Publicacions
2025
Li CX, Wang PC, Feliu A, Laverty AA, Martinez C, Filippidis FT.
Nicotine Tob Res. 2025.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid40795943,
title = {Perceptions of e-cigarettes and heated tobacco products among never users of nicotine in the European Union},
author = {Li CX and Wang PC and Feliu A and Laverty AA and Martinez C and Filippidis FT},
doi = {10.1093/ntr/ntaf168},
issn = {1469-994X},
year = {2025},
date = {2025-08-01},
journal = {Nicotine Tob Res},
abstract = {INTRODUCTION: Emerging tobacco and nicotine products, such as e-cigarettes and heated tobacco products (HTPs), are gaining popularity, particularly among young people. This study examines the perceptions of e-cigarettes and HTPs among nicotine-naive individuals and their variations across sociodemographic subgroups.nnMETHODS: We conducted a cross-sectional analysis of the Special Eurobarometer 99.3 (May-June 2023) among never users of tobacco or nicotine products in the European Union (EU) (n = 13 436). We estimated the weighted prevalence of perceptions of e-cigarettes and HTPs: appeal, perceived effectiveness for smoking cessation, support for them being regulated like cigarettes, and support for keeping them out of sight in points-of-sale. Multi-level Poisson regression models examined associations of sociodemographic factors with these perceptions.nnRESULTS: Among never users in the EU, 2.6% found e-cigarettes appealing, while 2.0% found HTPs appealing. 50.8% and 58.8% of participants supported strict regulations and point-of-sale restrictions for these products, respectively. Younger age groups were more likely to find e-cigarettes (Prevalence Ratio [PR] = 1.70, for ages 15-39 vs. 55+) and HTPs (PR = 1.88, PR = 1.54 for ages 15-24 and 25-39) appealing and view them as effective for smoking cessation. Support for regulations similar to cigarettes was higher among women, individuals with higher education, those living with children, and those without financial difficulties.nnCONCLUSION: While the appeal of these products to never users remained low overall, the study found that young people were more likely to find them appealing, posing a risk for experimentation. Meanwhile, over 50% of respondents supported stricter regulations, which could influence policy changes in this area.nnIMPLICATIONS: Although appeal of e-cigarettes and Heated Tobacco Products (HTPs) was relatively low among people who have never used e-cigarettes, HTPs or smoking tobacco in the European Union, appeal was higher among younger age groups, which are often targeted by the industry. We also found substantial support for stricter regulatory policies for e-cigarettes and HTPs across the EU. These findings might encourage governments to increase restrictions around these emerging nicotine and tobacco products.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Emerging tobacco and nicotine products, such as e-cigarettes and heated tobacco products (HTPs), are gaining popularity, particularly among young people. This study examines the perceptions of e-cigarettes and HTPs among nicotine-naive individuals and their variations across sociodemographic subgroups.nnMETHODS: We conducted a cross-sectional analysis of the Special Eurobarometer 99.3 (May-June 2023) among never users of tobacco or nicotine products in the European Union (EU) (n = 13 436). We estimated the weighted prevalence of perceptions of e-cigarettes and HTPs: appeal, perceived effectiveness for smoking cessation, support for them being regulated like cigarettes, and support for keeping them out of sight in points-of-sale. Multi-level Poisson regression models examined associations of sociodemographic factors with these perceptions.nnRESULTS: Among never users in the EU, 2.6% found e-cigarettes appealing, while 2.0% found HTPs appealing. 50.8% and 58.8% of participants supported strict regulations and point-of-sale restrictions for these products, respectively. Younger age groups were more likely to find e-cigarettes (Prevalence Ratio [PR] = 1.70, for ages 15-39 vs. 55+) and HTPs (PR = 1.88, PR = 1.54 for ages 15-24 and 25-39) appealing and view them as effective for smoking cessation. Support for regulations similar to cigarettes was higher among women, individuals with higher education, those living with children, and those without financial difficulties.nnCONCLUSION: While the appeal of these products to never users remained low overall, the study found that young people were more likely to find them appealing, posing a risk for experimentation. Meanwhile, over 50% of respondents supported stricter regulations, which could influence policy changes in this area.nnIMPLICATIONS: Although appeal of e-cigarettes and Heated Tobacco Products (HTPs) was relatively low among people who have never used e-cigarettes, HTPs or smoking tobacco in the European Union, appeal was higher among younger age groups, which are often targeted by the industry. We also found substantial support for stricter regulatory policies for e-cigarettes and HTPs across the EU. These findings might encourage governments to increase restrictions around these emerging nicotine and tobacco products.
Blanco-Ferreiro A, Rey-Brandariz J, Ahluwalia JS, Varela-Lema L, Galán I, Santiago-Pérez MI, Sureda X, Fu M, Schiaffino A, José López M, Continente X, Candal-Pedreira C, Mahabee-Gittens M, Pérez-Ríos M.
