1
|
Espina C, Feliu A, González Vingut A, Liddle T, Jimenez-Garcia C, Olaya-Caro I, Perula-De-Torres LÁ. Population-Based Cancer Prevention Education Intervention Through mHealth: A Randomized Controlled Trial. J Med Syst 2024; 48:9. [PMID: 38194118 PMCID: PMC10776794 DOI: 10.1007/s10916-023-02026-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/02/2023] [Indexed: 01/10/2024]
Abstract
Despite the high potential of mHealth-related educational interventions to reach large segments of the population, implementation and adoption of such interventions may be challenging. The objective of this study was to gather knowledge on the feasibility of a future cancer prevention education intervention based on the European Code Against Cancer (ECAC), using a population-based mHealth implementation strategy. A type-2 hybrid effectiveness-implementation study was conducted in a sample of the Spanish general population to assess adoption, fidelity, appropriateness, and acceptability of an intervention to disseminate cancer prevention messages, and willingness to consult further digital information. Participation rates, sociodemographic data, mHealth use patterns and implementation outcomes were calculated. Receiving cancer prevention messages through mHealth is acceptable, appropriate (frequency, timing, understandability and perceived usefulness) and feasible. mHealth users reported high access to the Internet through different devices, high ability and confidence to browse a website, and high willingness to receive cancer prevention messages in the phone, despite low participation rates in comparison to the initial positive response rates. Although adoption of the intervention was high, post-intervention fidelity was seriously hampered by the disruptions caused by the Covid-19 pandemic, which may have affected recall bias. In the context of the Europe's Beating Cancer Plan to increase knowledge about cancer prevention across the European Union, this study contributes to inform the design of future interventions using mHealth at large scale, to ensure a broad coverage and adoption of cancer prevention messages as those promoted by the ECAC.Trial Registration: ClinicalTrials.gov from the U.S. National Library of Medicine, NCT05992792. Registered 15 August 2023 - Retrospectively registered https://clinicaltrials.gov/study/NCT05992792?cond=Cancer&term=NCT05992792&rank=1 .
Collapse
Affiliation(s)
- Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366, Lyon CEDEX 07, France.
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366, Lyon CEDEX 07, France
| | - Albert González Vingut
- Health Emergencies Center 061, CRM e I+D+I Salud Responde, Consejería de Salud y Consumo, Junta de Andalucía, Seville, Spain
| | - Theresa Liddle
- Health Emergencies Center 061, Salud Responde, Consejería de Salud y Consumo, Junta de Andalucía, Jaén, Spain
| | - Celia Jimenez-Garcia
- Maimonides Institute of biomedical Research of Cordoba (IMIBIC)/University of Cordoba, Córdoba, Spain
- Health District of Cordoba-Guadalquivir, Córdoba, Spain
| | - Inmaculada Olaya-Caro
- Maimonides Institute of biomedical Research of Cordoba (IMIBIC)/University of Cordoba, Córdoba, Spain
- Health District of Cordoba-Guadalquivir, Córdoba, Spain
| | - Luis Ángel Perula-De-Torres
- Maimonides Institute of biomedical Research of Cordoba (IMIBIC)/University of Cordoba, Córdoba, Spain
- Programa de Actividades de Promoción y Prevención de la Salud (PAPPS-semFYC), Barcelona, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS), Cooperative Research Networks Oriented to Health Results (RICORS), Carlos III Health Institute, Madrid, Spain
| |
Collapse
|
2
|
Camargo MC, Feliu A, Stern MC, Villarreal-Garza C, Ferreccio C, Espina C. The Latin America and the Caribbean Code Against Cancer: an opportunity for empowerment and progress. Lancet Reg Health Am 2023; 28:100644. [PMID: 38076409 PMCID: PMC10701346 DOI: 10.1016/j.lana.2023.100644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 02/12/2024]
Affiliation(s)
- Maria Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Ariadna Feliu
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Mariana C. Stern
- Department of Population and Public Health Sciences and Urology, Norris Comprehensive Cancer Center, Keck School of Medicine of USC, Los Angeles, United States
| | - Cynthia Villarreal-Garza
- Centro de Cáncer de Mama, Hospital Zambrano Hellion - TecSalud, Tecnológico de Monterrey, Monterrey, Mexico
| | - Catterina Ferreccio
- Facultad de Medicina, Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases ACCDIS, Santiago, Chile
| | - Carolina Espina
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| |
Collapse
|
3
|
Feliu A, Martinez C, Peruga A, Fernandez E. The WHO MPOWER Package and the Tobacco Control Scale: Two Tools to Monitor Country-level Tobacco Control Policy Implementation in Latin America. Arch Bronconeumol 2023; 59:785-786. [PMID: 37714765 DOI: 10.1016/j.arbres.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/17/2023]
Affiliation(s)
- Ariadna Feliu
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Spain; Center for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Cristina Martinez
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Spain; Center for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain; Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain; School of Nursing, Campus Bellvitge, Universitat de Barcelona, Hospitalet de Llobregat, Spain; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, United States
| | - Armando Peruga
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Spain; Center for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain; Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain; Center for Epidemiology & Health Policies, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Esteve Fernandez
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Spain; Center for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain; Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain; School of Medicine & Health Sciences, Campus Bellvitge, Universitat de Barcelona, Hospitalet de Llobregat, Spain.
| |
Collapse
|
4
|
Llop D, Feliu A, Ibarretxe D, Escribano J, Plana N, Borjabad-Rodríguez C, Masana L, Vallvé JC. Lipoprotein profile assessed by 1H NMR, BMI and blood pressure are associated with vascular alterations in children with familial hypercholesterolaemia. Nutr Metab Cardiovasc Dis 2023; 33:2035-2043. [PMID: 37543518 DOI: 10.1016/j.numecd.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND AND AIMS Children with familial hypercholesterolaemia (FH) have elevated low-density lipoprotein cholesterol (LDL-C) concentrations since birth, which increases the risk of cardiovascular disease in adulthood. Arterial injury and stiffness parameters, including carotid intima media thickness (cIMT), pulse wave velocity (PWV) and distensibility (DIST), can be detected early in childhood. We studied the associations between cIMT, PWV and DIST with the lipoprotein profile assessed by proton nuclear magnetic resonance (1H NMR) and with influential variables such as blood pressure (BP) or body mass index (BMI) in children with FH. METHODS AND RESULTS In this cross-sectional study, we included 201 children (96 with FH and 105 non-FH controls). Clinical history, physical examination and standard biochemical studies were performed. FH genetic testing was performed when clinically indicated. Carotid ultrasonography and an advanced lipoprotein profile by 1H NMR were performed. Multivariate and classification methods were used. There were no differences between cIMT, PWV and DIST between FH and non-FH children. FH children presented more total LDL and large, medium and small particles. Small LDL particles, BMI and systolic BP determined the presence of pathological IMT in the FH group. LDL size, high-density lipoproteins and very low-density lipoprotein particles together with blood pressure determined the presence of pathological arterial wall elasticity. CONCLUSIONS Alterations in lipoprotein parameters assessed by are associated with early structural and functional arterial characteristics in children with FH. BMI and BP act as boosting factors. Cardiovascular prevention should start early in children with FH, encompassing all components of a healthy lifestyle.
Collapse
Affiliation(s)
- D Llop
- Unitat de Recerca de Lípids I Arteriosclerosi, Universitat Rovira I Virgili, Reus, Catalonia, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Madrid, Spain
| | - A Feliu
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira I Virgili, IISPV, Reus, Spain
| | - D Ibarretxe
- Unitat de Recerca de Lípids I Arteriosclerosi, Universitat Rovira I Virgili, Reus, Catalonia, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Sant Joan, Reus, Catalonia, Spain
| | - J Escribano
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira I Virgili, IISPV, Reus, Spain
| | - N Plana
- Unitat de Recerca de Lípids I Arteriosclerosi, Universitat Rovira I Virgili, Reus, Catalonia, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Sant Joan, Reus, Catalonia, Spain
| | - C Borjabad-Rodríguez
- Unitat de Recerca de Lípids I Arteriosclerosi, Universitat Rovira I Virgili, Reus, Catalonia, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Sant Joan, Reus, Catalonia, Spain
| | - L Masana
- Unitat de Recerca de Lípids I Arteriosclerosi, Universitat Rovira I Virgili, Reus, Catalonia, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Sant Joan, Reus, Catalonia, Spain
| | - J C Vallvé
- Unitat de Recerca de Lípids I Arteriosclerosi, Universitat Rovira I Virgili, Reus, Catalonia, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Madrid, Spain.
| |
Collapse
|
5
|
Blanco E, Algranti E, Cifuentes LA, López-Carrillo L, Mora AM, Rodríguez-Guzmán J, Rodríguez-Villamizar LA, Veiga LHS, Canelo-Aybar C, Nieto-Gutierrez W, Feliu A, Espina C, Ferreccio C. Latin America and the Caribbean Code Against cancer 1st edition: Environment, occupation, and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102381. [PMID: 37852723 DOI: 10.1016/j.canep.2023.102381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/21/2023] [Accepted: 03/25/2023] [Indexed: 10/20/2023]
Abstract
Within the framework of the Latin America and Caribbean region (LAC) Code Against Cancer 1st edition, the current work presents recommendations to reduce exposure to environmental and occupational carcinogenic agents relevant for LAC. Using the methodology established by the International Agency for Research on Cancer (IARC) in the World Code Against Cancer Framework and experience from developing the European Code Against Cancer 4th edition, a working group of LAC cancer-prevention experts reviewed the list of Group I IARC carcinogenic agents, identified prevalent environmental and occupational exposures in the region, and proposed evidence-based cancer prevention recommendations suited to the epidemiological, socioeconomic, and cultural conditions of LAC countries. Two sets of recommendations were drafted: those targeting the general public and a second set for policymakers. Outdoor and indoor air pollution, ultra-violet radiation and occupational exposures to silica dust, asbestos, benzene, diesel, and welding fumes were identified as prevalent carcinogens in LAC and as agents that could be reduced or eliminated to prevent cancers. Recommendations for additional risk factors were not included due to insufficient data of their attributable burden in LAC (sunbeds, radon, aflatoxin), or lack of a clear preventive action to be taken by the individual (arsenic in drinking water, medical radiation), or lack of evidence of carcinogenicity effect (bisphenol A, phthalates, and pesticides). A broad consensus was reached on environmental and occupational carcinogenic exposures present throughout the LAC region and on individual-level and public policy-level recommendations to reduce or eliminate these exposures. Key educational content for the dissemination of these recommendations was also developed as part of LAC Code Against Cancer 1st Edition.
Collapse
Affiliation(s)
- Estela Blanco
- Centro de Investigación en Sociedad y Salud y Nucleo Milenio SocioMed, Universidad Mayor, Badajoz 130, Oficina 1305, Las Condes, Santiago 7550000, Chile; Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Libertador Bernardo O'Higgins 340, Región Metropolitana, Postal/Zip Code: 8331150, Santiago, Chile
| | | | - Luis Abdon Cifuentes
- Departamento de Ingeniería, Pontificia Universidad Católica de Chile, Avenida Libertador Bernardo O'Higgins 340, Región Metropolitana, Postal/Zip Code: 8331150, Santiago, Chile
| | - Lizbeth López-Carrillo
- Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico
| | - Ana M Mora
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, 1995 University Avenue, Suite 265, Berkeley, CA 94720-7392, USA
| | | | - Laura Andrea Rodríguez-Villamizar
- Escuela de Medicina, Facultad de Salud, Universidad Industrial de Santander, Cra. 32 #29-31, Bucaramanga, Santander 680002, Colombia
| | - Lene H S Veiga
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, MSC 9776, Bethesda 20892, MD, USA
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Wendy Nieto-Gutierrez
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, CEDEX 0769366, Lyon, France
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, CEDEX 0769366, Lyon, France
| | - Catterina Ferreccio
- Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Libertador Bernardo O'Higgins 340, Región Metropolitana, Postal/Zip Code: 8331150, Santiago, Chile; Advanced Center for Chronic Diseases ACCDIS, Santiago, Chile.
| |
Collapse
|
6
|
Feliu A, Finck C, Lemos M, Bahena Botello A, de Albuquerque Melo Nogueira F, Bonvecchio Arenas A, Garcés-Palacio IC, Jurberg C, Pesce K, Espina C. Latin America and the Caribbean Code Against Cancer 1st edition: Building capacity on cancer prevention to primary healthcare professionals. Cancer Epidemiol 2023; 86 Suppl 1:102400. [PMID: 37852724 DOI: 10.1016/j.canep.2023.102400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/11/2023] [Accepted: 06/15/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION Every year 1.5 million new cancer cases are diagnosed in Latin America and the Caribbean (LAC). Of these, about 40 % could be prevented. Health illiteracy has been identified as a main barrier for cancer prevention. Primary healthcare professionals (HCP) are key in cancer prevention as they are the first entry point of the population into the healthcare system. The LAC Code Against Cancer 1st edition aims to improve health literacy and awareness of cancer prevention in the LAC population, through building capacity of primary HCP. METHODS The definition and development of the learning objectives, curriculum, structure, and evaluation of an online learning program for primary HCP was led by a dedicated group of experts from the LAC Code Against Cancer project. A pedagogical guideline and a template to ensure harmonization across topics were produced to guide the program development. Two rounds of internal revisions and an editorial process were performed. RESULTS An online competency-based microlearning program for primary HCP was produced, taking the LAC Code Against Cancer as a basis. The competences addressed in the curriculum are core knowledge, communication skills, decision-making and applying knowledge to real-world situations. A comprehensive evaluation to assess acquisition of these competences, based on the Miller's Pyramid, was designed with three data collection points: a) immediately before, to assess baseline knowledge and skills; b) immediately after, to determine acquired competences; and c) at 3-6 months follow-up, to assess performance in daily practice. The e-learning will be freely available in the Virtual Campus for Public Health of the Pan American Health Organization in Spanish, English, and Portuguese. CONCLUSION Primary HCP, perceived as trustworthy sources of information, are key actors to increase the population's awareness and literacy on cancer prevention. Building capacity of these professionals has the potential to increase dissemination and impact of the LAC Code Against Cancer by prompting communication with the public and offering personalized actionable preventive messages through counselling.
