008 and June 2009 from 11 centers. All patients received a standardized smoking cessation program with varenicline and psychological support. Adverse events of the drug were monitored at weeks 1, 2, 4, 6, 8, and 12 of treatment. Bivariate analysis has been used.nnRESULTS: None of the 90 patients included, presented a serious adverse event. The most frequent adverse effect was dry mouth (28.9%), followed by the presence of flatulence (27.8%), abnormal dreams (27.8%), and nausea (22%), especially between weeks 2 and 6 of treatment. None of the patients referred intense suicidal ideation, although two referred to moderate suicidal ideation, which was solved in one case and in the other, treatment was discontinued. Four participants (4.4%) abandoned treatment because of gastrointestinal symptoms. The initial dose of varenicline was reduced in 25% of patients during the study.nnCONCLUSIONS: Gastrointestinal adverse events are the most incident in this sample of psychiatric patients and no exacerbation of psychiatric symptoms was detected, thus indicating a good safety record for varenicline use for smoking cessation in psychiatric patients.
Antunes H, Precioso J, Araújo AC, Machado JC, Samorinha C, Rocha V, Gaspar Â, Becoña E, Belo-Ravara S, Vitória P, Rosas M, Fernandez E.
Rev Port Pneumol (2006). 2016;22:190–195.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid26906288,
title = {Prevalence of secondhand smoke exposure in asthmatic children at home and in the car: A cross-sectional study},
author = {Antunes H and Precioso J and Araújo AC and Machado JC and Samorinha C and Rocha V and Gaspar  and Becoña E and Belo-Ravara S and Vitória P and Rosas M and Fernandez E},
doi = {10.1016/j.rppnen.2015.12.009},
issn = {2173-5115},
year = {2016},
date = {2016-01-01},
journal = {Rev Port Pneumol (2006)},
volume = {22},
number = {4},
pages = {190--195},
abstract = {OBJECTIVE: To compare secondhand smoke exposure (SHSe) prevalence at home and inside the car between asthmatic and non-asthmatic Portuguese children.nnMATERIALS AND METHODS: This is a cross-sectional study that assessed children's SHSe in a representative sample of nine Portuguese cities. A validated self-reported questionnaire was administered to a random sample of 4th grade students during the school year of 2010/2011. The asthma prevalence was defined by the answers to three questions regarding asthma symptoms, medication and inhaler use. We performed chi-square tests and analysed frequencies, contingency tables, confidence intervals, and odd-ratios.nnRESULTS: The self-reported questionnaire was administered to 3187 students. Asthma prevalence was 14.8% (472 students). Results showed that 32.3% of non-asthmatic children and 32.4% of asthmatic children were exposed to secondhand smoke as at least one of their household members smoked at home. The prevalence of parental smoking, smoking among fathers and smoking among mothers at home was also similar in both groups (asthmatic and non-asthmatic children). SHSe inside the car was 18.6% among non-asthmatic children and 17.9% among asthmatic children.nnCONCLUSIONS: Asthmatic and non-asthmatic children were equally exposed to secondhand smoke, because no significant differences were found between the two groups concerning the prevalence of SHSe at home and inside the car. These findings highlight the need to include SHSe brief advice in paediatric asthma management.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To compare secondhand smoke exposure (SHSe) prevalence at home and inside the car between asthmatic and non-asthmatic Portuguese children.nnMATERIALS AND METHODS: This is a cross-sectional study that assessed children's SHSe in a representative sample of nine Portuguese cities. A validated self-reported questionnaire was administered to a random sample of 4th grade students during the school year of 2010/2011. The asthma prevalence was defined by the answers to three questions regarding asthma symptoms, medication and inhaler use. We performed chi-square tests and analysed frequencies, contingency tables, confidence intervals, and odd-ratios.nnRESULTS: The self-reported questionnaire was administered to 3187 students. Asthma prevalence was 14.8% (472 students). Results showed that 32.3% of non-asthmatic children and 32.4% of asthmatic children were exposed to secondhand smoke as at least one of their household members smoked at home. The prevalence of parental smoking, smoking among fathers and smoking among mothers at home was also similar in both groups (asthmatic and non-asthmatic children). SHSe inside the car was 18.6% among non-asthmatic children and 17.9% among asthmatic children.nnCONCLUSIONS: Asthmatic and non-asthmatic children were equally exposed to secondhand smoke, because no significant differences were found between the two groups concerning the prevalence of SHSe at home and inside the car. These findings highlight the need to include SHSe brief advice in paediatric asthma management.