Dimensions and domains to assess secondhand tobacco smoke exposure: insights from a Delphi study. Article
Gac Sanit. 2025;39:102508.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid40554131,
title = {Dimensions and domains to assess secondhand tobacco smoke exposure: insights from a Delphi study},
author = {Blanco-Ferreiro A and Rey-Brandariz J and Ahluwalia JS and Varela-Lema L and Galán I and Santiago-Pérez MI and Sureda X and Fu M and Schiaffino A and José López M and Continente X and Candal-Pedreira C and Mahabee-Gittens M and Pérez-Ríos M},
doi = {10.1016/j.gaceta.2025.102508},
issn = {1578-1283},
year = {2025},
date = {2025-06-01},
journal = {Gac Sanit},
volume = {39},
pages = {102508},
abstract = {OBJECTIVE: To identify the dimensions and domains to be included in questionnaires when assessing self-reported secondhand tobacco smoke (SHS) exposure in etiological studies and in population health surveys.nnMETHOD: A qualitative study was conducted in two stages. In stage one, based on a Delphi methodology, 16 experts in tobacco epidemiology completed two questionnaires and attended a group session. In stage two, triangulation interviews were conducted with six experts from the Delphi study to provided in-depth reflection on the domains identified in stage one. The recorded transcriptions were analyzed using a thematic approach.nnRESULTS: The experts discussed the importance of assessing SHS exposure in specific scenarios, highlighting the home, workplace, leisure venues, and private transport. They discussed the importance of asking about cohabiting with smokers when assessing exposure at home. The experts stressed the importance of differentiating between leisure venues, by prioritizing closed over open spaces. In population-based health surveys, the experts recommended that the recall time should be recent, referring to the last seven days. In etiological studies, they suggested that lifetime exposures should be explored.nnCONCLUSIONS: This study marks the first step toward identifying the dimensions and domains for assessing self-reported SHS exposure. Question standardization when ascertaining SHS exposure is critical to permit cross study comparisons and to analyze trends in the evolution of SHS exposure.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To identify the dimensions and domains to be included in questionnaires when assessing self-reported secondhand tobacco smoke (SHS) exposure in etiological studies and in population health surveys.nnMETHOD: A qualitative study was conducted in two stages. In stage one, based on a Delphi methodology, 16 experts in tobacco epidemiology completed two questionnaires and attended a group session. In stage two, triangulation interviews were conducted with six experts from the Delphi study to provided in-depth reflection on the domains identified in stage one. The recorded transcriptions were analyzed using a thematic approach.nnRESULTS: The experts discussed the importance of assessing SHS exposure in specific scenarios, highlighting the home, workplace, leisure venues, and private transport. They discussed the importance of asking about cohabiting with smokers when assessing exposure at home. The experts stressed the importance of differentiating between leisure venues, by prioritizing closed over open spaces. In population-based health surveys, the experts recommended that the recall time should be recent, referring to the last seven days. In etiological studies, they suggested that lifetime exposures should be explored.nnCONCLUSIONS: This study marks the first step toward identifying the dimensions and domains for assessing self-reported SHS exposure. Question standardization when ascertaining SHS exposure is critical to permit cross study comparisons and to analyze trends in the evolution of SHS exposure.
Tigova O, Stival C, Castellano Y, Lugo A, Fu M, Mar López A, Martínez C, Soriano JB, O'Donnell R, Semple S, López MJ, Fernández E, Gallus S.
Prevalence and determinants of smoke-free homes in 12 European countries: the TackSHS Survey. Article
ERJ Open Res. 2025;11.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid40129551,
title = {Prevalence and determinants of smoke-free homes in 12 European countries: the TackSHS Survey},
author = {Tigova O and Stival C and Castellano Y and Lugo A and Fu M and Mar López A and Martínez C and Soriano JB and O'Donnell R and Semple S and López MJ and Fernández E and Gallus S},
doi = {10.1183/23120541.00950-2024},
issn = {2312-0541},
year = {2025},
date = {2025-03-01},
journal = {ERJ Open Res},
volume = {11},
number = {2},
abstract = {BACKGROUND: Homes are one of the primary locations where people are exposed to second-hand smoke (SHS) in Europe. We describe the prevalence and identify the main determinants of having home-smoking restrictions in 12 European countries.nnMETHODS: Cross-sectional survey in 12 European countries conducted in 2017-2018 (TackSHS project). Approximately 1000 participants representing the general population aged ≥15 years of each country were interviewed face to face. Individual- and country-level characteristics were explored through adjusted prevalence ratios (PRs) obtained from multilevel Poisson models with random effects.nnRESULTS: Among 11 734 participants, 70.2% (95% confidence interval (CI) 69.4-71.0%) had smoke-free homes and 17.5% (95% CI 16.8-18.2%) had partial home-smoking restrictions in place. Prevalence of smoke-free homes ranged from 44.4% in Greece to 84.5% in England. Having a smoke-free home was significantly inversely associated with current (PR=0.60) or former (PR=0.95) smoking and living in a household with one (PR=0.70) or two or more (PR=0.58) people who smoke. It was also significantly associated with being ≥65 years old (PR=1.05), being female (PR=1.07), having a high educational level (PR=1.09) and living with children (PR=1.09). Having a smoke-free home was associated with living in northern Europe, while partial home-smoking restrictions were more likely among respondents from eastern Europe and countries with lower gross domestic product.nnCONCLUSIONS: The prevalence of smoke-free homes in Europe is relatively high, but with large variability across countries. European countries with a lower prevalence of smoke-free homes should implement tailored interventions targeting identified determinants and incorporate the success of other countries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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.