Collapse
Affiliation(s)
- Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, Lyon CEDEX 07 69366, France.
| | - Carolyn Finck
- Departamento de Psicología, Universidad de los Andes, Cra 1 Nr 18A-12, Bogotá, Colombia
| | - Mariantonia Lemos
- Universidad EAFIT, Escuela de Artes y Humanidades, Carrera 49 #7 sur 50, Medellín, Colombia
| | - Arlette Bahena Botello
- Escuela de Salud Pública, Instituto Nacional de Salud Pública, Universidad 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, Cuernavaca, Morelos, Mexico
| | - Fernanda de Albuquerque Melo Nogueira
- Instituto Nacional do Câncer José Alencar Gomes da Silva, Coordenação de Prevenção e Controle do Câncer, Área Técnica Ambiente, Trabalho e Câncer, Rua Marqueês de Pombal, 125, 5o andar, Centro, Rio de Janeiro CEP: 20230-240, Brazil
| | - Anabelle Bonvecchio Arenas
- Centro de Investigación en Nutrición y Salud (CINyS), Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, Cuernavaca, Morelos, Mexico
| | - Isabel C Garcés-Palacio
- Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Claudia Jurberg
- Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro, Av. Erasmo Braga 118 - 6º andar, Rio de Janeiro, Brazil
| | - Karina Pesce
- Diagnostico e Intervencionismo mamario del Hospital Italiano de Buenos Aires Argentina, Peron 4190. Capital Federal, Argentina
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, Lyon CEDEX 07 69366, France
| |
Collapse
|
7
|
Lemos M, Restrepo J, Espina C, Feliu A, Ferreccio C, Garcés-Palacio IC, Jurberg C, de Albuquerque Melo F, Cornejo-Ovalle M, Arrossi S, Murillo R, Acosta Pérez E, Venegas G, Finck C. Latin America and the Caribbean Code Against Cancer 1st edition: Formative research on the comprehension and persuasiveness of the recommendations by the general population. Cancer Epidemiol 2023; 86 Suppl 1:102456. [PMID: 37852727 DOI: 10.1016/j.canep.2023.102456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/13/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Cancer prevention is the most efficient and cost-effective strategy in cancer control. One prevention strategy is giving credible, clear, and evidence-based recommendations to the individual; however, it is key that these messages are accepted and understood properly by the public. This study aimed to pilot the draft recommendations developed as part of the Latin America and the Caribbean (LAC) Code Against Cancer 1st edition, in terms of comprehension and persuasion of each message. METHODS A mixed method two-wave study, in which two versions of the messages were presented to the general population in five LAC countries. We used an ad-hoc questionnaire and interviews that followed the cognitive-pretesting methodology. RESULTS Findings suggest that the messages were generally well understood, especially in Spanish speaking countries, and that the messages were generally more understandable than persuasive. We adapted and revised the recommendations based on the findings of the first Wave and held a second iteration in the Spanish speaking countries. We observed a better understanding of most messages in Wave 2. CONCLUSION The LAC Code Against Cancer is a valuable tool of well understood messages for the public, with concrete actions everyone can take to prevent cancer. Further research should assess particularities of the region for further efficient dissemination of these important health messages, identify key messages for certain population groups and future interventions that strengthen health literacy in rural and less educated populations to increase behavior change.
Collapse
Affiliation(s)
- Mariantonia Lemos
- Escuela de Artes y Humanidades, Universidad EAFIT, Medellín, Colombia
| | - Julia Restrepo
- Escuela de Artes y Humanidades, Universidad EAFIT, Medellín, Colombia
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 CEDEX 07 Lyon, France
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 CEDEX 07 Lyon, France
| | - Catterina Ferreccio
- Facultad de Medicina, Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile. Advanced Center for Chronic Diseases (ACCDiS), Santiago, Chile
| | | | - Claudia Jurberg
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation and Carlos Chagas Filho Foundation for Research Support of Rio de Janeiro State (FAPERJ), Rio de Janeiro, Brazil
| | | | | | - Silvina Arrossi
- Centre for the Study of State and Society, National Council for Scientific and Technical Research, Buenos Aires, Argentina
| | - Raúl Murillo
- Centro Javeriano de Oncología - Hospital Universitario San Ignacio - Facultad de Medicina - Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Gino Venegas
- Clínica Angloamericana Lima-Peru - Facultad de medicina, Universidad de Piura, Lima, Peru
| | - Carolyn Finck
- Departamento de Psicología Universidad de los Andes, Bogotá, Colombia.
| |
Collapse
|
8
|
Aburto TC, Romieu I, Stern MC, Barquera S, Corvalán C, Hallal PC, Reynales-Shigematsu LM, Barnoya J, Cavalcante TM, Canelo-Aybar C, Santero M, Feliu A, Espina C, Rivera JA. Latin American and the Caribbean Code Against Cancer 1st edition: Weight, physical activity, diet, breastfeeding, and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102436. [PMID: 37852731 DOI: 10.1016/j.canep.2023.102436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 10/20/2023]
Abstract
In Latin America and the Caribbean a considerable proportion of the population have excess body weight, do not meet the recommendations of physical activity and healthy diet, and have suboptimal rates of breastfeeding. Excess body weight is associated with at least 15 cancer sites, physical activity protects against three cancers, with some evidence suggesting a protective effect for eight more cancer sites, and sedentary behavior probably increases the risk of five cancer sites. Fiber and wholegrains protect against colorectal cancer, high intake of fruits and vegetables could reduce the risk of aerodigestive cancers; processed and red meat increase the risk of colorectal cancer; and very hot beverages are associated with esophageal cancer. Moreover, sugar-sweetened beverages and ultra-processed foods are a convincing cause for excess body weight, increasing cancer risk through this pathway, with some emerging evidence suggesting also direct pathways. Breastfeeding protects against breast cancer, and could protect against ovarian cancer. Taking this evidence into account, the Latin America and the Caribbean Code Against Cancer recommends the general public to maintain a healthy body weight, be physically active and limit sedentary behavior, eat a healthy diet (eat plenty of vegetables, fruits, wholegrains and legumes; avoid sugar-sweetened beverages and processed meat; and limit ultra-processed foods, red meat and very hot beverages), and breastfeed. Moreover, the Latin America and the Caribbean Code Against Cancer also includes a set of public policy recommendations for cancer prevention to inform policy makers and civil society about the need of policies to shape healthy environments and create opportunities to facilitate the adoption of the recommendations directed to the public.
Collapse
Affiliation(s)
- Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Isabelle Romieu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Mariana C Stern
- Department of Preventive Medicine and Urology, Keck School of Medicine of USC, 90033 Los Angeles, United States
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, University of Illinois Champaign-Urbana, Illinois, United States
| | - Luz M Reynales-Shigematsu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Joaquín Barnoya
- Research Department, Integra Cancer Institute, Guatemala City, Guatemala; Department of Environmental and Occupational Health, Colorado School of Public Health, CU Anschutz, United States
| | - Tania M Cavalcante
- Instituto Nacional de Câncer José de Alencar Gomes da Silva, Secretaria Executiva da Comissão Nacional para a Implementação da Convenção-Quadro para o Controle do Tabaco, Rio de Janeiro, RJ, Brasil
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Marilina Santero
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico.
| |
Collapse
|
9
|
Baena A, Paolino M, Villarreal-Garza C, Torres G, Delgado L, Ruiz R, Canelo-Aybar C, Song Y, Feliu A, Maza M, Jeronimo J, Espina C, Almonte M. Latin America and the Caribbean Code Against Cancer 1st Edition: Medical interventions including hormone replacement therapy and cancer screening. Cancer Epidemiol 2023; 86 Suppl 1:102446. [PMID: 37852728 DOI: 10.1016/j.canep.2023.102446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/04/2023] [Accepted: 08/17/2023] [Indexed: 10/20/2023]
Abstract
Prostate, breast, colorectal, cervical, and lung cancers are the leading cause of cancer in Latin America and the Caribbean (LAC) accounting for nearly 50% of cancer cases and cancer deaths in the region. Following the IARC Code Against Cancer methodology, a group of Latin American experts evaluated the evidence on several medical interventions to reduce cancer incidence and mortality considering the cancer burden in the region. A recommendation to limit the use of HRT was issued based on the risk associated to develop breast, endometrial, and ovarian cancer and on growing concerns related to the over-the-counter and without prescription sales, which in turn bias estimations on current use in LAC. In alignment with WHO breast and cervical cancer initiatives, biennial screening by clinical breast examination (performed by trained health professionals) from the age of 40 years and biennial screening by mammography from the age of 50 years to 74, as well as cervical screening by HPV testing (either self-sampling or provider-sampling) every 5-10 years for women aged 30-64 years, were recommended. The steadily increasing rates of colorectal cancer in LAC also led to recommend colorectal screening by occult blood testing every two years or by endoscopic examination of the colorectum every 10 years for both men and women aged 50-74 years. After evaluating the evidence, the experts decided not to issue recommendations for prostate and lung cancer screening; while there was insufficient evidence on prostate cancer mortality reduction by prostate-specific antigen (PSA) testing, there was evidence of mortality reduction by low-dose computed tomography (LDCT) targeting high-risk individuals (mainly heavy and/or long-term smokers) but not individuals with average risk to whom recommendations of this Code are directed. Finally, the group of experts adapted the gathered evidence to develop a competency-based online microlearning program for building cancer prevention capacity of primary care health professionals.
Collapse
Affiliation(s)
- Armando Baena
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France.
| | - Melisa Paolino
- Centro de Estudios de Estado y Sociedad / Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Cynthia Villarreal-Garza
- Centro de Cáncer de Mama, Hospital Zambrano Hellion - TecSalud, Tecnológico de Monterrey, Monterrey, Mexico
| | - Gabriela Torres
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Lucia Delgado
- Escuela de Graduados, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Rossana Ruiz
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Yang Song
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 CEDEX 07 Lyon, France
| | - Mauricio Maza
- Department of Noncommunicable Diseases and Mental Health, Unit of Noncommunicable Diseases, Violence, and Injury Prevention, Pan American Health Organization, Washington, DC, USA
| | - Jose Jeronimo
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 CEDEX 07 Lyon, France
| | - Maribel Almonte
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| |
Collapse
|
10
|
Herrero R, Carvajal LJ, Camargo MC, Riquelme A, Porras C, Ortiz AP, Camargo LA, Fink V, van De Wyngard V, Lazcano-Ponce E, Canelo-Aybar C, Balbin-Ramon G, Feliu A, Espina C. Latin American and the Caribbean Code Against Cancer 1st edition: Infections and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102435. [PMID: 37852729 DOI: 10.1016/j.canep.2023.102435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/10/2023] [Accepted: 07/23/2023] [Indexed: 10/20/2023]
Abstract
About 13% of all cancers around the world are associated with infectious agents, particularly in low-resource settings. The main infectious agents associated with cancer are Helicobacter pylori (H. pylori), that causes gastric cancer, human papillomavirus (HPV) that causes cervical, vulvar, vaginal, penile, anal, and oropharyngeal cancer, hepatitis B and C viruses that cause liver cancer, and human immunodeficiency virus (HIV), associated with cancers of the cervix, Kaposi sarcoma (KS) and non-Hodgkin´s lymphoma. In Latin America and the Caribbean (LAC), about 150,000 cancer cases are caused annually by infections. The LAC Cancer Code Against Cancer consists of a set of 17 evidence-based and individual-level cancer prevention recommendations targeted to the general population, suited to the epidemiological, socioeconomic, and cultural conditions of the region, and tailored to the availability and accessibility of health-care systems. The recommendations with respect to infection-driven malignancies include testing and treating for H. pylori in the context of specific public health programs, vaccination against HPV and Hepatitis B Virus (HBV) and detection and treatment of chronic infections with HBV, Hepatitis C virus (HCV) and HIV, in addition to the promotion of safe sex and use of condoms to prevent sexually transmitted infections (STI). Countries, policy makers, health care systems and individuals should consider the adoption of these recommendations to help reduce the incidence and mortality of infection-related cancers in LAC, to improve quality of life of individuals and reduce the costs of cancer care in the region.
Collapse
Affiliation(s)
- Rolando Herrero
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, Costa Rica.
| | - Loretto J Carvajal
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, Costa Rica
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Arnoldo Riquelme
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Carolina Porras
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, Costa Rica
| | - Ana Patricia Ortiz
- Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | | | - Valeria Fink
- Research Department, Fundación Huésped, Pasaje Carlos Gianantonio 3932 (1202), Buenos Aires, Argentina
| | - Vanessa van De Wyngard
- Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Advanced Center for Chronic Diseases (ACCDiS), FONDAP, Santiago, Chile
| | | | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Graciela Balbin-Ramon
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| |
Collapse
|
11
|
Espina C, Feliu A, Maza M, Almonte M, Ferreccio C, Finck C, Herrero R, Dommarco JR, de Almeida LM, Arrossi S, García PJ, Garmendia ML, Mohar A, Murillo R, Santamaría J, Tortolero-Luna G, Cazap E, Gabriel OO, Paonessa D, Zoss JW, Luciani S, Carvalho A, Schüz J. Latin America and the Caribbean Code Against Cancer 1st Edition: 17 cancer prevention recommendations to the public and to policy-makers (World Code Against Cancer Framework). Cancer Epidemiol 2023; 86 Suppl 1:102402. [PMID: 37852725 DOI: 10.1016/j.canep.2023.102402] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/02/2023] [Accepted: 06/15/2023] [Indexed: 10/20/2023]
Abstract
Preventable risk factors are responsible of at least 40% of cases and almost 45% of all cancer deaths worldwide. Cancer is already the leading cause of death in almost half of the Latin American and the Caribbean countries constituting a public health problem. Cost-effective measures to reduce exposures through primary prevention and screening of certain types of cancers are critical in the fight against cancer but need to be tailored to the local needs and scenarios. The Latin America and the Caribbean (LAC) Code Against Cancer, 1st edition, consists of 17 evidence-based recommendations for the general public, based on the most recent solid evidence on lifestyle, environmental, occupational, and infectious risk factors, and medical interventions. Each recommendation is accompanied by recommendations for policymakers to guide governments establishing the infrastructure needed to enable the public adopting the recommendations. The LAC Code Against Cancer has been developed in a collaborative effort by a large number of experts from the region, under the umbrella strategy and authoritative methodology of the World Code Against Cancer Framework. The Code is a structured instrument ideal for cancer prevention and control that aims to raise awareness and educate the public, while building capacity and competencies to policymakers, health professionals, stakeholders, to contribute to reduce the burden of cancer in LAC.
Collapse
Affiliation(s)
- Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 CEDEX 07 Lyon, France.