Binefa G, Garcia M, Milà N, Fernández E, Rodríguez-Moranta F, Gonzalo N, Benito L, Clopés A, Guardiola J, Moreno V.
Sci Rep. 2016;6:19532.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid26787510,
title = {Colorectal Cancer Screening Programme in Spain: Results of Key Performance Indicators After Five Rounds (2000-2012)},
author = {Binefa G and Garcia M and Milà N and Fernández E and Rodríguez-Moranta F and Gonzalo N and Benito L and Clopés A and Guardiola J and Moreno V},
doi = {10.1038/srep19532},
issn = {2045-2322},
year = {2016},
date = {2016-01-01},
journal = {Sci Rep},
volume = {6},
pages = {19532},
abstract = {Effective quality assurance is essential in any screening programme. This article provides a unique insight into key quality indicators of five rounds of the first population-based colorectal cancer screening programme implemented in Spain (2000-2012), providing the results according to the type of screening (prevalent or first screen and incident or subsequent screen) and test (guaiac or immunochemical). The total crude participation rate increased from 17.2% (11,011) in the first round to 35.9% (22,988) in the last one. Rescreening rate was very high (88.6% in the fifth round). Positivity rate was superior with the faecal immunochemical test (6.2%) than with the guaiac-based test (0.7%) (p < 0.0001) and detection rates were also better with the immunochemical test. The most significant rise in detection rate was observed for high risk adenoma in men (45.5 per 1,000 screened). Most cancers were diagnosed at an early stage (61.4%) and there was a statistically significant difference between those detected in first or subsequent screening (52.6% and 70.0% respectively; p = 0.024). The availability of these results substantially improves data comparisons and the exchange of experience between screening programmes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Effective quality assurance is essential in any screening programme. This article provides a unique insight into key quality indicators of five rounds of the first population-based colorectal cancer screening programme implemented in Spain (2000-2012), providing the results according to the type of screening (prevalent or first screen and incident or subsequent screen) and test (guaiac or immunochemical). The total crude participation rate increased from 17.2% (11,011) in the first round to 35.9% (22,988) in the last one. Rescreening rate was very high (88.6% in the fifth round). Positivity rate was superior with the faecal immunochemical test (6.2%) than with the guaiac-based test (0.7%) (p < 0.0001) and detection rates were also better with the immunochemical test. The most significant rise in detection rate was observed for high risk adenoma in men (45.5 per 1,000 screened). Most cancers were diagnosed at an early stage (61.4%) and there was a statistically significant difference between those detected in first or subsequent screening (52.6% and 70.0% respectively; p = 0.024). The availability of these results substantially improves data comparisons and the exchange of experience between screening programmes.
Ruano-Ravina A, Álvarez-Dardet C, Domínguez-Berjón MF, Fernández E, García AM, Borrell C.