Martinez C, Saura J, Enriquez M, Feliu A, Roca X, Castellano Y, Cabezas C, Suelves JM, Mondon S, Barrio P, Andreu M, Raich A, Fonseca F, Masferrer L, Bautista P, Fernandez E.
J Psychoactive Drugs. 2025:1–15.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid40135674,
title = {Patterns of Tobacco Use, Dependence, and Motivation to Quit Among Individuals Seeking Treatment for Alcohol and Cannabis Consumption in Catalonia (Spain)},
author = {Martinez C and Saura J and Enriquez M and Feliu A and Roca X and Castellano Y and Cabezas C and Suelves JM and Mondon S and Barrio P and Andreu M and Raich A and Fonseca F and Masferrer L and Bautista P and Fernandez E},
doi = {10.1080/02791072.2025.2479102},
issn = {2159-9777},
year = {2025},
date = {2025-03-01},
journal = {J Psychoactive Drugs},
pages = {1--15},
abstract = {Understanding smoking behaviors in vulnerable groups is essential for effective cessation services. This study characterizes tobacco consumption and identifies factors associated with nicotine dependence and motivation to quit among individuals entering alcohol and cannabis treatment programs. A multi-center cross-sectional study was conducted in ten centers in Barcelona province. Participants' sociodemographics and tobacco use were assessed, including cigarette consumption and nicotine dependence (Fagerström test). Self-efficacy and motivation to quit were measured on a 0-10 Likert scale. A decision-tree analysis identified factors linked to moderate-to-high nicotine dependence (Fagerström ≥ 5) and high cessation motivation (≥7). Most participants (96.1%) use tobacco daily, with 57.0% using manufactured and 42.2% roll-your-own (RYO) cigarettes. Mean cigarette consumption was 15.2/day (SD = 8.7), with nicotine dependence (4.4, SD = 2.3). Cannabis users started smoking tobacco earlier than those who used alcohol. Over the past year, two-thirds attempted quitting and 60% had high cessation motivation. Self-efficacy for quitting was moderate (mean = 5.1; SD = 3.3). RYO use, age over 45, and alcohol use were associated with moderate-to-high nicotine dependence (probabilities = 0.52, 0.62, and 0.71, respectively). Having a non-tobacco social network was linked to a high motivation to quit (probability = 0.72). Participants had moderate nicotine dependence, low self-efficacy, and high motivation to quit tobacco. Dependence was higher among RYO users, ≥45 years/old, and people with alcohol use disorder. High motivation was more frequent among those with a non-tobacco social network. Integrating cessation support into substance treatment, focusing on RYO and young users, and promoting self-efficacy and tobacco-free socialization may enhance cessation success.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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.
Martínez C, Camarelles Guillem F, González-Viana A, Sánchez Á, Tigova O, Fernández E.
[From evidence to practice: The Disemination and Implementation Science in primary care]. Article
Aten Primaria. 2025;57:103077.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid39265319,
title = {[From evidence to practice: The Disemination and Implementation Science in primary care]},
author = {Martínez C and Camarelles Guillem F and González-Viana A and Sánchez Á and Tigova O and Fernández E},
doi = {10.1016/j.aprim.2024.103077},
issn = {1578-1275},
year = {2025},
date = {2025-01-01},
journal = {Aten Primaria},
volume = {57},
number = {1},
pages = {103077},
abstract = {Dissemination and Implementation Science focuses on bridging the gap between scientific research and its practical application in the real world. By identifying and promoting effective strategies, the Science of Dissemination and Implementation disseminates and implements evidence-based interventions in healthcare settings, taking into account the needs, barriers, context, resources, and end users. This special article introduces and debates the most recent advances in this field, highlighting key approaches, theoretical frameworks, as well as specific challenges and opportunities applied to primary and community care. Additionally, concrete examples tailored to the Spanish context are presented. Given the nascent state of the use of the Dissemination and Implementation Science in Spain, the authors recommend strategically adopting this approach and its principles in primary and community care to expedite the adoption of effective interventions that promote health.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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.
Teshima A, Martínez C, Filippidis FT, Laverty AA, Vardavas CI, Feliu A, Peruga A, Fernandez E.