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 CEDEX 07 Lyon, France
| | - Mauricio Maza
- Pan American Health Organization (PAHO), Cancer Prevention and Control, Washington, DC 20037, United States
| | - Maribel Almonte
- World Health Organization (WHO), Department of Sexual and Reproductive Health and Research, Geneva, Switzerland
| | - Catterina Ferreccio
- Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Advanced Center for Chronic Diseases ACCDIS, Santiago, Chile
| | - Carolyn Finck
- Departamento de Psicología, Universidad de los Andes, Bogotá, Colombia
| | - Rolando Herrero
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, Costa Rica
| | | | - Liz Maria de Almeida
- National Cancer Institute of Brazil (INCA), Prevention and Surveillance, Rio de Janeiro, Brazil
| | - Silvina Arrossi
- Centro de Estudios de Estado y Sociedad (CEDES), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | | | | | - Alejandro Mohar
- Instituto Nacional de Cancerología, Instituto de Investigaciones Biomédicas (UNAM), Tlalpan, Mexico
| | - Raúl Murillo
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | | | | | - Eduardo Cazap
- Sociedad Latinoamercia y del Caribe de Oncología Médica (SLACOM), Red de Institutos e Instituciones Nacionales de Cáncer (RINC-SLACOM), Buenos Aires, Argentina
| | - Owen O Gabriel
- Owen King EU Hospital, Department of Oncology, Saint Lucia
| | - Diego Paonessa
- Asociación Latina e Ibérica Contra el Cáncer (ALICC), Buenos Aires, Argentina
| | - J Walter Zoss
- Red de Institutos e Instituciones Nacionales de Cáncer (RINC-SLACOM), Rio de Janeiro, Brazil
| | - Silvana Luciani
- Pan American Health Organization (PAHO), Cancer Prevention and Control, Washington, DC 20037, United States
| | - Andre Carvalho
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 CEDEX 07 Lyon, France
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 CEDEX 07 Lyon, France
| |
Collapse
|
12
|
Reynales-Shigematsu LM, Barnoya J, Cavalcante T, Aburto TC, Romieu I, Stern MC, Barquera S, Corvalán C, Hallal PC, Canelo-Aybar C, Alvarado-Villacorta R, Espina C, Feliu A, Rivera JA. Latin America and the Caribbean Code Against Cancer 1st edition: Tobacco and nicotine-related products, secondhand smoke, and alcohol and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102413. [PMID: 37852726 DOI: 10.1016/j.canep.2023.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 10/20/2023]
Abstract
Tobacco, secondhand smoke (SHS), and alcohol, all carcinogens, are leading preventable cancer risk factors in Latin America and the Caribbean (LAC). Since 2000, smoking and SHS exposure have significantly decreased in the region. Yet alcohol consumption remains high. The entry of nicotine-related products such as electronic cigarettes (e-cigs) threatens achievements made in tobacco control and chronic diseases prevention, including cancer. E-cigs use is likely associated with smoking initiation among adolescents who had never smoked and dual use with combustible tobacco products. Therefore, the LAC Code Against Cancer recommends to the public actions they can take to reduce their risk of cancer: 1. Don't smoke or use any type of tobacco. If you do, quitting is possible, with professional help if needed. Don't use e-cigarettes either, as they lead to tobacco use. 2. Make your home a smoke-free place. Respect and promote laws that ensure smoke-free spaces to protect our health. and 3. Avoid drinking alcoholic beverages. This helps prevent several types of cancer. The Code recommends to policymakers a package of cost-effective policies based on the MPOWER and SAFER to prevent cancer at the population level. It also recommends that primary care health professionals: 1. Ask all their patients and their families whether they smoke or vape, inform them about the harms of smoking and vaping, and promote tobacco and nicotine related products cessation strategies among users. 2. Inform about the harms of exposure to SHS, especially among children, and promote smoke-free environments, and 3. Prevent alcohol use by their patients and their families, use tools to assess use, intensity, and frequency, and apply brief counseling intervention to support alcohol abstinence in primary care.
Collapse
Affiliation(s)
- Luz Myriam Reynales-Shigematsu
- Tobacco Control and Preventive Department. Center for Population Health Research. National Institute of Public Health. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico.
| | - Joaquin Barnoya
- Integra Cancer Institute, Guatemala, 9ª calle 4-52 zona 10, Guatemala, Guatemala
| | - Tania Cavalcante
- Instituto Nacional del Cáncer, INCA, Brasil.Pr. da Cruz Vermelha, 23 - Centro, Rio de Janeiro, RJ 20230-130, Brazil
| | - Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, CP 62100 Cuernavaca, Mexico
| | - Isabelle Romieu
- Center for Population Health Research, National Institute of Public Health, CP 62100, Cuernavaca, Mexico
| | - Mariana C Stern
- Department of Preventive Medicine and Urology, Keck School of Medicine of USC, 90033 Los Angeles, USA
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, CP 62100 Cuernavaca, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Macul, Chile
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, United States
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberossssamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Rosa Alvarado-Villacorta
- Department of Clinical Epidemiology and Public Health, Iberossssamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, CP 62100, Cuernavaca, Mexico
| |
Collapse
|
13
|
Laroussy K, Castellano Y, Fu M, Baena A, Feliu A, Peruga A, Margalef M, Aldazabal J, Tigova O, Galimany J, Puig M, Moreno C, Bueno A, López A, Roca J, Saura J, Fernández E, Martínez C. Transitions in smoking status in nursing students: A prospective longitudinal study. J Adv Nurs 2023; 79:3456-3472. [PMID: 36978253 DOI: 10.1111/jan.15665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/09/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023]
Abstract
AIM To describe transitions in smoking status and their determining factors among nursing students between baseline (2015-2016) and follow-up (2018-2019). DESIGN Observational prospective longitudinal study of 4381 nursing students in Catalonia (Spain). METHODS We examined transitions in smoking status from: (i) current smokers to recent quitters, (ii) never smokers to new smokers and (iii) former smokers to quitters who relapsed. We fitted logistic regression models to assess the predictors of quitting smoking. RESULTS The proportion of current smokers decreased from 29.7% at baseline to 23.6% at follow-up, with a cumulative incidence rate of quitting of 28.3% during follow-up. Nondaily smokers were more likely to quit than daily smokers. Of those who were never smokers at baseline, 4.6% were smokers at follow-up, and 23.2% of former smokers at baseline had relapsed at follow-up. CONCLUSIONS Nondaily smokers were more likely to have quit smoking at follow-up among this cohort of nursing students. The early implementation of a comprehensive tobacco control program that includes tobacco-free campus policies, tobacco prevention interventions and cessation support during college years may decrease tobacco use among nursing students. IMPACT Nursing students' tobacco use is concerning, as they are the future workforce of nurses who have a key role in tobacco product use prevention and cessation. During college years, nursing students have a greater likelihood of experimenting with several smoking status changes as well as to consolidate smoking behaviors. This is the first longitudinal study to highlight the factors associated with quitting smoking among a cohort of Spanish nursing students. Being a nondaily smoker at baseline predicted quitting at follow-up. Our findings support the early implementation of a comprehensive tobacco control program that includes tobacco-free campus policies, tobacco prevention interventions and tobacco cessation support during college years to decrease tobacco product use prevalence among nursing students. REPORTING METHOD We have adhered to STROBE guidelines. No Patient or Public Contribution. This observational study has not been registered.
Collapse
Affiliation(s)
- Kenza Laroussy
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of the Medicine and Health Sciences, University of Barcelona, C. Feixa llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain
| | - Yolanda Castellano
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Marcela Fu
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of the Medicine and Health Sciences, University of Barcelona, C. Feixa llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain
| | - Antoni Baena
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of e-Health, Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla de Poblenou 156, 08018, Barcelona, Spain
| | - Ariadna Feliu
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Armando Peruga
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Faculty of Medicine, Center for Epidemiology and Health Policy, Clínica Alemana, Universidad del Desarrollo, Región Metropolitana, Lo Barnechea, Chile
| | - Mercè Margalef
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - Jon Aldazabal
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - Olena Tigova
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of the Medicine and Health Sciences, University of Barcelona, C. Feixa llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain
| | - Jordi Galimany
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of the Medicine and Health Sciences, University of Barcelona, C. Feixa llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain
| | - Montserrat Puig
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of the Medicine and Health Sciences, University of Barcelona, C. Feixa llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain
| | - Carmen Moreno
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of the Medicine and Health Sciences, University of Barcelona, C. Feixa llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain
| | - Albert Bueno
- Nursing Care Management, EAP Roses, Institut Català de Salut, Crta Mas Oliva no. 23, Roses, 17480, Alt Empordà, Spain
| | - Antonio López
- Nursing Care Management, EAP Valls Urbano, c/ Vallvera no. 8, 43800, Tarragona, Spain
| | - Judith Roca
- Department of Nursing and Physiotherapy, University of Lleida, C/Montserrat Roig 2, 25198, Lleida, Spain
| | - Judith Saura
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of the Medicine and Health Sciences, University of Barcelona, C. Feixa llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain
| | - Esteve Fernández
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of Clincial Science, School of the Medicine and Health Sciences, University of Barcelona, C. Feixa llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain
| | - Cristina Martínez
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of the Medicine and Health Sciences, University of Barcelona, C. Feixa llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain
| |
Collapse
|
14
|
Sreeramareddy CT, Fernandez E, Feliu A. Hardening determinants among adult daily smokers in nine African countries: Data from the Global Adult Tobacco Survey. Prev Med Rep 2023; 34:102226. [PMID: 37228834 PMCID: PMC10203766 DOI: 10.1016/j.pmedr.2023.102226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/27/2023] Open
Abstract
Little has been reported about hardening nor softening indicators in Africa where smoking prevalence is low. We aimed to examine the determinants of hardening in nine African countries. We conducted two separate analyses using data from the most recent Global Adult Tobacco Survey in Botswana, Cameroon, Egypt, Ethiopia, Kenya, Nigeria, Senegal, Tanzania, and Uganda (total sample of 72,813 respondents): 1) multilevel logistic regression analysis to assess individual and country-level factors associated with hardcore, high dependence, and light smoking.; 2) a Spearman-rank correlation analysis to describe the association between daily smoking and hardcore, high dependence, and light smoking at an ecological level. Age-standardized daily smoking prevalence varied from 37.3% (95 %CI: 34.4, 40.3) (Egypt) to 6.1% (95 %CI: 3.5, 6.3) (Nigeria) among men; and 2.3% (95 %CI: 0.7, 3.9) (Botswana) to 0.3% (95 %CI: 0.2, 0.7) (Senegal) among women. The proportion of hardcore and high-dependence smokers was higher among men whereas for light smokers the proportion was higher among women. At the individual level, higher age and lower education groups had higher odds of being hardcore smokers and having high dependence. Smoke-free home policies showed decreased odds of both being hardcore and highly dependent smokers daily smoking correlated weakly and negatively with hardcore smoking (r = -0.243, 95 %CI: -0.781, 0.502) among men and negatively with high dependence (r = -0.546, 95 %CI: -0.888, 0.185) and positively with light smokers (r = 0.252, 95 %CI: -0.495, 0.785) among women. Hardening determinants varied between the countries in the African region. Wide sex differentials and social inequalities in heavy smoking do exist and should be tackled.
Collapse
Affiliation(s)
| | - Esteve Fernandez
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d’Oncologia-ICO, L’Hospitalet de Llobregat (Barcelona), Spain
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat (Barcelona), Spain
- CIBER en Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, Campus de Bellvitge,Universitat de Barcelona, L'Hospitalet del Llobregat (Barcelona), Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d’Oncologia-ICO, L’Hospitalet de Llobregat (Barcelona), Spain
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat (Barcelona), Spain
- CIBER en Enfermedades Respiratorias (CIBERES), Madrid, Spain
| |
Collapse
|
15
|
Fu M, Castellano Y, Laroussy K, Baena A, Margalef M, Feliu A, Galimany-Masclans J, Puig-Llobet M, Moreno-Arroyo C, Sancho R, Bueno A, López A, Guydish J, Fernández E, Martínez C. Passive exposure and perceptions of smoke-free policies in hospital and university campuses among nursing students: A cross-sectional multicenter study. Tob Induc Dis 2023; 21:93. [PMID: 37465255 PMCID: PMC10350793 DOI: 10.18332/tid/167390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/29/2023] [Accepted: 06/02/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION Outdoor smoke-free regulations reduce exposure to secondhand smoke (SHS) and help to denormalize tobacco use. As future key agents in health promotion, nursing students' attitudes should agree with tobacco-control policies. The objectives of this study were: 1) assess nursing students' exposure to SHS in nursing schools, 2) explore their perceptions of compliance with the existing smoke-free regulations in acute-care hospitals; and 3) describe their support for indoor and outdoor smoking bans on hospital and university campuses. METHODS This was a cross-sectional multicenter study conducted in 2015-2016 in all 15 university nursing schools in Catalonia, Spain. A questionnaire gathered information on SHS exposure, awareness of the smoke-free regulation in acutecare hospitals, and support for smoke-free policies in indoor and outdoor areas of hospitals and university campuses. Participants were nursing students attending classes on the day of the survey. We performed descriptive analyses and calculated adjusted prevalence ratios (APR) and 95% confidence interval (CI). RESULTS Of 4381 respondents, 99.1% had seen people smoking in outdoor areas of their university campus, and 75.2% had been exposed to SHS on the campus (6.0% indoors and 69.2% outdoors). Nearly 60% were aware of the smoking regulation in place in acute-care hospitals. There was widespread support for smoke-free indoor hospital regulation (98.7%), but less support (64.8%) for outdoor regulations. Approximately 33% supported the regulation to make outdoor healthcare campuses smoke-free, which was higher among third-year students compared to first-year students (APR=1.41; 95% CI: 1.24-1.62), among never smokers (41.4%; APR=2.84; 95% CI: 2.21-3.64) compared to smokers, and among those who were aware of the regulation (38.4%; 95% CI: 1.37-1.75). CONCLUSIONS Exposure to SHS on university campuses is high. Nursing students express low support for strengthening outdoor smoking bans on hospital and university campuses. Interventions aiming to increase their support should be implemented.
Collapse
Affiliation(s)
- Marcela Fu
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
- Department of Public Health, Mental Health, and Maternal and Child Health Nursing, School of Nursing, Universitat de Barcelona, Barcelona, Spain
- Center for Biomedical Research in Respiratory, Madrid, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
- Center for Biomedical Research in Respiratory, Madrid, Spain
- Department of Odonto-Stomatology, School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Kenza Laroussy
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
- Department of Public Health, Mental Health, and Maternal and Child Health Nursing, School of Nursing, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Baena
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
- eHealth Center, School of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Mercè Margalef
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
- Center for Biomedical Research in Respiratory, Madrid, Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
- Center for Biomedical Research in Respiratory, Madrid, Spain
| | - Jordi Galimany-Masclans
- Department of Public Health, Mental Health, and Maternal and Child Health Nursing, School of Nursing, Universitat de Barcelona, Barcelona, Spain
| | - Montse Puig-Llobet
- Department of Public Health, Mental Health, and Maternal and Child Health Nursing, School of Nursing, Universitat de Barcelona, Barcelona, Spain
| | - Carmen Moreno-Arroyo
- Department of Fundamental and Medical-Surgical Nursing, School of Nursing, Universitat de Barcelona, Barcelona, Spain
- Nursing Research Group, Digestive System, Diagnostics, Pharmacogenetics, Care Support and Clinical Prevention Program, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
| | - Raül Sancho
- Department of Public Health, Mental Health, and Maternal and Child Health Nursing, School of Nursing, Universitat de Barcelona, Barcelona, Spain
- Nursing Research Group, Digestive System, Diagnostics, Pharmacogenetics, Care Support and Clinical Prevention Program, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
| | - Albert Bueno
- Nursing Care Management, Equip d'Atenció Primària Roses, Institut Català de la Salut, Girona, Spain
| | - Antonio López
- Nursing Care Management, Equip d'Atenció Primària Valls Urbà, Institut Català de la Salut, Tarragona, Spain
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, United States
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
- Center for Biomedical Research in Respiratory, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, Universitat de Barcelona, l'Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
- Department of Public Health, Mental Health, and Maternal and Child Health Nursing, School of Nursing, Universitat de Barcelona, Barcelona, Spain
- Center for Biomedical Research in Respiratory, Madrid, Spain
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, United States
| |
Collapse
|
16
|
Feliu A, Quintero A, Peruga A, Carnicer-Pont D, Antón L, Rey-Pino JM, Fernández E. Changes in tobacco imagery and smokers' depiction in Spanish top-grossing films before and after the implementation of a comprehensive tobacco control policy in Spain. Tob Induc Dis 2023; 21:66. [PMID: 37215193 PMCID: PMC10198122 DOI: 10.18332/tid/162700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 05/24/2023] Open
Abstract
INTRODUCTION As more restrictions on tobacco marketing communication are implemented, tobacco marketing has persisted through smoking in films. Our aims were to assess changes in tobacco imagery exposure in Spanish top-grossing films before and after the banning of tobacco advertising in Spain, and to determine whether the depiction of smoking characters has changed over the years. METHODS A repeated cross-sectional study measured the tobacco content in the 10 Spanish top-grossing films in 2005, 2010 and 2015 (n=30) before and after a complete tobacco advertising ban. We conducted a descriptive and regression analysis of changes in tobacco impressions by year. RESULTS The 30 films contained 1378 tobacco occurrences (90.2% positive for tobacco) with a median length of eight seconds onscreen. Total tobacco occurrences deemed positive for tobacco interests significantly increased in 2010 and 2015 compared to 2005. However, we observed decreased odds of tobacco brands appearances (OR=0.25; p<0.001) in 2010 and of implied tobacco use (OR=0.44; p=0.002), and tobacco brands appearances (OR=0.36; p<0.001) in 2015 compared to 2005. There was a change of pattern in the type of role smokers played from a leading role to a supporting one (p<0.001). The population reach of positive for tobacco occurrence in Spanish top-grossing films decreased from 15.9 (95% CI: 15.86-15.86) per 1000 spectators in 2005 to 0.8 (95% CI: 0.82-0.82) in 2015. CONCLUSIONS The implementation of a ban on complete tobacco product advertising was followed by a decrease in tobacco incidents across top-grossing Spanish films. Yet, exposure to smoking in films is still unacceptably high.