Ann Epidemiol. 2016;26:81–84.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid26596957,
title = {Externalities and article citations: experience of a national public health journal (Gaceta Sanitaria)},
author = {Ruano-Ravina A and Álvarez-Dardet C and Domínguez-Berjón MF and Fernández E and García AM and Borrell C},
doi = {10.1016/j.annepidem.2015.09.010},
issn = {1873-2585},
year = {2016},
date = {2016-01-01},
journal = {Ann Epidemiol},
volume = {26},
number = {1},
pages = {81--84},
abstract = {PURPOSE: The purpose of the study was to analyze the determinants of citations such as publication year, article type, article topic, article selected for a press release, number of articles previously published by the corresponding author, and publication language in a Spanish journal of public health.nnMETHODS: Observational study including all articles published in Gaceta Sanitaria during 2007-2011. We retrieved the number of citations from the ISI Web of Knowledge database in June 2013 and also information on other variables such as number of articles published by the corresponding author in the previous 5 years (searched through PubMed), selection for a press release, publication language, article type and topic, and others.nnRESULTS: We included 542 articles. Of these, 62.5% were cited in the period considered. We observed an increased odds ratio of citations for articles selected for a press release and also with the number of articles published previously by the corresponding author. Articles published in English do not seem to increase their citations.nnCONCLUSIONS: Certain externalities such as number of articles published by the corresponding author and being selected for a press release seem to influence the number of citations in national journals.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: The purpose of the study was to analyze the determinants of citations such as publication year, article type, article topic, article selected for a press release, number of articles previously published by the corresponding author, and publication language in a Spanish journal of public health.nnMETHODS: Observational study including all articles published in Gaceta Sanitaria during 2007-2011. We retrieved the number of citations from the ISI Web of Knowledge database in June 2013 and also information on other variables such as number of articles published by the corresponding author in the previous 5 years (searched through PubMed), selection for a press release, publication language, article type and topic, and others.nnRESULTS: We included 542 articles. Of these, 62.5% were cited in the period considered. We observed an increased odds ratio of citations for articles selected for a press release and also with the number of articles published previously by the corresponding author. Articles published in English do not seem to increase their citations.nnCONCLUSIONS: Certain externalities such as number of articles published by the corresponding author and being selected for a press release seem to influence the number of citations in national journals.
Martínez C, Martínez-Sánchez JM, Antón L, Riccobene A, Fu M, Quirós N, Saltó E, Fernández E, of the Coordinators Group Hospitals Network.
[Smoking prevalence in hospital workers: meta-analysis in 45 Catalan hospitals]. Article
Gac Sanit. 2016;30:55–58.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid26422688,
title = {[Smoking prevalence in hospital workers: meta-analysis in 45 Catalan hospitals]},
author = {Martínez C and Martínez-Sánchez JM and Antón L and Riccobene A and Fu M and Quirós N and Saltó E and Fernández E and Coordinators Group of the Hospitals Network},
doi = {10.1016/j.gaceta.2015.08.006},
issn = {1578-1283},
year = {2016},
date = {2016-01-01},
journal = {Gac Sanit},
volume = {30},
number = {1},
pages = {55--58},
abstract = {OBJECTIVE: To estimate the prevalence of smoking in workers from hospitals within the Catalan Network for Smoke-free hospitals from 2009 to 2012 according to workers' sociodemographic characteristics and the type of hospital.nnMETHOD: A meta-analysis was performed of prevalence surveys from representative samples of workers from 45 hospitals. The combined prevalence for all hospitals was calculated using a regression model with a random effects model weighted by sample size.nnRESULTS: The overall prevalence of smoking was 28.1% (95%CI: 26.1 to 30.0%) with a maximum and minimum of 40.3% and 19.1%, respectively. The health professionals with the lowest prevalence of smoking were physicians (16.4%; 95%CI: 12.9 to 19.9) and nurses (25.4%; 95%CI 21.6 to 29.2).nnCONCLUSION: The prevalence of smoking in hospital health workers was lower than in the general population of working age. Physicians were the group with the lowest smoking prevalence. Smoking cessation should be promoted among other professional groups.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To estimate the prevalence of smoking in workers from hospitals within the Catalan Network for Smoke-free hospitals from 2009 to 2012 according to workers' sociodemographic characteristics and the type of hospital.nnMETHOD: A meta-analysis was performed of prevalence surveys from representative samples of workers from 45 hospitals. The combined prevalence for all hospitals was calculated using a regression model with a random effects model weighted by sample size.nnRESULTS: The overall prevalence of smoking was 28.1% (95%CI: 26.1 to 30.0%) with a maximum and minimum of 40.3% and 19.1%, respectively. The health professionals with the lowest prevalence of smoking were physicians (16.4%; 95%CI: 12.9 to 19.9) and nurses (25.4%; 95%CI 21.6 to 29.2).nnCONCLUSION: The prevalence of smoking in hospital health workers was lower than in the general population of working age. Physicians were the group with the lowest smoking prevalence. Smoking cessation should be promoted among other professional groups.