Tob Induc Dis. 2025;23.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid40241742,
title = {Mapping indicators of tobacco and related product use: Unveiling challenges and variations in the Eurobarometer surveys over three decades},
author = {Teshima A and Martínez C and Filippidis FT and Laverty AA and Vardavas CI and Feliu A and Peruga A and Fernandez E},
doi = {10.18332/tid/202651},
issn = {1617-9625},
year = {2025},
date = {2025-01-01},
journal = {Tob Induc Dis},
volume = {23},
abstract = {INTRODUCTION: The European Commission's Special Eurobarometer surveys on tobacco are widely used as comparable and representative data across the European Union for monitoring consumption patterns. Despite their broad use, certain challenges persist, including inconsistencies in survey timelines and variations in the collected information across waves. This study aims to identify available tobacco and related product indicators, and assess their temporal comparability, to support researchers to better understand the potential uses of these data and their alignment with other sources.nnMETHODS: We explored questionnaires and reports in these surveys on tobacco from the Eurobarometer official website since its inception (1992, 2002, 2005, 2006, 2008, 2009, 2012, 2014, 2017, 2020 and 2023 waves). We extracted and compared questions and responses on use of tobacco and related products, as well as on sociodemographic variables. Finally, we compared all indicators, including frequency and wording, and further mapped the consistency of the indicators and type of product used across the different waves.nnRESULTS: Current, daily, former and never use of conventional cigarettes has been consistently assessed across all waves, enabling temporal comparisons. From 2009, the surveys have expanded to include e-cigarette use; since 2012, the surveys include various combusted products such as cigars, pipes, cigarillos, and waterpipes, and from 2020, heated tobacco products. By contrast, detailed data on product-specific use intensity and initiation remain limited. While indicators for secondhand smoke exposure and smoking cessation were present in multiple waves, their comparability is hindered by variations in question-wording and responses.nnCONCLUSIONS: Some challenges exist in using Eurobarometer surveys for temporal estimation of tobacco-related burden. Nonetheless, these surveys remain a valuable and unique tool for monitoring tobacco and related product use across the European Union. To further enhance their utility, periodic re-evaluation by tobacco control experts is recommended to ensure that the surveys maintain comparability with past data while capturing effectively emerging products and trends.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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.
Koprivnikar H, Carnicer-Pont D, López AM, González-Marrón A, Sæbø G, Gallus S, Possenti I, Lambrou A, Papachristou E, Pénzes M, Schoretsaniti S, Arteta N, Fernández E.
Tob Prev Cessat. 2025;11.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid40443706,
title = {Recommendations for updating regulations on advertising, promotion and sponsorship of tobacco and nicotine products in the European Union},
author = {Koprivnikar H and Carnicer-Pont D and López AM and González-Marrón A and Sæbø G and Gallus S and Possenti I and Lambrou A and Papachristou E and Pénzes M and Schoretsaniti S and Arteta N and Fernández E},
doi = {10.18332/tpc/204275},
issn = {2459-3087},
year = {2025},
date = {2025-01-01},
journal = {Tob Prev Cessat},
volume = {11},
abstract = {INTRODUCTION: Comprehensive bans on advertising, promotion and sponsorship of tobacco and nicotine products (TAPS) have proven effective in reducing their use. The Joint Action on Tobacco Control 2 (JATC2) aims to identify TAPS gaps in the current European Union (EU) regulations and to provide comprehensive recommendations for updating them.nnMETHODS: An online consultation with European TAPS national experts was conducted in 2023. Seventy-seven experts from 27 European countries were contacted and 38 experts from 21 countries participated in the consultation.nnRESULTS: Significant gaps in current TAPS regulations were identified, particularly in entertainment, online media and points of sale. Citizens are not adequately protected from TAPS, the tobacco industry extensively uses loopholes to circumvent regulations. TAPS-related issues currently affect tobacco and particularly non-therapeutic nicotine products, devices, accessories, products imitations and all marketing channels, entertainment, online media and especially, social networks. To address these challenges, regulations should include bans on internet sales and TAPS at points of sale, licensing, decreased retail availability, plain packaging and ban on corporate social responsibility actions, corporate promotion and 'brand stretching'. These measures should be accompanied by effective monitoring and enforcement, dissuasive sanctions, formalized collaboration among countries and international collaboration, civil society involvement, strong public education, and community awareness programs.nnCONCLUSIONS: There is an urgent need to address the current gaps in the EU TAPS regulations through comprehensive and harmonized TAPS bans across all EU countries. Updated regulations must anticipate emerging industry strategies and new products, ensuring continuous adaptation to counteract them effectively.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Comprehensive bans on advertising, promotion and sponsorship of tobacco and nicotine products (TAPS) have proven effective in reducing their use. The Joint Action on Tobacco Control 2 (JATC2) aims to identify TAPS gaps in the current European Union (EU) regulations and to provide comprehensive recommendations for updating them.nnMETHODS: An online consultation with European TAPS national experts was conducted in 2023. Seventy-seven experts from 27 European countries were contacted and 38 experts from 21 countries participated in the consultation.nnRESULTS: Significant gaps in current TAPS regulations were identified, particularly in entertainment, online media and points of sale. Citizens are not adequately protected from TAPS, the tobacco industry extensively uses loopholes to circumvent regulations. TAPS-related issues currently affect tobacco and particularly non-therapeutic nicotine products, devices, accessories, products imitations and all marketing channels, entertainment, online media and especially, social networks. To address these challenges, regulations should include bans on internet sales and TAPS at points of sale, licensing, decreased retail availability, plain packaging and ban on corporate social responsibility actions, corporate promotion and 'brand stretching'. These measures should be accompanied by effective monitoring and enforcement, dissuasive sanctions, formalized collaboration among countries and international collaboration, civil society involvement, strong public education, and community awareness programs.nnCONCLUSIONS: There is an urgent need to address the current gaps in the EU TAPS regulations through comprehensive and harmonized TAPS bans across all EU countries. Updated regulations must anticipate emerging industry strategies and new products, ensuring continuous adaptation to counteract them effectively.