Collapse
Affiliation(s)
- Ariadna Feliu
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, Espana
| | - Alex Quintero
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
| | - Armando Peruga
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, Espana
- Centro de Epidemiologia y Politicas de Salud, Facultad de Medicina Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Dolors Carnicer-Pont
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, Espana
| | - Laura Antón
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, Espana
| | - Juan M. Rey-Pino
- Departamento de Comercializacion e Investigacion de Mercados, Facultad de Ciencias Economicas y Empresariales, Universidad de Granada, Granada, Espana
| | - Esteve Fernández
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, Espana
- Departamento de Ciencias Clinicas, Facultad de Medicina, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Espana
| |
Collapse
|
17
|
Pueyo-Garrigues M, Agüera Z, Andrés A, Lluch-Canut MT, Tricas-Sauras S, Duaso MJ, Feliu A, Pardavila-Belio MI, Antón L, Cornejo-Ovalle M, Puig-Llobet M, Moreno-Arroyo C, Barroso T, Roca J, Martínez C. Knowledge, attitudes, behavioral and organizational factors of health professions students for a competent smoking cessation practice: An instrument adaptation and psychometric validation study in Spanish and English samples. Nurse Educ Pract 2023; 70:103647. [PMID: 37121026 DOI: 10.1016/j.nepr.2023.103647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/12/2023] [Accepted: 04/16/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND To improve smoking cessation, training of health professions students is essential. However, no specific instrument is available to assess factors that may affect students' learning about smoking cessation practice. AIM To adapt and validate the Knowledge, Attitudes, Behaviors and Organization questionnaire in the population of undergraduate health professions students. DESIGN Methodological research. METHODS The researchers conducted this study with 511 Spanish and 186 English health professions students from four different universities. We used a four-step approach: 1) adaptation of the items to the target population and validation of the content by a panel of experts; 2) a pilot study to test face validity; 3) linguistic adaptation of the Spanish version to English; and 4) the psychometric assessment based on construct validity, criterion validity and internal consistency. RESULTS Exploratory factor analysis revealed four subscales for the Spanish version, namely 'Individual knowledge and skills', 'Individual attitudes and beliefs', 'Organizational support' and 'Organizational resources', which accounted for 85.1% of the variance. Confirmatory factor analysis in the holdout Spanish and English samples revealed adequate goodness-of-fit values, supporting the factor structure. Hypotheses testing demonstrated significant differences by capacitation in smoking cessation interventions and degree courses, providing further evidence regarding construct validity. All the subscales correlated positively with the criterion variables (5 A's smoking cessation model), except for the 'Organizational resources' subscale, which was not significantly correlated with the 5 A's. The overall Cronbach's alpha was.83 for the Spanish version and.88 for the English one. CONCLUSIONS Our results provide empirical support for the use of the Knowledge, Attitudes, Behaviors and Organization questionnaire for Students as a reliable and valid instrument to assess knowledge, attitudes, behaviors and organization perceptions in health professions students, which is essential for competent smoking cessation practice. Interestingly, 'Organizational resources' subscale presented the lowest correlations among factors and did not correlate with any component of the 5 A's, suggesting the need of enhancing students' responsibility and involvement during their internships, as well as the interest of some organizations.
Collapse
Affiliation(s)
- María Pueyo-Garrigues
- University of Navarra, School of Nursing, Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Spain
| | - Zaida Agüera
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), 08907 Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28015 Madrid, Spain.
| | - Ana Andrés
- Faculty of Psychology, Education and Sport Sciences, Ramon Llull University, Blanquerna, 08022 Barcelona, Spain
| | - Maria Teresa Lluch-Canut
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), 08907 Barcelona, Spain
| | - Sandra Tricas-Sauras
- Centre for Research in Social Approaches to Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium; Erasmus Hogeschool Brussel, Departement Gezondheidszorg, Belgium
| | - Maria José Duaso
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, SE1 8WA London, United Kingdom
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Miren Idoia Pardavila-Belio
- University of Navarra, School of Nursing, Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Spain
| | - Laura Antón
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Center for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Marco Cornejo-Ovalle
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Montserrat Puig-Llobet
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), 08907 Barcelona, Spain
| | - Carmen Moreno-Arroyo
- Departament d'Infermeria Fonamental i Médico-Quirúrgica, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), 08907 Barcelona, Spain
| | - Tereza Barroso
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Portugal
| | - Judith Roca
- Department of Nursing and Physiotherapy. Faculty of Nursing and Physiotherapy, University of Lleida, Spain; Health Care Research Group (GRECS), Biomedical Research Institute of Lleida, Spain
| | - Cristina Martínez
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), 08907 Barcelona, Spain; Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Center for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois St., 7th floor, San Francisco, CA 94158, United States.
| |
Collapse
|
18
|
Fu M, Castellano Y, Feliu A, Saura J, Estrada J, Galimany-Masclans J, Moreno C, Fernández E, Martínez C. Compliance with the smoke-free policy in hospitals in Spain: the patients' perspective. Eur J Cancer Prev 2023; 32:81-88. [PMID: 35671260 DOI: 10.1097/cej.0000000000000757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To explore compliance with the smoke-free policy in hospitals in Catalonia, Spain, by exploring inpatients' perceptions. METHODS We conducted a cross-sectional study of a random sample of 1047 inpatients from 13 public hospitals. We collected data about: (a) type of information about the smoke-free policy provided by the hospital, (b) patients' knowledge about the policy, (c) general appreciation of the compliance with the policy, and (d) specific appreciation of such compliance by noticing any sign of tobacco consumption. We described the data by several patients' and hospitals' characteristics and assessed their association with the perceived noncompliance using prevalence ratios (PR) and their 95% confidence intervals (CIs). RESULTS Few patients were informed about the smoke-free policy (4.8% orally, 6.1% in writing, and 55.6% through sign postings). About 64% were aware of the regulation and 73.5% believed that it was properly obeyed. While 0.7% had never or rarely observed smoking indoors, 36.2% had seen someone smoking outdoors sometimes or many times. Signs of tobacco consumption were observed indoors and outdoors. Factors associated with the perception of noncompliance were: being less than 45 years old versus being more than 64 years old (adjusted PR, 2.33; 95% CI, 1.09-4.98) and currently smoking versus have never smoked (adjusted PR, 1.84; 95% CI, 1.02-3.34). CONCLUSION Compliance with the smoke-free policy in hospitals according to the patients' view is notable, although several infringements were reported, mainly outdoors. The smoke-free policy in hospitals should be reinforced by prompting continuous awareness campaigns and the exemplary role of hospital workers.
Collapse
Affiliation(s)
- Marcela Fu
- Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Programme, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat
- Faculty of Medicine and Health Sciences - Bellvitge Campus, Universitat de Barcelona, Barcelona
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid
| | - Yolanda Castellano
- Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Programme, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid
| | - Ariadna Feliu
- Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Programme, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid
| | - Judith Saura
- Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Programme, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid
| | - Joan Estrada
- Faculty of Medicine and Health Sciences - Bellvitge Campus, Universitat de Barcelona, Barcelona
| | - Jordi Galimany-Masclans
- Faculty of Medicine and Health Sciences - Bellvitge Campus, Universitat de Barcelona, Barcelona
| | - Carmen Moreno
- Faculty of Medicine and Health Sciences - Bellvitge Campus, Universitat de Barcelona, Barcelona
- Nursing Research Group, Digestive System, Diagnostics, Pharmacogenetics, Care Support and Clinical Prevention Programme, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Programme, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat
- Faculty of Medicine and Health Sciences - Bellvitge Campus, Universitat de Barcelona, Barcelona
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid
| | - Cristina Martínez
- Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control
- Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Programme, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat
- Faculty of Medicine and Health Sciences - Bellvitge Campus, Universitat de Barcelona, Barcelona
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
19
|
Feliu A, Martinez C, Peruga A, Joossens L, Bianco E, Cornejo M, Nogueira SO, Fernández E. Tool to monitor tobacco control policy implementation: the Tobacco Control Scale in Latin America. Adaptation process and pilot study. Tob Control 2022; 31:642-648. [PMID: 34031228 DOI: 10.1136/tobaccocontrol-2020-056395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Monitoring tobacco control policy implementation is one of the keys for tobacco consumption reduction in Latin America (LA). This study reports on the adaptation of the Tobacco Control Scale (TCS) for use in LA countries and the level of tobacco control policy implementation in this region according to the scale. METHODS Ecological cross-sectional survey. The questionnaire to measure tobacco control policies was a translated (into Spanish and Portuguese) and adapted version of the last TCS as used in Europe. The resulting TCS-LA maintains the same structure as the original TCS, with eight policy domains and 100 points (pts) as maximum score; however, four policy domains were adapted because the exact same rationale could not be applied. At least two non-governmental tobacco control experts were contacted per country to answer the TCS-LA. RESULTS Informants from 17 out of 18 countries completed the questionnaire. Using the TCS-LA, Panama (70 pts), Uruguay (68 pts) and Ecuador (61 pts) exhibited the strongest tobacco control policies, while Guatemala (32 pts), Bolivia (30 pts) and Dominican Republic (29 pts) have implemented a lower number of tobacco control policies. Eight countries reached 50% of the TCS-LA total possible score, indicating a relatively good implementation level of tobacco control policies. CONCLUSIONS Panama, Uruguay and Ecuador are the tobacco control policy leaders in LA; however, tobacco control in the region has room for improvement since nine countries have a total score under 50 pts. The TCS is a feasible and adaptable tool to monitor tobacco control in other WHO regions beyond Europe.
Collapse
Affiliation(s)
- Ariadna Feliu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Catalonia, Spain
- Tobacco Control Research Group, Institut d'Investigacio Biomedica de Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
- School of Medicine and Health Sciences, Campus Bellvitge, Universitat de Barcelona, Hospitalet de Llobregat, Catalonia, Spain
- Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Cristina Martinez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Catalonia, Spain
- Tobacco Control Research Group, Institut d'Investigacio Biomedica de Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
- School of Medicine and Health Sciences, Campus Bellvitge, Universitat de Barcelona, Hospitalet de Llobregat, Catalonia, Spain
- Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA 94118, USA
| | - Armando Peruga
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Catalonia, Spain
- Tobacco Control Research Group, Institut d'Investigacio Biomedica de Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
- Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
- Center for Epidemiology and Health Policies, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Las Condes, Región Metropolitana de Santiago, Chile
| | | | - Eduardo Bianco
- Regional Coordinator for the Americas, Framework Convention Alliance (FCA), Montevideo, Uruguay
| | - Marco Cornejo
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Catalonia, Spain
- Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Sarah O Nogueira
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Catalonia, Spain
- Tobacco Control Research Group, Institut d'Investigacio Biomedica de Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
- School of Medicine and Health Sciences, Campus Bellvitge, Universitat de Barcelona, Hospitalet de Llobregat, Catalonia, Spain
- Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Esteve Fernández
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Catalonia, Spain
- Tobacco Control Research Group, Institut d'Investigacio Biomedica de Bellvitge, L'Hospitalet de Llobregat, Catalonia, Spain
- School of Medicine and Health Sciences, Campus Bellvitge, Universitat de Barcelona, Hospitalet de Llobregat, Catalonia, Spain
- Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| |
Collapse
|
20
|
Alcazar M, Escribano J, Ferré N, Closa-Monasterolo R, Selma-Royo M, Feliu A, Castillejo G, Luque V, Closa-Monasterolo R, Escribano J, Luque V, Feliu-Rovira A, Ferré N, Muñoz-Hernando J, Gutiérrez-Marín D, Zaragoza-Jordana M, Gispert-Llauradó M, Rubio-Torrents M, Núñez-Roig M, Alcázar M, Sentís S, Esteve M, Monné-Gelonch R, Basora J, Flores G, Hsu P, Rey-Reñones C, Alegret C, Guillen N, Alegret-Basora C, Ferre R, Arasa F, Alejos A, Diéguez M, Serrano M, Mallafré M, González-Hidalgo R, Braviz L, Resa A, Palacios M, Sabaté A, Simón L, Losilla A, De La Torre S, Rosell L, Adell N, Pérez C, Tudela-Valls C, Caro-Garduño R, Salvadó O, Pedraza A, Conchillo J, Morillo S, Garcia S, Mur E, Paixà S, Tolós S, Martín R, Aguado F, Cabedo J, Quezada L, Domingo M, Ortega M, Garcia R, Romero O, Pérez M, Fernández M, Villalobos M, Ricomà G, Capell E, Bosch M, Donado A, Sanchis F, Boix A, Goñi X, Castilla E, Pinedo M, Supersaxco L, Ferré M, Contreras J, Sanz-Manrique N, Lara A, Rodríguez M, Pineda T, Segura S, Vidal S, Salvat M, Mimbrero G, Albareda A, Guardia J, Gil S, Lopez M, Ruiz-Escusol S, Gallardo S, Machado P, Bocanegra R, Espejo T, Vendrell M, Solé C, Urbano R, Vázquez M, Fernández-Antuña L, Barrio M, Baudoin A, González N, Olivé R, Lara R, Dinu C, Vidal C, González S, Ruiz-Morcillo E, Ainsa M, Vilalta P, Aranda B, Boada A, Balcells E. Gut microbiota is associated with metabolic health in children with obesity. Clin Nutr 2022; 41:1680-1688. [DOI: 10.1016/j.clnu.2022.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/16/2022] [Accepted: 06/04/2022] [Indexed: 11/03/2022]
|
21
|
Laroussy K, Castellano Y, Fu M, Baena A, Feliu A, Margalef M, Aldazabal J, Tigova O, Galimany J, Puig M, Moreno C, Bueno A, López A, Roca J, Fernández E, Martínez C. Determinants of participation in an online follow-up survey among nursing students. J Prof Nurs 2022; 41:108-114. [DOI: 10.1016/j.profnurs.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 11/29/2022]
|
22
|
Trujillo I, Feliu A, Palahi M, Martin A, Moret R, Cotán D, Sandalinas M. O-145 Limitations of designing carrier screening panels based on estimated frequencies. Concordance between recommendations and observed frequencies. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Are recommended carrier screening (CS) panels suitable worldwide or should they be designed taking into account observed carrier frequencies (CF)?