Ferketich AK, Lugo A, La Vecchia C, Fernandez E, Boffetta P, Clancy L, Gallus S.
Tob Control. 2016;25:60–65.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid25335901,
title = {Relation between national-level tobacco control policies and individual-level voluntary home smoking bans in Europe},
author = {Ferketich AK and Lugo A and La Vecchia C and Fernandez E and Boffetta P and Clancy L and Gallus S},
doi = {10.1136/tobaccocontrol-2014-051819},
issn = {1468-3318},
year = {2016},
date = {2016-01-01},
journal = {Tob Control},
volume = {25},
number = {1},
pages = {60--65},
abstract = {BACKGROUND: Little is known about the relationship between national tobacco control policies and implementation of private home smoking bans.nnOBJECTIVE: To determine the relationship between the Tobacco Control Scale (TCS), a score measuring national-level strength of tobacco control policies, and the prevalence of in-home smoking bans and beliefs on other tobacco control policies, among the Member States (MS) of the European Union (EU) that participated in the Pricing Policy And Control of Tobacco in Europe (PPACTE) project.nnMETHODS: A face-to-face representative survey, based on 18 056 individuals aged ≥15 years, from 18 European countries-including 16 EU MS-was conducted in 2010. Multilevel logistic regression models were fit to examine the relationship between the TCS score and in-home smoking ban prevalence and beliefs that other policy approaches are useful.nnRESULTS: In 2010, the TCS scores ranged from 32 in Austria and Greece to 77 in England. The TCS score correlated with the prevalence of in-home smoking bans (rsp=0.65). A 10-unit increase in the TCS score significantly increased the odds of in-home smoking ban (OR=1.33; 95% CI 1.01 to 1.76). The odds of believing that providing cessation services (OR=1.21), raising prices (OR=1.01) and extending bans is useful (OR=0.93) were not significant.nnCONCLUSIONS: Government tobacco control policies are positively related to the individual-level tobacco policy of having an in-home smoking ban.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Little is known about the relationship between national tobacco control policies and implementation of private home smoking bans.nnOBJECTIVE: To determine the relationship between the Tobacco Control Scale (TCS), a score measuring national-level strength of tobacco control policies, and the prevalence of in-home smoking bans and beliefs on other tobacco control policies, among the Member States (MS) of the European Union (EU) that participated in the Pricing Policy And Control of Tobacco in Europe (PPACTE) project.nnMETHODS: A face-to-face representative survey, based on 18 056 individuals aged ≥15 years, from 18 European countries-including 16 EU MS-was conducted in 2010. Multilevel logistic regression models were fit to examine the relationship between the TCS score and in-home smoking ban prevalence and beliefs that other policy approaches are useful.nnRESULTS: In 2010, the TCS scores ranged from 32 in Austria and Greece to 77 in England. The TCS score correlated with the prevalence of in-home smoking bans (rsp=0.65). A 10-unit increase in the TCS score significantly increased the odds of in-home smoking ban (OR=1.33; 95% CI 1.01 to 1.76). The odds of believing that providing cessation services (OR=1.21), raising prices (OR=1.01) and extending bans is useful (OR=0.93) were not significant.nnCONCLUSIONS: Government tobacco control policies are positively related to the individual-level tobacco policy of having an in-home smoking ban.