Peruga A, Tigova O, Feliu A, Carnicer-Pont D, Anton L, Bosch F, Rey-Pino JM, Salto E, Fernández E, Martínez C.
Tobacco imagery in prime-time television in Spain: A content analysis. Article
Tob Induc Dis. 2025;23.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid40495994,
title = {Tobacco imagery in prime-time television in Spain: A content analysis},
author = {Peruga A and Tigova O and Feliu A and Carnicer-Pont D and Anton L and Bosch F and Rey-Pino JM and Salto E and Fernández E and Martínez C},
doi = {10.18332/tid/204750},
issn = {1617-9625},
year = {2025},
date = {2025-01-01},
journal = {Tob Induc Dis},
volume = {23},
abstract = {INTRODUCTION: Exposure to tobacco content in media among youth is a well-established risk factor for smoking initiation and continued use. This study assessed the prevalence and nature of tobacco imagery on Spanish prime-time television (TV) programming and its associations with program characteristics: genre, production nationality, and broadcast timing.nnMETHODS: A content analysis of 63959 minutes of TV programming in 2021, excluding advertisements and trailers, across 18 broadcast channels examined the presence of tobacco imagery: actual tobacco use, tobacco cultural cues, smoking ban violations, tobacco brand appearances, or any of these.nnRESULTS: The analysis revealed that 2.4% of the TV programming time contained at least one instance of tobacco imagery, resulting in 8.5 million impressions for viewers aged 4-24 years. Feature films had the highest prevalence of tobacco-related content (adjusted prevalence ratio, APR=11.9; 95% CI: 9.5-14.9). Tobacco-related content appeared more frequently outside designated children's protection hours (PR=0.7; 95% CI: 0.6-0.80). However, its presence within the designated children's protection schedule remains a significant concern, generating 15.6 million tobacco impressions for young viewers.nnCONCLUSIONS: The seemingly modest content level of tobacco imagery (2.4%) translates into a substantial number of impressions for young viewers aged 4-24 years, including during the designated children's protection schedule. Reducing tobacco imagery in films and TV series represents a promising strategy for curbing youth smoking. However, the current reliance on youth protection schedules is inadequate. To better protect children from tobacco imagery, policies should mandate strong anti-tobacco disclaimers preceding programs featuring tobacco and certificates of No Pay-off for tobacco portrayals.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Exposure to tobacco content in media among youth is a well-established risk factor for smoking initiation and continued use. This study assessed the prevalence and nature of tobacco imagery on Spanish prime-time television (TV) programming and its associations with program characteristics: genre, production nationality, and broadcast timing.nnMETHODS: A content analysis of 63959 minutes of TV programming in 2021, excluding advertisements and trailers, across 18 broadcast channels examined the presence of tobacco imagery: actual tobacco use, tobacco cultural cues, smoking ban violations, tobacco brand appearances, or any of these.nnRESULTS: The analysis revealed that 2.4% of the TV programming time contained at least one instance of tobacco imagery, resulting in 8.5 million impressions for viewers aged 4-24 years. Feature films had the highest prevalence of tobacco-related content (adjusted prevalence ratio, APR=11.9; 95% CI: 9.5-14.9). Tobacco-related content appeared more frequently outside designated children's protection hours (PR=0.7; 95% CI: 0.6-0.80). However, its presence within the designated children's protection schedule remains a significant concern, generating 15.6 million tobacco impressions for young viewers.nnCONCLUSIONS: The seemingly modest content level of tobacco imagery (2.4%) translates into a substantial number of impressions for young viewers aged 4-24 years, including during the designated children's protection schedule. Reducing tobacco imagery in films and TV series represents a promising strategy for curbing youth smoking. However, the current reliance on youth protection schedules is inadequate. To better protect children from tobacco imagery, policies should mandate strong anti-tobacco disclaimers preceding programs featuring tobacco and certificates of No Pay-off for tobacco portrayals.
Martínez C, Pla M, Feliu A, Enríquez M, Saura J, Cabezas C, Colom J, Suelves JM, Mondon S, Barrio P, Andreu M, Raich A, Bernabeu J, Roca X, Narváez M, Fernández E, of clinicians of the ACT_ATAC Group study.