Summary answer
Limitations of carrier screening panel recommendations based on estimated frequencies could be avoided with a worldwide-database of observed carrier frequencies.
What is known already
Currently, there is no consensus for specific gene panel for CS, but some scientific societies, based on estimated carrier frequencies, recommend to analyze a narrow panel rather than exome. The American College of Medical Genetics and Genomics (ACMG) recently recommended a 4-tiered system, encouraging to analyze genes in tier 3, genes with less carrier frequency (tier 4) are only recommended to be analyzed on specific cases. Similarly, Sociedad Española de Fertilidad (SEF) recommends in absence of genetic matching (GM) a 6 gene basic panel for donor screening and in a GM context suggests a 50-diseases panel.
Study design, size, duration
This study includes 8542 patients analyzed with an expanded carrier screening panel of 300 genes, including autosomal recessive (AR) and X-linked (XL) disorders by next-generation sequencing (NGS). ACMG guidelines were followed for variant interpretation and only pathogenic and likely pathogenic variants were reported. The study has been conducted between August 2018 and December 2021.
Participants/materials, setting, methods
DNA was extracted and sequenced. Obtained data was processed by bioinformatic tools. CF for diseases analyzed was stablished. Genes were categorized according to tier-3 of the ACMG recommendations (112 genes, only 80 included on this study) and also by 50-disease panel of SEF recommendations (49 genes, 40 included on this study). Likewise, analyzed diseases were divided in two groups according to the obtained CF: A (CF ≤ 1/200 - 56 genes); B (CF > 1/200 - 244 genes).
Main results and the role of chance
The analysis of the 8542 patients showed that 2582 (30.23%) of them were not carriers of any disease analyzed, 2205 (25.81%) of them were only carriers of one or more of the diseases included in the ACMG tier3 panel and 3755 (43.96%) were carriers of at least one disease not included this category.
When diseases analyzed were categorized by SEF 50-disease panel, 2280 (26.69%) patients were only carriers of one or more of the diseases included in this panel and 3680 (43.08%) were carriers of at least one disease that would not be analyzed by this panel.
On the other hand, when diseases were divided by observed carrier frequency, a total of 3476 patients (40.69%) were carriers only of a disease(s) included in A group. With this panel, only 2484 (29.08%) of the 8542 patients would not have been correctly diagnosed. Moreover, the variants undetected would affect less frequent diseases (B group).
It is important to notice that group A has been created regarding the data of a 300 gene panel. If another panel would have been analyzed, the group of genes may have changed, but the data collected highlights the importance of observed CF on panel design.
Limitations, reasons for caution
Not all Tier3 ACMG and 50-disease SEF genes are included due to original panel limitations. Observed CF may vary depending on the population analyzed. NGS panel design does not cover variants in regulatory or deep intronic regions. Pseudogenes can interfere. Not all structural variants can be detected by NGS.
Wider implications of the findings
These data highlight the importance of reviewing the genes included in carrier screening panels by their frequency. Furthermore, it points out the need to have updated databases with observed CF available so an universal panel can be designed or adapted to patient’s needs.
Trial registration number
Not applicable
Collapse
Affiliation(s)
- I Trujillo
- FullGenomics S.L., NGS Laboratory , Barcelona, Spain
| | - A Feliu
- FullGenomics S.L., NGS Laboratory , Barcelona, Spain
| | - M Palahi
- FullGenomics S.L., NGS Laboratory , Barcelona, Spain
| | - A Martin
- FullGenomics S.L., NGS Laboratory , Barcelona, Spain
| | - R Moret
- FullGenomics S.L., NGS Laboratory , Barcelona, Spain
| | - D Cotán
- FullGenomics S.L., NGS Laboratory , Barcelona, Spain
| | - M Sandalinas
- FullGenomics S.L., NGS Laboratory , Barcelona, Spain
| |
Collapse
|
23
|
Martínez C, Feliu A, Torres N, Nieva G, Pinet C, Raich A, Mondon S, Barrio P, Andreu M, Hernández-Ribas R, Vicens J, Costa S, Suelves JM, Vilaplana J, Enríquez M, Alaustre L, Vilalta E, Subirà S, Bruguera E, Castellano Y, Saura J, Guydish J, Fernández E, Ballbè M. Acceptability and participation predictors for a pragmatic randomized controlled trial to test a smoking cessation intervention after discharge from mental health wards. Drug Alcohol Depend 2022; 234:109390. [PMID: 35278807 DOI: 10.1016/j.drugalcdep.2022.109390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 02/25/2022] [Accepted: 02/27/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIM Hospitalization is an ideal time to promote smoking cessation, but interventions are limited for supporting cessation maintenance after discharge. This study aimed to evaluate the acceptability of participating in a trial that tested the efficacy of an intensive telephone-based intervention for smokers after discharge. METHODS Adult smokers admitted to mental health wards of six hospitals were invited to participate in the trial. We studied the study acceptance/decline rates by analyzing the characteristics of participants (e.g., sex, age, psychiatric disorder, smoking pattern) and hospitals (e.g., size, tobacco control implementation). We calculated adjusted odds ratios (aOR) to assess predictors of non-participation. RESULTS Of 530 smokers that met the study inclusion criteria, 55.5% (n = 294) agreed to participate. Participant and non-participants were not different in sex, age, or psychiatric diagnosis. Compared to non-participants, participants had made more attempts to quit in the past year (66.1% vs 33.9%; p < 0.001) and reported higher abstinence rates during the hospital stay (66.7% vs. 33.3%; p = 0.05). Participation rates by hospital varied from 30.9% to 82.0% (p < 0.001). Predictors of non-participation were not having attempted to quit in the last year (aOR=2.42; 95%CI: 1.66-3.53) and low level of tobacco control in the hospital (aOR range: 1.79-6.39, p < 0.05). CONCLUSIONS A telephone-based intervention to promote smoking cessation after discharge was accepted by half of the smokers with mental health disorders. Smokers that had attempted to quit previously and those that stayed in hospitals with a strong tobacco control policy were more likely to participate in the trial.
Collapse
Affiliation(s)
- Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Public Health, Maternal Health and Mental Health, School of Medicine and Health Sciences, Universitat de Barcelona, C. Feixa Llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois St., 7th floor, San Francisco, CA 94158, United States; Center for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Public Health, Maternal Health and Mental Health, School of Medicine and Health Sciences, Universitat de Barcelona, C. Feixa Llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain; Center for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Núria Torres
- 061 CatSalut Respon, Sistema d'Emergències Mèdiques, C. Pablo Iglesias 115, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Gemma Nieva
- Smoking Cessation Unit, Addictive Behaviors Unit, Psychiatry Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institute of Research, CIBERSAM, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Cristina Pinet
- Addictive Behaviors Unit, Psychiatry Department, Hospital de la Santa Creu i Sant Pau, C. San Antoni Mª Claret 167, 08025 Barcelona, Spain
| | - Antònia Raich
- Mental Health Department, Althaia Xarxa Assistencial Universitària, C. Dr. Llatjós s/n, 08243 Manresa, Barcelona, Spain
| | - Sílvia Mondon
- Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona, C. Villarroel 170, 08036 Barcelona, Spain
| | - Pablo Barrio
- Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona, C. Villarroel 170, 08036 Barcelona, Spain
| | - Magalí Andreu
- Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona, C. Villarroel 170, 08036 Barcelona, Spain
| | - Rosa Hernández-Ribas
- Alcohol Program, Psychiatry Department, Hospital Universitari de Bellvitge, Institut Català d'Oncologia, IDIBELL, CIBERSAM, Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jordi Vicens
- Psychiatry Department, Hestia Duran i Reynals, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sílvia Costa
- Addictive Behaviors Unit, Psychiatry Department, Hospital de la Santa Creu i Sant Pau, C. San Antoni Mª Claret 167, 08025 Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau, C. San Antoni Mª Claret 167, 08025 Barcelona, Spain
| | - Josep Maria Suelves
- Public Health Agency of Catalonia, Health Department, Government of Catalonia, C. Roc Boronat 81-95, 08005 Barcelona, Spain; Universitat Oberta de Catalunya, Rambla del Poblenou, 156, 08018 Barcelona, Spain
| | - Jordi Vilaplana
- Serra Húnter Fellow / Computer Science Department, University of Lleida, Jaume II, 69, 25001 Lleida, Spain
| | - Marta Enríquez
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Alaustre
- 061 CatSalut Respon, Sistema d'Emergències Mèdiques, C. Pablo Iglesias 115, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Eva Vilalta
- 061 CatSalut Respon, Sistema d'Emergències Mèdiques, C. Pablo Iglesias 115, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Susana Subirà
- Psychiatry Department, Hestia Duran i Reynals, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Eugeni Bruguera
- Smoking Cessation Unit, Addictive Behaviors Unit, Psychiatry Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institute of Research, CIBERSAM, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Judith Saura
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, C. Feixa Llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois St., 7th floor, San Francisco, CA 94158, United States
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Center for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain; Department of Clinical Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, C. Feixa Llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain.
| | - Montse Ballbè
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Gran Via de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Center for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain; Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona, C. Villarroel 170, 08036 Barcelona, Spain.
| |
Collapse
|
24
|
Feliu A, Martínez C, Fernández E. [Lights and shadows for public health: A critical analysis of the tobacco legislation in Spain]. Gac Sanit 2022; 36:48-52. [PMID: 34419288 DOI: 10.1016/j.gaceta.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/04/2022]
Abstract
Tobacco smoking is a chronic disease that is the leading preventable cause of death in developed countries. In Spain, the prevalence of tobacco use has decreased driven by the implementation of tobacco control policies; however, current legislation does not establish a harmonized regulation for all tobacco products. The aim of this article is to review the current legislation and critically analyze its limitations in relation to the principles of good administration now defined in the Law 39/2015. Spanish in force tobacco control policies main limitations can be divided into four areas: the lack of specific regulation for new tobacco products; the differences in their regulation; the lack of information to the general population on their harmful effects and the new developments in the regulation of smoke-free spaces; and the lack of adaptation of the regulation to the most recent scientific evidence. All in all, the quality of tobacco control regulations in Spain, despite the successes achieved with the Law 28/2005, has been compromised by the State's laxity in the legislative, regulatory, and administrative spheres, which has led to a regulatory stagnation that runs counter to the principles of good regulation. This review should encourage scientific organizations and civil society associations to call for an actualization of the tobacco legislation, with determined and coordinated prevention and control policies to promote a tobacco-free Spain.
Collapse
Affiliation(s)
- Ariadna Feliu
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, España; Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España; Facultad de Medicina y Ciencias de la Salud, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), España; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, United States of America.
| | - Cristina Martínez
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, España; Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España; Facultad de Medicina y Ciencias de la Salud, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), España; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, United States of America
| | - Esteve Fernández
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, España; Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España; Facultad de Medicina y Ciencias de la Salud, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), España
| |
Collapse
|
25
|
Feliu A, Fernández E, Castellano Y, Enríquez M, Saura J, Cabezas C, Colom J, Suelves JM, Pla M, Parejo M, Mondon S, Barrio P, Andreu M, Raich A, Bernabeu J, Vilaplana J, Roca X, Bautista P, Guydish J, Martínez C. Tobacco cessation among smokers under substance use treatment for alcohol and/or cannabis: study protocol and pilot study. Addict Sci Clin Pract 2022; 17:66. [PMID: 36451226 PMCID: PMC9709380 DOI: 10.1186/s13722-022-00348-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 11/11/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Approximately 80% of people with a substance use disorder (SUD) are smokers. Starting SUD treatment offers the opportunity to also quit smoking. The ACT-ATAC project aims to identify the predictors associated with smoking cessation among persons treated for alcohol and/or cannabis use disorder in Barcelona. This manuscript reports its methodology and the experience of carrying it out during the COVID-19 pandemic. METHODS Mixed methods project with three substudies. Substudy 1 (S1) comprises heterogeneous discussion groups among clinicians. S2 has two prospective cohorts composed of smokers under treatment for alcohol and/or cannabis use disorder and the clinicians in charge of these patients. Participating smokers will be followed for 12 months and interviewed about their substance use and the tobacco cessation services received using the Spanish version of the users' Knowledge, Attitudes, and Services (S-KAS) scale. The clinicians will be asked about their self-reported practices in smoking cessation using the Knowledge, Attitudes, and Practices (S-KAP) scale. S3 comprises heterogeneous discussion groups with smokers. Data will be triangulated using qualitative and quantitative analyses. To facilitate the recruitment process, the researchers have introduced several strategies (design clear protocols, set monthly online meetings, extend the project, provide gift cards, etc.). DISCUSSION The results of S1 were used to develop the questionnaires. S2 required some adjustments due to the COVID-19 pandemic, particularly the follow-up interviews being conducted by phone instead of face-to-face, and the recruitment rhythm was lower than expected. Recruitment will last until reaching at least 200-250 users. The fieldwork could not have been possible without the collaboration of the ACT-ATAC team and the introduction of several strategies. Trial registration The ACT-ATAC project has been successfully registered at Clinicaltrials.gov [NCT04841655].
