Nuevas y viejas adicciones: implicaciones para la salud pública

[Addictions to information and communication technologies in Comunitat Valenciana (Spain), 2018-2020]

OBJECTIVE

To describe the sociodemographic profile of the people treated for addiction to information and communication technologies (ICTs) in the addictive behavior units (ABU) of Comunitat Valenciana, Spain, in 2018-2020.

METHOD

Annual analysis and for the global period according to information collected in the ABU records.

RESULTS

219 registered cases, mostly men (87%), under 30 years of age (53%), with primary education or less (51%), and living with parents (57%). In the study period significant changes were observed in age (increase) and employment situation (more active workers). The COVID-19 pandemic's year (2020) accentuated or maintained previous trends.

CONCLUSIONS

The person treated for addiction to ICTs in Comunitat Valenciana is mostly male, under 30 years of age and with a primary education level or less, with a trend to increase in age and in proportion of active workers. Prevention should focus on these groups at higher risk.

[Changes in the population smoking patterns: Barcelona, 1983-2006]

OBJECTIVE

To describe the distribution of smoking in the population and to assess existing trends.

SUBJECTS AND METHODS

Cross sectional study in a sample of the resident non-institutionalized population over 14 years of age (n = 6,050) in Barcelona (Catalonia, Spain) using the Health Survey of 2006 and comparing trends for 1983-2006 with previous surveys. Independent variables included sex and age. Dependent variables were having ever been a smoker, quitting, and being a current smoker. Prevalence and proportions were estimated, stratifying or adjusting for age.

RESULTS

The prevalence of daily smokers was 27.3% for men and 20.6% for women. Age groups smoking more were 25-34 years for men and 35-44 for women. From 1983 to 2006 the decline for men was sharp, and the prevalence for women is now decreasing. The change accelerated progressively for men, in absolute and relative terms. Estimating the probability of quitting for smokers, there was an increase in cessations over this period. The proportion of smokers of an older age is now much smaller.

CONCLUSIONS

The evolution of the smoking epidemic over the last years shows promising trends. Quit rates have increased, and the decline in prevalence increases among men and has started in women. Smokers are increasingly becoming a minority, although to improve public health it would be desirable to speed the process of change.

Smoking status, changes in smoking status and health-related quality of life: findings from the SUN ("Seguimiento Universidad de Navarra") cohort

We aimed to evaluate the association between smoking, changes in smoking, and quality of life in a cohort of Spanish university graduates. Smoking habits were self-reported at baseline and four years later. Quality of life was assessed using the Short Form-36 (SF-36) at year 4. Statistical differences in SF-36 scores between groups were determined using ANCOVA with age and sex as covariates. Out of 5,234 eligible participants over 2000-2006, there were 2,639 non-smoker participants, 1,419 ex-smokers, and 1,048 smokers. Within the previous four years, 435 participants became recent quitters and 205 starters. Comparing smoking and health status in year 4, non-smokers showed better scores than the other categories of ever smoking in all dimensions except in the vitality scale value, which was similar in non-smokers and in those smoking less than 15 cigarettes/day. Comparing changes in smoking and health in year 4, continuing smokers had statistically significant worse scores than non-smokers in general health, social functioning, role-emotional and mental health, whereas recent quitters showed statistically significant improvements in role-emotional and mental health over those who had continued smoking or those who became smokers. Our findings support a dose-response relationship between cigarette consumption and a worse quality of life in general and mental health in particular. They also support that changes in smoking have an impact on health.

[Regulatory policies on alcohol in Spain. Experience-based public health? 2008 SESPAS Report]

The present article reviews the proposal for alcohol regulation made in Spain in 2006 by the Ministry of Health and Consumer Affairs and dropped a few months later as adverse positions took over the debate in the political arena and the media. The background to these regulations, as well as their components, the process, and the actors involved are analyzed, and the factors leading to this outcome are discussed. A comparison is made with the tobacco regulation initiative in 2005, which resulted in a regulatory law with a highly favorable impact on public health. The actors interested in promoting alcohol consumption and opposed to any regulation have a privileged institutional presence, generating powerful resistance. Although these regulatory proposals would have marginal impacts on their trade, wine growers and wineries have been the most visible forces against regulation and have had the greatest political and media impact. Equally, manipulated messages on the health benefits of alcohol use have fed arguments against regulation. The lack of political and media consensus in this case stands in contrast with the tobacco regulation process, in which a certain political consensus had previously been reached and the smoking prevention movement had permeated the media with preventive messages, framing the issue in terms favorable for regulation. To gain ground, the sectors interested in expanding public policies for the prevention of the harm caused by alcohol need greater cohesion and organization. Professional public health organizations can substantially contribute to this field.

[Trends of HIV mother-to-child transmission in Catalonia, Spain, between 1987 and 2003]

BACKGROUND AND OBJECTIVE

To describe and to analyze the evolution of the mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV), the clinical and epidemiological characteristics and the use of antiretrovirals (ARV) in the HIV infected pregnant women and their new-borns alive between 1987 and 2003 in Catalonia.

MATERIAL AND METHOD

The available clinical-epidemiological and treatment data were obtained from 4 reference hospitals that take care of most of the children born to HIV infected mothers in Catalonia. Two of the hospitals had a data base designed to the follow up of their patients, whereas in the other 2 data were gathered by reviewing clinical registries. For the analysis, 3 periods, based on the recommendations of treatment ARV during pregnancy, were settled down: 1987-1993; 1994-1996, and 1997-2003.

RESULTS

1,105 mother-infant pairs were studied. HIV MTCT was reduced from 20.4% to 3.5% from first to third period of study (p < 0.001). The median age of the mothers increased from 24.6 to 30.5 years of age (p < 0.001). The proportion of women infected by sexual transmission increased from 17.2% to 58.8% (p < 0.001), whereas that of parenteral transmission decreased from the 79.2% to 43.5% (p < 0.001). In the last period, 74.1% of mother-child pairs received complete ARV prophylaxis regimens and 21.6% partial ones. The rate of elective caesarean-section went up from 32.2% to 58.2% (p < 0.001).

CONCLUSIONS

The rates of MTCT in our setting have followed the same trend as in other countries of our surroundings. The observed changes reflect the variations in the characteristics of the epidemic in the general population. The implementation of the recommendations on ARV prophylaxis has begun early and it has extended progressively without getting to be total. Additional strategies for the universal coverage of the screening test during pregnancy are still needed.