Subst Abuse Treat Prev Policy. 2025;20:3.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid39838401,
title = {Clinician's perceptions and experiences with tobacco treatment in people who use cannabis: a qualitative study},
author = {Martínez C and Pla M and Feliu A and Enríquez M and Saura J and Cabezas C and Colom J and Suelves JM and Mondon S and Barrio P and Andreu M and Raich A and Bernabeu J and Roca X and Narváez M and Fernández E and Group of clinicians of the ACT_ATAC study},
doi = {10.1186/s13011-024-00632-8},
issn = {1747-597X},
year = {2025},
date = {2025-01-01},
journal = {Subst Abuse Treat Prev Policy},
volume = {20},
number = {1},
pages = {3},
abstract = {INTRODUCTION: Global demand for the treatment of cannabis use disorder has increased significantly, prompting a need to understand effective strategies for addressing concurrent cannabis and tobacco use. This study focuses on clinicians' experiences and perceptions in delivering tobacco cessation services to people who use cannabis.nnMETHODS: Fifteen participants (12 females, 3 males) participated in three homogenous focus groups, including two groups with extensive experience in providing tobacco cessation among the substance use population in Catalonia, Spain, and one group of clinicians without such experience. Thematic analysis was conducted to identify key patterns and insights in their discourse, focusing on shared themes and divergences across groups.nnRESULTS: Five main themes and 17 subthemes emerged: Individual characteristics, Clinician characteristics, Models of intervention, Organizational healthcare models, and Health policies. Clinicians stressed the importance of intervention models and the active role of professionals in addressing tobacco use within routine care, as tobacco cessation could mitigate social and chronic stigma among people who use cannabis, especially those engaged in polydrug use.nnDISCUSSION AND CONCLUSIONS: Recommendations included integrating tobacco cessation into all services, reducing healthcare service fragmentation, improving resource accessibility, enhancing clinical documentation, and advocating for stronger population-level tobacco control policies.nnTRIAL REGISTRATION: The ACT-ATAC project has been successfully registered at Clinicaltrials.gov [NCT04841655].},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Global demand for the treatment of cannabis use disorder has increased significantly, prompting a need to understand effective strategies for addressing concurrent cannabis and tobacco use. This study focuses on clinicians' experiences and perceptions in delivering tobacco cessation services to people who use cannabis.nnMETHODS: Fifteen participants (12 females, 3 males) participated in three homogenous focus groups, including two groups with extensive experience in providing tobacco cessation among the substance use population in Catalonia, Spain, and one group of clinicians without such experience. Thematic analysis was conducted to identify key patterns and insights in their discourse, focusing on shared themes and divergences across groups.nnRESULTS: Five main themes and 17 subthemes emerged: Individual characteristics, Clinician characteristics, Models of intervention, Organizational healthcare models, and Health policies. Clinicians stressed the importance of intervention models and the active role of professionals in addressing tobacco use within routine care, as tobacco cessation could mitigate social and chronic stigma among people who use cannabis, especially those engaged in polydrug use.nnDISCUSSION AND CONCLUSIONS: Recommendations included integrating tobacco cessation into all services, reducing healthcare service fragmentation, improving resource accessibility, enhancing clinical documentation, and advocating for stronger population-level tobacco control policies.nnTRIAL REGISTRATION: The ACT-ATAC project has been successfully registered at Clinicaltrials.gov [NCT04841655].
Martínez C, Camarelles Guillem F, González-Viana A, Sánchez Á, Tigova O, Fernández E.
[From evidence to practice: The Disemination and Implementation Science in primary care]. Article
Aten Primaria. 2025;57:103077.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid39265319b,
title = {[From evidence to practice: The Disemination and Implementation Science in primary care]},
author = {Martínez C and Camarelles Guillem F and González-Viana A and Sánchez Á and Tigova O and Fernández E},
doi = {10.1016/j.aprim.2024.103077},
issn = {1578-1275},
year = {2025},
date = {2025-01-01},
journal = {Aten Primaria},
volume = {57},
number = {1},
pages = {103077},
abstract = {Dissemination and Implementation Science focuses on bridging the gap between scientific research and its practical application in the real world. By identifying and promoting effective strategies, the Science of Dissemination and Implementation disseminates and implements evidence-based interventions in healthcare settings, taking into account the needs, barriers, context, resources, and end users. This special article introduces and debates the most recent advances in this field, highlighting key approaches, theoretical frameworks, as well as specific challenges and opportunities applied to primary and community care. Additionally, concrete examples tailored to the Spanish context are presented. Given the nascent state of the use of the Dissemination and Implementation Science in Spain, the authors recommend strategically adopting this approach and its principles in primary and community care to expedite the adoption of effective interventions that promote health.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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.
Feliu A, Fernandez E, Tamí-Maury I, Martinez C.