Collapse
Affiliation(s)
- Ariadna Feliu
- grid.418701.b0000 0001 2097 8389Tobacco Control Unit, Cancer Control and Prevention Program, WHO Collaborating Center On Tobacco Control, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain ,Cancer Control and Prevention Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.512891.6CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Esteve Fernández
- grid.418701.b0000 0001 2097 8389Tobacco Control Unit, Cancer Control and Prevention Program, WHO Collaborating Center On Tobacco Control, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain ,Cancer Control and Prevention Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.512891.6CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences. School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Yolanda Castellano
- grid.418701.b0000 0001 2097 8389Tobacco Control Unit, Cancer Control and Prevention Program, WHO Collaborating Center On Tobacco Control, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain ,Cancer Control and Prevention Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.512891.6CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Marta Enríquez
- grid.418701.b0000 0001 2097 8389Tobacco Control Unit, Cancer Control and Prevention Program, WHO Collaborating Center On Tobacco Control, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain ,Cancer Control and Prevention Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Judith Saura
- grid.418701.b0000 0001 2097 8389Tobacco Control Unit, Cancer Control and Prevention Program, WHO Collaborating Center On Tobacco Control, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain ,Cancer Control and Prevention Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Public Health, Maternal Health and Mental Health, School of Medicine and Health Sciences, Universitat de Barcelona, L’Hospitalet del Llobregat, Barcelona, Spain
| | - Carmen Cabezas
- grid.454735.40000000123317762Government of Catalonia, Public Health Secretariat, Barcelona, Spain
| | - Joan Colom
- grid.500777.2Public Health Agency of Catalonia, Barcelona, Spain
| | - Josep M. Suelves
- grid.500777.2Public Health Agency of Catalonia, Barcelona, Spain ,grid.36083.3e0000 0001 2171 6620Universitat Oberta de Catalunya, Barcelona, Spain
| | - Margarida Pla
- grid.5841.80000 0004 1937 0247Department of Public Health, Maternal Health and Mental Health, School of Medicine and Health Sciences, Universitat de Barcelona, L’Hospitalet del Llobregat, Barcelona, Spain
| | - Mar Parejo
- grid.5841.80000 0004 1937 0247Department of Public Health, Maternal Health and Mental Health, School of Medicine and Health Sciences, Universitat de Barcelona, L’Hospitalet del Llobregat, Barcelona, Spain
| | - Sílvia Mondon
- grid.410458.c0000 0000 9635 9413Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Pablo Barrio
- grid.410458.c0000 0000 9635 9413Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Magalí Andreu
- grid.410458.c0000 0000 9635 9413Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Antonia Raich
- grid.488391.f0000 0004 0426 7378Mental Health Department, Althaia Xarxa Assistencial Universitària, Manresa, Barcelona, Spain
| | - Jordi Bernabeu
- grid.488391.f0000 0004 0426 7378Mental Health Department, Althaia Xarxa Assistencial Universitària, Manresa, Barcelona, Spain
| | - Jordi Vilaplana
- grid.15043.330000 0001 2163 1432Serra Húnter Fellow, Computer Science Department, Universitat de Lleida, Lleida, Spain
| | - Xavier Roca
- grid.413396.a0000 0004 1768 8905Addictive Behaviors Unit, Psychiatry Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Pablo Bautista
- grid.5841.80000 0004 1937 0247Department of Public Health, Maternal Health and Mental Health, School of Medicine and Health Sciences, Universitat de Barcelona, L’Hospitalet del Llobregat, Barcelona, Spain
| | - Joseph Guydish
- grid.266102.10000 0001 2297 6811Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA 94158 USA
| | - Cristina Martínez
- grid.418701.b0000 0001 2097 8389Tobacco Control Unit, Cancer Control and Prevention Program, WHO Collaborating Center On Tobacco Control, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain ,Cancer Control and Prevention Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.512891.6CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain ,grid.5841.80000 0004 1937 0247Department of Public Health, Maternal Health and Mental Health, School of Medicine and Health Sciences, Universitat de Barcelona, L’Hospitalet del Llobregat, Barcelona, Spain ,grid.266102.10000 0001 2297 6811Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA 94158 USA
| | | |
Collapse
|
26
|
Feliu A, Ravara S, Papadakis S, Enriquez M, Antón L, Saura J, Company A, Romero O, Ripoll R, Ruz A, Precioso J, Pascoal I, Videira L, Correia C, Ferreira S, Fernández E, Martínez C. Factors associated with changes in inpatients' smoking pattern during hospitalization and one month after discharge: A cohort study. J Nurs Scholarsh 2021; 54:332-344. [PMID: 34755457 DOI: 10.1111/jnu.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Smokers are frequent users of healthcare services. Admissions to hospital can serve as a "teachable moment" for quitting smoking. Clinical guidelines recommend initiating smoking cessation services during hospitalization; however, in Southern European countries less than 5% of inpatients receive a brief intervention for smoking cessation. OBJECTIVES The aims of this study were (i) to examine rates of smoking abstinence during and after hospitalization; (ii) to measure changes in smoking patterns among persons who continued smoking after discharge; and (iii) to identify predictors of abstinence during hospitalization and after discharge. METHODS A cohort study of a representative sample of current adult smokers hospitalized in two Spanish and two Portuguese hospitals. We surveyed smokers during hospitalization and recontacted them one month after discharge. We used a 25-item ad hoc questionnaire regarding their smoking pattern, the smoking cessation intervention they have received during hospitalization, and hospital and sociodemographic characteristics. We performed a descriptive analysis using the chi-square test and a multivariate logistic regression to characterize the participant, hospital, and smoking cessation intervention (5As model) characteristics associated with smoking abstinence. RESULTS Smoking patients from both countries presented high abstinence rates during hospitalization (Spain: 76.4%; Portugal: 70.2%); however, after discharge, their abstinence rates decreased to 55.3% and 46.8%, respectively. In Spain, smokers who tried to quit before hospital admission showed higher abstinence rates, and those who continued smoking reduced a mean of five cigarettes the number of cigarettes per day (p ≤ 0.001). In Portugal, abstinence rates were higher among women (p = 0.030), those not living with a smoker (p = 0.008), those admitted to medical-surgical wards (p = 0.035), who consumed their first cigarette within 60 min after waking (p = 0.006), and those who were trying to quit before hospitalization (p = 0.043). CONCLUSIONS Half of the smokers admitted into the Spanish hospitals are abstinent one month after discharge or have reduced their cigarettes per day. Nevertheless, success rates could be increased by implementing evidence-based tobacco cessation programs at the organizational-level, including post-discharge active quitting smoking support. CLINICAL RELEVANCE Three-quarters of the inpatients who smoke remain abstinent during hospitalization and over half achieve to maintain their abstinence or at least reduce their consumption one month after discharge, proving that admission to hospitals is an excellent teachable moment to quit smoking.
Collapse
Affiliation(s)
- Ariadna Feliu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España
| | - Sofia Ravara
- CICS-UBI, Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal.,CISP-ENSP, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal.,Centro Hospitalar Universitário da Cova da Beira, EPE, Covilhã, Portugal
| | - Sophia Papadakis
- Division of Prevention and Rehabilitation, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Marta Enriquez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Antón
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España.,Catalan Network for Smoke-free Hospitals, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Judith Saura
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Assumpta Company
- E-oncologia, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Olga Romero
- E-oncologia, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ruth Ripoll
- Consorci Sanitari Integral, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Angels Ruz
- Consorci Sanitari Integral, L'Hospitalet de Llobregat, Barcelona, Spain
| | - José Precioso
- Centro de Investigação em Estudos da Criança, Instituto de Educação, Universidade do Minho, Braga, Portugal
| | - Ivone Pascoal
- Serviço de Pneumologia. Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Lídia Videira
- Centro Hospitalar Universitário da Cova da Beira, EPE, Covilhã, Portugal
| | - Claudia Correia
- Centro de Investigação em Estudos da Criança, Instituto de Educação, Universidade do Minho, Braga, Portugal
| | - Soraia Ferreira
- CISP-ENSP, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Esteve Fernández
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España
| | - Cristina Martínez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
27
|
Martínez C, Castellano Y, Laroussy K, Fu M, Baena A, Margalef M, Feliu A, Aldazabal J, Tigova O, Galimany J, Puig-Llobet M, Moreno C, Bueno A, López A, Guydish J, Fernández E. Knowledge, Attitudes, and Training in Tobacco Dependence and Cessation Treatment Among Nursing Students in Catalonia (ECTEC Study): Cross-Sectional Study. Int J Ment Health Addict 2021. [PMID: 37261115 PMCID: PMC10229109 DOI: 10.1007/s11469-021-00640-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Nursing students are part of the future health labor force; thus, knowing their knowledge and participation in tobacco control is of importance. Multicentre cross-sectional study conducted to assess nursing students' knowledge, attitudes, and training in tobacco dependence and treatment at 15 nursing schools in Catalonia. We employed a self-administered questionnaire. 4,381 students participated. Few respondents (21.1%) knew how to assess smokers' nicotine dependence, and less than half (41.4%) knew about the smoking cessation therapies. Most (80%) had been educated on the health risks of smoking, 50% about the reasons why people smoke and, one third on how to provide cessation aid. Students in the last years of training were more likely to have received these two contents. Nursing students lack sufficient knowledge to assess and treat tobacco dependence and are rarely trained in such subjects. Nursing curricula in tobacco dependence and treatment should be strengthened to tackle the first preventable cause of disease worldwide.
Collapse
|
28
|
Fu M, Feliu A, Fernández E. Shishas: another way of tobacco smoking… Another source of exposure to toxic compounds. Arch Bronconeumol 2021; 57:449-450. [PMID: 35698948 DOI: 10.1016/j.arbr.2021.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/02/2020] [Indexed: 06/15/2023]
Affiliation(s)
- Marcela Fu
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat; Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat; Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona (UB), L'Hospitalet de Llobregat; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
| | - Ariadna Feliu
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat; Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat; Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona (UB), L'Hospitalet de Llobregat; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Esteve Fernández
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat; Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat; Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona (UB), L'Hospitalet de Llobregat; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| |
Collapse
|
29
|
Koczkodaj P, Feliu A, Picão E, Schüz J. Youth Ambassadors for the European Code Against Cancer Initiative: A call to action. Cancer Epidemiol 2020; 69:101854. [PMID: 33168480 DOI: 10.1016/j.canep.2020.101854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Paweł Koczkodaj
- Association of European Cancer Leagues, Brussels, Belgium; Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Ariadna Feliu
- Association of European Cancer Leagues, Brussels, Belgium; WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, L'Hospitalet del Llobregat, Barcelona, Spain.
| | - Elsa Picão
- Association of European Cancer Leagues, Brussels, Belgium; NOVA IMS, Lisbon, Portugal
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| |
Collapse
|
30
|
Feliu A, Fernández E, Baena A, Joossens L, Peruga A, Fu M, Martínez C. The Tobacco Control Scale as a research tool to measure country-level tobacco control policy implementation. Tob Induc Dis 2020; 18:91. [PMID: 33192223 PMCID: PMC7656742 DOI: 10.18332/tid/128318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/30/2020] [Accepted: 10/09/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The Tobacco Control Scale (TCS) was designed for advocacy purposes but has also been used as a research tool. In the present study, we characterized TCS use, its limitations and strengths, and critically assessed its use as a research instrument. METHODS We conducted an extensive search of the biomedical databases PubMed and Web of Science for the keyword ‘tobacco control scale’ in all fields. The search was limited to studies published in the period March 2006 to December 2019. Out of 69 hits, 32 studies met the inclusion criteria. Two reviewers independently extracted information from each publication regarding their general characteristics, publication and research aspects, and the characteristics of the use of the TCS. RESULTS We found that researchers have used the TCS as a tool to monitor tobacco control policies mainly in cross-sectional observational studies with ecological and multilevel designs directed to advocacy and the promotion of further research. Different outcomes, such as smoking prevalence and quit ratios, have been associated with tobacco control policy scores. The main reported limitations of the TCS were a low variance across countries and a failure to express enforcement and to incorporate the most recent legislation. CONCLUSIONS The TCS has been commonly used to assess differences in outcomes according to tobacco control policies. However, there are still areas for improvement in its use in research regarding the lack of comparability of TCS scores across time. The lessons that have been learned should be used to adapt and expand the TCS overseas.
Collapse
Affiliation(s)
- Ariadna Feliu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Esteve Fernández
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Antoni Baena
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,eHealth Center, Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | | | - Armando Peruga
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain.,Center for Epidemiology and Health Policies, Clínica Alemana, School of Medicine, Universidad del Desarrollo, Santiago de Chile, Chile
| | - Marcela Fu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Cristina Martínez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, United States
| |
Collapse
|
31
|
Martínez C, Feliu A, Castellano Y, Fu M, Fernández P, Cabrera-Jaime S, Puig-Llobet M, Galimany J, Guydish J, Fernández E. Factors associated with receipt of the 5As model of brief intervention for smoking cessation among hospitalized patients. Addiction 2020; 115:2098-2112. [PMID: 32297373 DOI: 10.1111/add.15076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/18/2019] [Accepted: 04/01/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Guidelines recommend the 5As model of brief intervention for providing smoking cessation support in clinical settings. This study assessed patient and hospital characteristics associated with self-reported receipt of the 5As (ask, advise, assess, assist and arrange). DESIGN Multi-center cross-sectional study. SETTING AND PARTICIPANTS Adult inpatients (n = 1047) were randomly selected from 13 hospitals in the Barcelona province of Spain in 2014-2015. MEASUREMENTS We explored participants' receipt of the 5As through a questionnaire. Given the progressiveness of the 5As, we recoded the fulfillment of the intervention as: A0 : no intervention; A1 : ask; A2 : ask and advise; A3 : A2 and assess; A4 : A3 and assist; and A5 : A4 and arrange a follow-up. We explored patient (e.g. age, sex, comorbidities) and hospital (e.g. type of hospital, unit) characteristics. We adjusted multi-level robust Poisson regression models to estimate the adjusted prevalence ratios (aPR) of the association between the recoded 5As intervention received. FINDINGS A total of 60.4% (n = 624) of patients had been asked (A1 ) about their smoking status. Among smokers, 46.5% (n = 90) were advised (A2 ), 26.6% (n = 48) assessed (A3 ) and 4.6% (n = 10) received all the components of the 5As (A5 ). Middle-aged smokers [aPR = 3.63; 95% confidence interval (CI) = 1.69-7.79] with a respiratory disease (aPR = 2.19; 95% CI = 1.11-4.34) were most likely to have been asked, advised and assessed (A3 ). The cessation intervention was most frequently performed by physicians. CONCLUSIONS In the Barcelona province of Spain, it appears that fewer than half of hospitalized patients who smoke were advised to quit and few received the full 'five As' brief intervention for smoking cessation.
Collapse
Affiliation(s)
- Cristina Martínez
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Ariadna Feliu
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Marcela Fu
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Paz Fernández
- School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Sandra Cabrera-Jaime
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Montse Puig-Llobet
- School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Jordi Galimany
- School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Esteve Fernández
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | | |
Collapse
|
32
|
Fu M, Feliu A, Fernández E. Shishas: Another Way of Tobacco Smoking… Another Source of Exposure to Toxic Compounds. Arch Bronconeumol 2020:S0300-2896(20)30378-1. [PMID: 33160713 PMCID: PMC7550276 DOI: 10.1016/j.arbres.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/23/2020] [Accepted: 10/02/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Marcela Fu
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Instituto Catalán de Oncología (ICO), L'Hospitalet de Llobregat; Grupo de Investigación en Control del Tabaco, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat; Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona (UB), L'Hospitalet de Llobregat; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España.
| | - Ariadna Feliu
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Instituto Catalán de Oncología (ICO), L'Hospitalet de Llobregat; Grupo de Investigación en Control del Tabaco, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat; Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona (UB), L'Hospitalet de Llobregat; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España
| | - Esteve Fernández
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Instituto Catalán de Oncología (ICO), L'Hospitalet de Llobregat; Grupo de Investigación en Control del Tabaco, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat; Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona (UB), L'Hospitalet de Llobregat; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España
| |
Collapse
|
33
|
Feliu A, Fu M, Russo M, Martinez C, Sureda X, López MJ, Cortés N, Fernández E. Exposure to second-hand tobacco smoke in waterpipe cafés in Barcelona, Spain: An assessment of airborne nicotine and PM 2.5. Environ Res 2020; 184:109347. [PMID: 32179267 DOI: 10.1016/j.envres.2020.109347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/30/2020] [Accepted: 03/02/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Waterpipe tobacco smoking has grown in popularity worldwide, with the prevalence of use increasing in Spain from 6.2% to 10.8% in the last decade, despite the smoking ban enacted in 2010 for all hospitality premises. OBJECTIVE To assess exposure to second-hand smoke from waterpipes based on the concentrations of airborne nicotine and particulate matter ≤2.5 μm in diameter (PM2.5) in a sample of waterpipe cafés in the city of Barcelona (Spain). METHODS This cross-sectional study included a sample of 20 waterpipe cafés. Airborne nicotine and PM2.5 were sampled for 30 min in each venue using a nicotine sampling device connected by a tube to a pump and a TSI SidePak Personal Aerosol Monitor. Five outdoor control locations were also measured. We computed medians, interquartile ranges (IQRs), and maximum values and compared them according to venues' and sampling characteristics using the Kruskall-Wallis and U-Mann Whitney tests. Nicotine and PM2.5 were correlated by calculating the Spearman-rank correlation coefficient. RESULTS The median concentration of nicotine and PM2.5 were 1.15 and 230.50 μg/m3 in waterpipe cafés and 0.03 and 10.00 μg/m3 in control locations (p<0.05 in both cases). The Spearman correlation coefficient between both markers was 0.61 (95% confidence interval: 0.18-0.84). No differences were found in nicotine or PM2.5 concentration according to the venues' and sampling characteristics studied, with the exception of area. After stratifying for area, venues >100 m2, located in a tourist area, with >15 lit waterpipes, >8 waterpipes/100 m2, and a ratio of 2 users per waterpipe or less had significantly higher nicotine concentration. DISCUSSION Despite the current smoking ban, which includes hospitality venues, we found nicotine and PM2.5 levels in Barcelona waterpipe cafés that exceeded the threshold recommended by the World Health Organization. This exposure poses serious risks to the health of both workers and customers and constitutes a non-compliance of the legislation.