BMJ Public Health. 2025;3:e002418.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid40791264,
title = {Impact of tobacco control policies on socioeconomic inequalities in smoking prevalence and quit ratios: an ecological study in the European Union (2009-2020)},
author = {Feliu A and Fernandez E and Tamí-Maury I and Martinez C},
doi = {10.1136/bmjph-2024-002418},
issn = {2753-4294},
year = {2025},
date = {2025-01-01},
journal = {BMJ Public Health},
volume = {3},
number = {2},
pages = {e002418},
abstract = {BACKGROUND: Tobacco control efforts have succeeded in reducing smoking prevalence and increasing smoking cessation rates in the European Union Member States (EU27). However, the impact of these policies has been unequal across different income groups.nnMETHODS: Ecological study with the country as unit of analysis. We used the Tobacco Control Scale (TCS) in EU27 in 2010 and the prevalence of smoking and quit ratios from the Eurobarometer surveys (2009, n=27 788; and 2020, n=28 288). We analysed the relationship between the TCS scores (2010) and smoking indicators and their relative changes (between 2009 and 2020) using scatter plots and multiple linear regression models.nnFINDINGS: In the EU27, high inequalities exist among different income groups. High-income residents had lower smoking prevalence (19 vs 40%) and higher quit ratios (55 vs 32%) compared with the low-income group. Positive changes in smoking indicators from 2009 to 2020 were stronger in the high-income group. There was a stronger negative correlation between TCS scores and smoking prevalence in high-income groups (r=-0.615, p<0.01; r=-0.498; p=0.01) and between its relative changes but only in the high-income group (r=-0.478; p=0.01). A positive correlation was observed between TCS scores and quit ratios (r=0.580, r=0.548, both p<0.01) in high- and moderate-income populations.nnCONCLUSIONS: Declines in smoking prevalence and increases in quit ratios were considerably lower in moderate- and low-income groups. Tailoring tobacco control policies to address financial, social and structural barriers, such as ensuring free access to cessation services, implementing targeted outreach programmes, adopting culturally and linguistically appropriate interventions, among others, is essential for making these measures more equitable, which is key for the EU27 to achieve its tobacco-free goal by 2040.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Tobacco control efforts have succeeded in reducing smoking prevalence and increasing smoking cessation rates in the European Union Member States (EU27). However, the impact of these policies has been unequal across different income groups.nnMETHODS: Ecological study with the country as unit of analysis. We used the Tobacco Control Scale (TCS) in EU27 in 2010 and the prevalence of smoking and quit ratios from the Eurobarometer surveys (2009, n=27 788; and 2020, n=28 288). We analysed the relationship between the TCS scores (2010) and smoking indicators and their relative changes (between 2009 and 2020) using scatter plots and multiple linear regression models.nnFINDINGS: In the EU27, high inequalities exist among different income groups. High-income residents had lower smoking prevalence (19 vs 40%) and higher quit ratios (55 vs 32%) compared with the low-income group. Positive changes in smoking indicators from 2009 to 2020 were stronger in the high-income group. There was a stronger negative correlation between TCS scores and smoking prevalence in high-income groups (r=-0.615, p<0.01; r=-0.498; p=0.01) and between its relative changes but only in the high-income group (r=-0.478; p=0.01). A positive correlation was observed between TCS scores and quit ratios (r=0.580, r=0.548, both p<0.01) in high- and moderate-income populations.nnCONCLUSIONS: Declines in smoking prevalence and increases in quit ratios were considerably lower in moderate- and low-income groups. Tailoring tobacco control policies to address financial, social and structural barriers, such as ensuring free access to cessation services, implementing targeted outreach programmes, adopting culturally and linguistically appropriate interventions, among others, is essential for making these measures more equitable, which is key for the EU27 to achieve its tobacco-free goal by 2040.
Li CX, Wang PC, Feliu A, Laverty AA, Martinez C, Peruga A, Girvalaki C, Radu Loghin C, Vardavas CI, Filippidis FT.
BMJ Public Health. 2025;3:e002903.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid40756166,
title = {Exposure to secondhand smoke from cigarettes and secondhand aerosol from tobacco and nicotine products in indoor and outdoor public spaces in the European Union: a cross-sectional study},
author = {Li CX and Wang PC and Feliu A and Laverty AA and Martinez C and Peruga A and Girvalaki C and Radu Loghin C and Vardavas CI and Filippidis FT},
doi = {10.1136/bmjph-2025-002903},
issn = {2753-4294},
year = {2025},
date = {2025-01-01},
journal = {BMJ Public Health},
volume = {3},
number = {2},
pages = {e002903},