Collapse
Affiliation(s)
- Ariadna Feliu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Marcela Fu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Marta Russo
- School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain
| | - Cristina Martinez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco (UCSF), San Francisco, USA
| | - Xisca Sureda
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, USA; Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Maria José López
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Núria Cortés
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Esteve Fernández
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain.
| |
Collapse
|
34
|
Amalia B, Fu M, Feliu A, Tigova O, Fayokun R, Mauer-Stender K, Fernández E. Regulation of Electronic Cigarette Use in Public and Private Areas in 48 Countries Within the WHO European Region: A Survey to In-country Informants. J Epidemiol 2020; 32:131-138. [PMID: 33342937 PMCID: PMC8824658 DOI: 10.2188/jea.je20200332] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The objective of this study is to describe the legislation regulating the use of electronic cigarettes (e-cigarettes) in various places in European countries. Methods A survey among experts from all countries of the World Health Organization (WHO) European Region was conducted in 2018. We collected and described data on legislation regulating e-cigarette use indoors and outdoors in public and private places, the level of difficulties in adopting the legislation, and the public support and compliance. Factors associated with the legislation adoption were identified with Poisson and linear regression analyses. Results Out of 48 countries, 58.3% had legislation on e-cigarette use at the national level. Education facilities were the most regulated place (58.3% of countries), while private areas (eg, homes, cars) were the least regulated ones (39.6%). A third of countries regulated e-cigarette use indoors. Difficulty and support in adopting the national legislation and its compliance were all at a moderate level. Countries’ smoking prevalence and income levels were linked to legislation adoption. Conclusions Although most WHO European Region countries had introduced e-cigarette use legislation at the national level, only a few of the legislation protect bystanders in indoor settings.
Collapse
Affiliation(s)
- Beladenta Amalia
- Tobacco Control Unit, Catalan Institute of Oncology, WHO Collaborating Centre for Tobacco Control, L’Hospitalet de Llobregat
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L’Hospitalet de Llobregat
- School of Medicine and Health Sciences, University of Barcelona
- Consortium for Biomedical Research in Respiratory Diseases
| | - Marcela Fu
- Tobacco Control Unit, Catalan Institute of Oncology, WHO Collaborating Centre for Tobacco Control, L’Hospitalet de Llobregat
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L’Hospitalet de Llobregat
- School of Medicine and Health Sciences, University of Barcelona
- Consortium for Biomedical Research in Respiratory Diseases
| | - Ariadna Feliu
- Tobacco Control Unit, Catalan Institute of Oncology, WHO Collaborating Centre for Tobacco Control, L’Hospitalet de Llobregat
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L’Hospitalet de Llobregat
- School of Medicine and Health Sciences, University of Barcelona
- Consortium for Biomedical Research in Respiratory Diseases
| | - Olena Tigova
- Tobacco Control Unit, Catalan Institute of Oncology, WHO Collaborating Centre for Tobacco Control, L’Hospitalet de Llobregat
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L’Hospitalet de Llobregat
- School of Medicine and Health Sciences, University of Barcelona
- Consortium for Biomedical Research in Respiratory Diseases
| | | | | | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology, WHO Collaborating Centre for Tobacco Control, L’Hospitalet de Llobregat
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L’Hospitalet de Llobregat
- School of Medicine and Health Sciences, University of Barcelona
- Consortium for Biomedical Research in Respiratory Diseases
| |
Collapse
|
35
|
Martínez C, Castellano Y, Fu M, Riccobene A, Feliu A, Tigova O, Ballbè M, Anton L, Fernández P, Cabrera-Jaime S, Puig-Llobet M, Moreno C, Falcó-Pegueroles A, Galimany J, Estrada JM, Guydish J, Fernández E. Patient perceptions of tobacco control after smoke-free hospital grounds legislation: Multi-center cross-sectional study. Int J Nurs Stud 2019; 102:103485. [PMID: 31862532 DOI: 10.1016/j.ijnurstu.2019.103485] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine patient perceptions of the role of health care providers in tobacco control and tobacco-related services they should provide after the introduction of national smoke-free hospital grounds legislation in Spain. DESIGN Multi-center cross-sectional study. SETTING Thirteen hospitals in Barcelona province in 2014-2015. PARTICIPANTS A total of 1,047 adult hospital patients, with a stay ≥ 24 h were randomly selected. METHOD We explored participants' perceptions of the role of health professionals and hospitals in tobacco control by asking about their agreement with several statements after the introduction of national legislation on smoke-free hospital grounds: (i) health professionals "should set an example and not smoke" and "should provide smoking cessation support"; (ii) hospitals "should provide smoking cessation treatments" and are "role model organizations in compliance with the smoke-free legislation", and (iii) "hospitalization is a perfect moment to quit smoking". Responses were described overall and according to participant and hospital characteristics: patient sex and age, type of hospital unit, number of beds, and smoking prevalence among hospital staff. RESULTS The majority of participants considered that health professionals should be role models in tobacco cessation (75.3%), should provide smoking cessation support to patients (83.0%), and that hospitalization is a good opportunity for initiating an attempt to quit (71.5%). Inpatients admitted to general hospitals where smoking cessation was not given as part of their portfolio, with a low level of implementation in tobacco control, and who stayed in surgical units had higher expectations of receiving smoking cessation interventions. CONCLUSIONS Inpatients strongly support the role of hospitals and health professionals in tobacco control and expect to receive smoking cessation interventions during their hospital stay. Systematically providing smoking cessation services in hospitals may have a relevant impact on health outcomes among smokers and on health care system expenditures.
Collapse
Affiliation(s)
- Cristina Martínez
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States.
| | - Yolanda Castellano
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Marcela Fu
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Anna Riccobene
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Olena Tigova
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Montse Ballbè
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona. C/ Villarroel 170, 08036 Barcelona, Spain
| | - Laura Anton
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Paz Fernández
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain; Nursing Research Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Sandra Cabrera-Jaime
- Nursing Research Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Montse Puig-Llobet
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Carmen Moreno
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Anna Falcó-Pegueroles
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Jordi Galimany
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Joan María Estrada
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States
| | - Esteve Fernández
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | | |
Collapse
|
36
|
Salazar C, Obach M, Fontanet J, Garrido G, Feliu A, Riba M, Umbria M, Gasol M, Prat A, Vallano A, Pontes C. Consistency of ESMO-MCBS scores with drug access recommendations in Catalonia. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz263.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
37
|
Feliu A, Fernandez E, Martinez C, Filippidis FT. Are smokers "hardening" or rather "softening"? An ecological and multilevel analysis across 28 European Union countries. Eur Respir J 2019; 54:13993003.00596-2019. [PMID: 31221812 DOI: 10.1183/13993003.00596-2019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/12/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Tobacco control policies can reduce smoking prevalence. These measures may be less effective where smoking prevalence has significantly declined, as the remaining smokers have "hardened". Our aim was to empirically evaluate the "hardening hypothesis" at the population level in the European Union (EU) and explore factors associated with hardcore smoking. METHODS We conducted two separate analyses in the EU using data on smoking from the Eurobarometer surveys (2009-2017, n=112 745). 1) A panel-data fixed-effects linear regression to investigate changes over time in the percentage of hardcore smokers in relation to standardised smoking prevalence at the country level. 2) A multilevel logistic regression analysis with hardcore (daily smokers, ≥15 cigarettes per day who have not attempted to quit in the last 12 months) or light (<5 cigarettes per day) smoking as the dependent variable and time as the main independent variable, controlling for individual and ecological variables. RESULTS We studied 29 010 current smokers (43.8% hardcore smokers and 14.7% light smokers). The prevalence of hardcore smoking among adult smokers increased by 0.55 (95% CI 0.14-0.96) percentage points per each additional percentage point in the overall smoking prevalence. The odds of being a hardcore smoker increased over time and were higher in middle-aged males and people with financial difficulties, while the odds of being a light smoker significantly declined among females. CONCLUSION This study does not support the "hardening hypothesis" in the EU between 2009 and 2017, but suggests a softening of the smoking population. Existing tobacco control policies are likely to be suitable to further decrease smoking prevalence in Europe.
Collapse
Affiliation(s)
- Ariadna Feliu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Barcelona, Spain.,School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain
| | - Esteve Fernandez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Barcelona, Spain .,School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain
| | - Cristina Martinez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, Barcelona, Spain.,School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain
| | - Filippos T Filippidis
- Dept of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| |
Collapse
|
38
|
Rodríguez-Borjabad C, Ibarretxe D, Feliu A, Ferré R, Rosell L, Gil M, Masana L, Plana N. Significant Impact Of A Lifestyle Educational Program On Children With Genetically Driven Hypercholesterolemia. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
39
|
Feliu A, Martinez C, Enriquez M, Anton L, Ripoll R, Ruz À, Ravara S, Videira L, Correia C, Precioso J, Fernandez E. Smoking during and 1-month after discharge in Southern European countries (Spain and Portugal). Tob Prev Cessat 2019. [DOI: 10.18332/tpc/105268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
40
|
Feliu A, Filippidis F, Martinez C, Fernandez E. Are smokers in the European Union actually “hardening”? A multi-level and ecological approach. Tob Prev Cessat 2019. [DOI: 10.18332/tpc/105311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
41
|
Martínez C, Castellano Y, Andrés A, Fu M, Feliu A, Antón L, Ballbè M, Fernández P, Cabrera S, Riccobene A, Gavilan E, Baena A, Margalef M, Tigova O, Quirós N, Guillen O, Company A, Fernández E. Impact of an Online Training Program in Smoking Cessation Interventions in Hospitals. J Nurs Scholarsh 2019; 51:449-458. [PMID: 30874373 DOI: 10.1111/jnu.12469] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess changes in the self-reported performance of smoking cessation interventions according to the 5A's model (Ask; Advise; Assess; Assist; and Arrange follow-up) among clinicians; and to identify the main barriers and facilitators in smoking cessation implementation before and after an online smoking cessation training program. DESIGN Pre-post evaluation. METHODS We assessed self-reported smoking cessation interventions in the implementation of the 5A's model among clinicians working in Catalan hospitals (Spain). In addition, we assessed individual-, behavioral-, and organizational-level factors that act as barriers and facilitators in the implementation of the 5A's model. We used a questionnaire of 63 items reflecting each of the 5A's performance (scored from 0 = none to 10 = most possible). The questionnaire was completed both immediately before and 6 months after the training. We analyzed the data of those participants who had a clinical role and answered pre- and post-questionnaires. We used the nonparametric test for paired data (Wilcoxon) to examine changes in scores. FINDINGS A total of 127 clinicians completed the pre-post questionnaire; 63.0% were registered nurses, 17.3% were nursing assistants, 7.9% were physicians, and 11.8% were other professionals (p < .001). Overall, there were significant increases in the implementation of the assist component (from a score of 4.5 to 5.2; p < .003) and arrange a follow-up component (from 3.6 to 4.5; p < .001) of the intervention. Scores in the perception of the level of overall preparation, preparedness in using smoking cessation drugs, level of competence, and organizational recognition improved (p < .001) at the follow-up; however, the score in the perception that implementing smoking cessation is part of their job decreased (from 6.3 to 4.4; p < .001). CONCLUSIONS The online training had a positive impact on the implementation of assist and arrange follow-up components. Although self-preparedness in the management of smokers increased, the motivation and involvement of key professionals decreased. Organizational factors related to the incorporation of resources (such as protocols, records, etc.) should be improved for the correct progression of smoking cessation interventions within the institutions. CLINICAL RELEVANCE Smoking cessation training programs should incorporate some motivational content to increase the engagement of health professionals in smoking cessation interventions in their clinical practice.
Collapse
Affiliation(s)
- Cristina Martínez
- Associate Researcher, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL; and Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Yolanda Castellano
- Statistician, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Granvia de L'Hospitalet; and Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain
| | - Ana Andrés
- Lecturer and Researcher, Faculty of Psychology, Education and Sport Sciences, Ramon Llull Universityl, Barcelona, Spain
| | - Marcela Fu
- Researcher, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO; and Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain
| | - Ariadna Feliu
- Predoctoral student, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL; and Clinical Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Laura Antón
- Program coordinator, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO; and Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain
| | - Montse Ballbè
- Program Coordinator and Associate Researcher, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, and Cancer Control; and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL; and Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Paz Fernández
- Coordinator of Nursing Research, Nursing Research Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain
| | - Sandra Cabrera
- Coordinator of Nursing Researcher, Nursing Research Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain
| | - Ana Riccobene
- Nurse, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO; and Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain
| | - Eva Gavilan
- Nurse and Predoctoral student, Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Antoni Baena
- Associate Researcher, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO; and Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain
| | - Mercè Margalef
- Project Manager, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO; and Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain
| | - Olena Tigova
- Project Manager, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO. Av; and Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain
| | - Núria Quirós
- Administrative support, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO; and Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain
| | - Olga Guillen
- Program Coordinator, E_oncologia Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain
| | - Assumpta Company
- Director E-oncologia, E_oncologia Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain
| | - Esteve Fernández
- Director of the Tobacco Control Unit, Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL; and Department of Clinical Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
42
|
Martínez C, Baena A, Castellano Y, Fu M, Margalef M, Tigova O, Feliu A, Laroussy K, Galimany J, Puig M, Bueno A, López A, Fernández E. Prevalence and determinants of tobacco, e-cigarettes, and cannabis use among nursing students: A multicenter cross-sectional study. Nurse Educ Today 2019; 74:61-68. [PMID: 30583124 DOI: 10.1016/j.nedt.2018.11.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 11/03/2018] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Nurses are important agents in public health, which includes being active in tobacco control. Studies show that nurses who smoke are less inclined to offer smoking cessation aid. Nursing students, as the future labor force of nursing, are one of the key groups to monitor. OBJECTIVES To identify the prevalence and determinants of use of several tobacco products, e-cigarettes, and cannabis among nursing students in Catalonia. DESIGN Cross-sectional multicenter study. SETTINGS 15 university nursing schools in Catalonia (Spain) in 2015-2016. PARTICIPANTS Nursing students attending class at the day of the survey. METHODS An anonymous, self-administered questionnaire based on the Global Health Professional Survey was designed. The questions included information on consumption of several tobacco products (manufactured cigarettes, roll your own cigarettes, etc.), e-cigarettes, and cannabis. We estimated the prevalence of use (%) and computed multilevel logistic regressions models, at two levels, to calculate the odds ratios (OR) and their corresponding 95% confidence intervals (CI), adjusting for several individual sociodemographic variables and the nursing school as a grouping variable. RESULTS 4381 students participated in the study (57.2% of Nursing students in Catalonia at the time of the survey). 29.7% (95%CI: 27.2-32.2) were smokers (18.4% daily and 11.3% occasionally). 66.4% smoked manufactured cigarettes, 47.0% roll your own cigarettes, 10.0% waterpipe, and 0.4% e-cigarettes. The main predictors of smoking were: being ≥25 years (OR = 2.57, 95%CI: 2.03-3.26) and belonging to other Spanish regions (OR = 1.82, 95%CI: 1.30-2.54). 71.5% had low nicotine dependence as defined by the Heavy Smoking Index. Among 11.5% (95%CI: 10.6-12.4) of students used cannabis (daily or occasionally), and men presented higher odds of use (OR = 2.81, 95%CI: 2.11-3.73) than women. CONCLUSIONS Tobacco and cannabis use is high among nursing students. It is necessary to carry out early tobacco and cannabis cessation programs among young nursing students.