abstract = {INTRODUCTION: In December 2024, the Council of the European Union (EU) adopted a recommendation to expand regulations on the use of nicotine-containing products both in indoor settings and specific outdoor areas. This study aimed to examine sociodemographic factors associated with exposure to conventional tobacco smoke and aerosols across the EU and support for relevant regulations.nnMETHODS: We performed a secondary analysis of cross-sectional data from the Special Eurobarometer 99.3 (n=26 358, May-June 2023) across 27 EU Member States (MS). We estimated the weighted prevalence of secondhand exposure to tobacco smoke and aerosols and support for bans on smoking, e-cigarettes and heated tobacco products in public settings. Multilevel Poisson regression models explored associations between sociodemographic factors and these outcomes.nnRESULTS: Exposure to secondhand smoke and aerosols varied across EU MS. Younger individuals, those with higher education, living with children, and current and former tobacco and nicotine users (prevalence ratio (PR) 1.16, 1.01-1.33; and PR 1.22, 1.05-1.41, respectively) were more likely to report exposure to both tobacco smoke and aerosol from emerging products. Women (PR 1.05, 1.02-1.08; and PR 1.03, 1.02-1.05, respectively), those living with children (PR 1.05, 1.02-1.07; and PR 1.04, 1.02-1.07, respectively) and those with higher education levels (PR 1.10, 1.04-1.15; and PR 1.10, 1.06-1.14) were more likely to support bans, whereas those with financial difficulties (PR 0.94, 0.89-0.99 and PR: 0.95, 0.91-0.99, respectively), as well as current and former smokers (PR 0.61, 0.55-0.67; and PR 0.78, 0.73-0.84, respectively) and emerging product users (PR 0.84, 0.76-0.92; and PR 0.69, 0.62-0.76, respectively), were less supportive.nnCONCLUSION: Our analysis found that both exposure to secondhand smoke and aerosol and support for bans in public spaces vary substantially between population subgroups and across countries. Our findings can support EU MS in implementing targeted interventions to increase population support for and implement the recent EU Council recommendations.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: In December 2024, the Council of the European Union (EU) adopted a recommendation to expand regulations on the use of nicotine-containing products both in indoor settings and specific outdoor areas. This study aimed to examine sociodemographic factors associated with exposure to conventional tobacco smoke and aerosols across the EU and support for relevant regulations.nnMETHODS: We performed a secondary analysis of cross-sectional data from the Special Eurobarometer 99.3 (n=26 358, May-June 2023) across 27 EU Member States (MS). We estimated the weighted prevalence of secondhand exposure to tobacco smoke and aerosols and support for bans on smoking, e-cigarettes and heated tobacco products in public settings. Multilevel Poisson regression models explored associations between sociodemographic factors and these outcomes.nnRESULTS: Exposure to secondhand smoke and aerosols varied across EU MS. Younger individuals, those with higher education, living with children, and current and former tobacco and nicotine users (prevalence ratio (PR) 1.16, 1.01-1.33; and PR 1.22, 1.05-1.41, respectively) were more likely to report exposure to both tobacco smoke and aerosol from emerging products. Women (PR 1.05, 1.02-1.08; and PR 1.03, 1.02-1.05, respectively), those living with children (PR 1.05, 1.02-1.07; and PR 1.04, 1.02-1.07, respectively) and those with higher education levels (PR 1.10, 1.04-1.15; and PR 1.10, 1.06-1.14) were more likely to support bans, whereas those with financial difficulties (PR 0.94, 0.89-0.99 and PR: 0.95, 0.91-0.99, respectively), as well as current and former smokers (PR 0.61, 0.55-0.67; and PR 0.78, 0.73-0.84, respectively) and emerging product users (PR 0.84, 0.76-0.92; and PR 0.69, 0.62-0.76, respectively), were less supportive.nnCONCLUSION: Our analysis found that both exposure to secondhand smoke and aerosol and support for bans in public spaces vary substantially between population subgroups and across countries. Our findings can support EU MS in implementing targeted interventions to increase population support for and implement the recent EU Council recommendations.
Afolayan OK, Velazquez J, Tundealao S, Fernández E, Martínez C, Leon-Novelo L, Retamales J, Tamí-Maury I.
Subst Use Misuse. 2025;60:566–576.
Abstract | Links | BibTeX | Etiquetes:
@article{pmid39846443,
title = {Trends and Association between Smoking and the Socio-Demographic Index Among 11 South American Countries, 1990-2019},
author = {Afolayan OK and Velazquez J and Tundealao S and Fernández E and Martínez C and Leon-Novelo L and Retamales J and Tamí-Maury I},
doi = {10.1080/10826084.2024.2440384},
issn = {1532-2491},
year = {2025},
date = {2025-01-01},
journal = {Subst Use Misuse},
volume = {60},
number = {4},
pages = {566--576},
abstract = {OBJECTIVES: To examine prevalence trends in the use of smoked tobacco products in 11 South American (SA) countries (i.e., Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Suriname, Uruguay, and Venezuela) and their association with country-specific socio-demographic index (SDI) over 30 years.nnDATA AND METHODS: The estimates of SDI and smoked tobacco prevalence stratified by age, sex, and country were extracted from the Global Burden of Disease Study (1990-2019) on individuals aged 15+. The annual percentage changes (APCs) of trends in country-specific prevalence of smoked tobacco were evaluated using Joinpoint regression. Correlation analysis was also used to explore the association between country-specific prevalence of smoked tobacco and their SDIs, a measure of developmental status considering income per capita, educational attainment, and total fertility rate.nnRESULTS: While all SA countries showed an overall decline in smoked tobacco use prevalence between 1990 and 2019 (APCs between -0.52%-and -4.73%; < 0.05), Bolivia and Ecuador showed a significant increasing trend (APCs of 0.34% and 0.20%). Country-specific SDI was strongly and significantly correlated (rs = -0.99 to -0.85) with smoking prevalence in SA countries, except for Ecuador and Bolivia (rs = 0.16 and 0.36, respectively).nnCONCLUSION: In recent decades, most SA countries have experienced a significant reduction in the prevalence of smoked tobacco use, except Ecuador and Bolivia, where smoking rates have risen, showing a direct correlation with SDI. These findings can contribute to the design and implementation of strategies and policies for tobacco prevention and control in the SA region especially within the two affected countries - Ecuador and Bolivia.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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.