Collapse
Affiliation(s)
- Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain.
| | - Antoni Baena
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Health Sciences Studies Department, Universitat Oberta de Catalunya, Rambla de Poblenou, 156, 08018, Barcelona, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Mercè Margalef
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Olena Tigova
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Kenza Laroussy
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Jordi Galimany
- Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Montse Puig
- Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Albert Bueno
- Nursing Care Management, EAP Roses, Institut Català de Salut, Crta Mas Oliva no 23, 17480 Roses, Alt Empordà, Spain
| | - Antonio López
- Nursing Care Management, EAP Valls urbano, c/ Vallvera no 8, Valls, CP: 43800, Tarragona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| |
Collapse
|
43
|
Ballbè M, Martínez C, Feliu A, Torres N, Nieva G, Pinet C, Raich A, Mondon S, Barrio P, Hernández-Ribas R, Vicens J, Costa S, Vilaplana J, Alaustre L, Vilalta E, Blanch R, Subirà S, Bruguera E, Suelves JM, Guydish J, Fernández E. Effectiveness of a telephone-based intervention for smoking cessation in patients with severe mental disorders: study protocol for a randomized controlled trial. Trials 2019; 20:38. [PMID: 30635072 PMCID: PMC6329054 DOI: 10.1186/s13063-018-3106-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 12/05/2018] [Indexed: 01/01/2023] Open
Abstract
Background Up to 75% of inpatients with mental disorders smoke, and their life expectancy is decreased by up to 25 years compared to the general population. Hospitalized patients without monitoring after discharge quickly return to prehospitalization levels of tobacco use. The aim of the 061 QuitMental study is to assess the effectiveness of a multicomponent and motivational telephone-based intervention to stop smoking through a quitline addressed to smokers discharged from mental health hospital wards. Methods A pragmatic randomized controlled trial, single blinded, will include 2:1 allocation to the intervention group (IG) and the control group (CG). The IG will receive telephone assistance to quit smoking (including psychological and psychoeducational support, and pharmacological treatment advice if required) proactively for 12 months, and the CG will receive only brief advice after discharge. The sample size, calculated with an expected difference of 15 points on smoking abstinence between groups (IG, 20% and CG, 5%), α = 0.05, β = 0.10, and 20% loss, will be 334 participants (IG) and 176 participants (CG). Participants are adult smokers discharged from psychiatric units of five acute hospitals. Measurements include dependent variables (self-reported 7-day point prevalence smoking abstinence (carbon monoxide verified), duration of abstinence, number of quit attempts, motivation, and self-efficacy to quit) and independent variables (age, sex, and psychiatric diagnoses). In data analysis, IG and CG data will be compared at 48 h and 1, 6, and 12 months post discharge. Multivariate logistic regression (odds ratio; 95% confidence interval) of dependent variables adjusted for potential confounding variables will be performed. The number needed to treat to achieve one abstinence outcome will be calculated. We will compare the abstinence rate of enrolled patients between groups. Discussion This trial evaluates an innovative format of a quitline for smokers with severe mental disorders regardless of their motivation to quit. If effective, the pragmatic nature of the study will permit transfer to routine clinical practice in the National Health System. Trial registration ClinicalTrials.gov, NCT03230955. Registered on 24 July 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3106-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Montse Ballbè
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain.,Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, C. Villarroel 170, 08036, Barcelona, Spain
| | - Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain. .,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain. .,Medicine and Health Sciences School, Universitat Internacional de Catalunya, C. Josep Trueta s/n, 08915 Sant Cugat del Valles, Barcelona, Spain. .,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa Llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain.
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa Llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain
| | - Núria Torres
- 061 CatSalut Respon, Sistema d'Emergències Mèdiques, C. Pablo Iglesias 115, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - Gemma Nieva
- Smoking Cessation Unit, Addictive Behaviors Unit, Psychiatry Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institute of Research, CIBERSAM, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Cristina Pinet
- Addictive Behaviors Unit, Psychiatry Department, Hospital de la Santa Creu i Sant Pau, C. San Antoni Ma Claret 167, 08025, Barcelona, Spain
| | - Antònia Raich
- Mental Health Department, Althaia Xarxa Assistencial Universitària, C. Dr. Llatjós s/n, Manresa, 08243, Barcelona, Spain
| | - Sílvia Mondon
- Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, C. Villarroel 170, 08036, Barcelona, Spain
| | - Pablo Barrio
- Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, C. Villarroel 170, 08036, Barcelona, Spain
| | - Rosa Hernández-Ribas
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa Llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain.,Alcohol Program, Psychiatry Department, Hospital Universitari de Bellvitge, Institut Català d'Oncologia, IDIBELL, CIBERSAM, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Jordi Vicens
- Psychiatry Department, Hestia Duran i Reynals, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - Sílvia Costa
- Addictive Behaviors Unit, Psychiatry Department, Hospital de la Santa Creu i Sant Pau, C. San Antoni Ma Claret 167, 08025, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau, C. San Antoni Mª Claret 167, 08025, Barcelona, Spain
| | - Jordi Vilaplana
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Universitat de Lleida, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain
| | - Laura Alaustre
- 061 CatSalut Respon, Sistema d'Emergències Mèdiques, C. Pablo Iglesias 115, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - Eva Vilalta
- 061 CatSalut Respon, Sistema d'Emergències Mèdiques, C. Pablo Iglesias 115, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - Roser Blanch
- 061 CatSalut Respon, Sistema d'Emergències Mèdiques, C. Pablo Iglesias 115, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - Susana Subirà
- Psychiatry Department, Hestia Duran i Reynals, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - Eugeni Bruguera
- Smoking Cessation Unit, Addictive Behaviors Unit, Psychiatry Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institute of Research, CIBERSAM, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Josep Maria Suelves
- Public Health Agency of Catalonia, Health Department, Government of Catalonia, C. Roc Boronat 81-95, 08005, Barcelona, Spain
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA, 94118, USA
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa Llarga s/n, L'Hospitalet del Llobregat, 08907, Barcelona, Spain
| |
Collapse
|
44
|
Feliu A, Filippidis FT, Joossens L, Fong GT, Vardavas CI, Baena A, Castellano Y, Martínez C, Fernández E. Impact of tobacco control policies on smoking prevalence and quit ratios in 27 European Union countries from 2006 to 2014. Tob Control 2019; 28:101-109. [PMID: 29472445 PMCID: PMC6317447 DOI: 10.1136/tobaccocontrol-2017-054119] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/16/2018] [Accepted: 01/25/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Tobacco use is still highly prevalent in Europe, despite the tobacco control efforts made by the governments. The development of tobacco control policies varies substantially across countries. The Tobacco Control Scale (TCS) was introduced to quantify the implementation of tobacco control policies across European countries OBJECTIVE: To assess the midterm association of tobacco control policies on smoking prevalence and quit ratios among 27 European Union (EU) Member States (EU27). METHODS Ecological study. We used the TCS in EU27 in 2007 and the prevalence of tobacco and quit ratios data from the Eurobarometer survey (2006 (n=27 585) and 2014 (n=26 793)). We analysed the relationship between the TCS scores and smoking prevalence and quit ratios and their relative changes (between 2006 and 2014) by means of scatter plots and multiple linear regression models. RESULTS In EU27, countries with higher scores in the TCS, which indicates higher tobacco control efforts, have lower prevalence of smokers, higher quit ratios and higher relative decreases in their prevalence rates of smokers over the last decade. The correlation between TCS scores and smoking prevalence (rsp=-0.444; P=0.02) and between the relative changes in smoking prevalence (rsp=-0.415; P=0.03) was negative. A positive correlation was observed between TCS scores and quit ratios (rsp=0.373; P=0.06). The percentage of smoking prevalence explained by all TCS components was 28.9%. CONCLUSION EU27 should continue implementing comprehensive tobacco control policies as they are key for reducing the prevalence of smoking and an increase tobacco cessation rates in their population.
Collapse
Affiliation(s)
- Ariadna Feliu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d’Oncologia- ICO, L’Hospitalet de Llobregat, Barcelona, Spain
- Departament of Clinical Sciences, School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, L’Hospitalet del Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Luk Joossens
- Association of European Cancer Leagues (ECL), Brussels, Belgium
| | - Geoffrey T Fong
- Department of Psychology, School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Constantine I Vardavas
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
- Institute of Public Health, American College of Greece, Athens, Greece
| | - Antoni Baena
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d’Oncologia- ICO, L’Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d’Oncologia- ICO, L’Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Martínez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d’Oncologia- ICO, L’Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Medicine and Health Scienc School, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d’Oncologia- ICO, L’Hospitalet de Llobregat, Barcelona, Spain
- Departament of Clinical Sciences, School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, L’Hospitalet del Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| |
Collapse
|
45
|
Andrés A, Castellano Y, Fu M, Feliu A, Ballbè M, Antón L, Baena A, Fernández E, Martínez C. Exploring individual and contextual factors contributing to tobacco cessation intervention implementation. Addict Behav 2019; 88:163-168. [PMID: 30205255 DOI: 10.1016/j.addbeh.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Previous research suggests that smoking cessation interventions are poorly implemented. This study reports the development and testing of a questionnaire including knowledge, attitude, behavioral, and organizational (KABO) factors affecting the implementation of smoking cessation practices in hospitals by health care providers and organizations. METHODS An initial pool of 44 items was developed to assess the individual knowledge, attitudes, and beliefs of health professionals towards smoking cessation practices according to the 5 A's intervention model, as well as organizational barriers and opportunities for its implementation. Items were measured in a scale from 0="Not at all/Never" to 10 = "Completely/Always". Data were collected from health workers (n = 702) in Catalonia. The validity of the instrument was measured by: (a) analyzing the items, (b) assessing the internal structure, (c) estimating the internal consistency, and (d) analyzing the relationship between this tool and the 5 A's intervention model. RESULTS Seven domains were extracted: individual skills, positive organizational support, attitudes and beliefs, individual commitment, organizational resources, beliefs about patient desire/readiness to quit, and organizational endorsement. These domains explained 69.7% of the variance, and allowed for the development of a refined 26-item version of the questionnaire. Both the seven domains and the total scale showed adequate internal consistency. CONCLUSIONS Psychometric testing indicates that the KABO questionnaire is a reliable and valid instrument for assessing the main barriers and facilitators to smoking cessation intervention implementation. Individual factors better explained the implementation of smoking cessation interventions in hospitals, and the seven identified domains can be used for further investigations into how the implementation of evidence-based practices impacts smoking cessation performance.
Collapse
|
46
|
Lidón-Moyano C, Fu M, Pérez-Ortuño R, Ballbè M, Feliu A, Martín-Sánchez JC, Matilla-Santander N, Pascual JA, Fernández E, Martínez-Sánchez JM. Impact of the Spanish smoking legislation among smokers: A longitudinal study with biomarkers in Barcelona (Spain). Addict Behav 2018; 87:101-108. [PMID: 29975878 DOI: 10.1016/j.addbeh.2018.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/12/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The aim of this study is to assess the impact of the Spanish tobacco control legislation on smoking behavior and salivary cotinine concentration among smokers. METHODS We used data from a longitudinal study, before (2004-2005) and after (2013-2014) the implementation of the two national smoking bans (in 2006 and 2011), in a representative sample of adults (≥16 years old) from Barcelona (Spain). We only analyzed a subsample of continuing smokers (n = 116). We conducted a survey on smoking behavior and obtained saliva sample for cotinine analyses. For this report, we analyzed a subsample of continuing smokers (n = 116). We calculated geometric means (GM). RESULTS Among continuing smokers, salivary cotinine concentration significantly increased by 28.7% (GM from 91.7 ng/ml to 117.3 ng/ml, p = 0.015) after the implementation of the two Spanish smoke-free bans. Nonetheless, no pattern of change was observed in the self-reported number of cigarettes smoked daily. CONCLUSIONS Our study shows a significant increase in the salivary cotinine concentration among adult continuing smokers after both Spanish legislations. This increase could be due to differences in smoking topography (increase in the depth of inhalation when smoking) along with changes in the type of tobacco smoked (increase in smoking roll-your-own cigarettes or mixed use of roll-your-own and manufactured cigarettes). Our results suggest the need to extend tobacco control policies, focusing on the reduction of use of any type of tobacco product and implementing better treatment to help smokers stop smoking.
Collapse
|
47
|
Girona J, Rodríguez-Borjabad C, Ibarretxe D, Heras M, Amigó N, Feliu A, Masana L, Plana N. Plasma IDOL, soluble LDLR and PCSK9 levels as potential biomarkers of familial hypercholesterolemia in children. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
48
|
Martínez C, Fu M, Castellano Y, Riccobene A, Fernández P, Cabrera S, Gavilan E, Feliu A, Puig-Llobet M, Fuster P, Martínez-Sánchez JM, Montes J, Estrada JM, Moreno C, Falcó-Pegueroles A, Galimany J, Brando C, Suñer-Soler R, Capsada A, Fernández E. Smoking among hospitalized patients: A multi-hospital cross-sectional study of a widely neglected problem. Tob Induc Dis 2018; 16:34. [PMID: 31516433 PMCID: PMC6659490 DOI: 10.18332/tid/92927] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/25/2018] [Accepted: 07/05/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION A comprehensive smoking ban was recently enacted for acute-care hospital campuses in Spain. The aim of this study was to assess the prevalence and patterns of smoking among inpatients before and during hospitalization. METHODS Multi-center cross-sectional study was conducted in 13 hospitals in the province of Barcelona, Spain from May 2014 to May 2015. Participants were adults who provided informed consent. The sample size was calculated to be representative of each hospital (prevalence 29.4%, precision ± 5%, error 5%). We approached 1228 subjects, 888 accepted to participate and 170 were replaced (were not available or declined to participate). Final sample comprised 1047 subjects. We used a computer-assisted personal interview system to collect data, including sociodemographic variables and use of tobacco before and during hospitalization. Smoking status was validated with exhaled carbon monoxide. We calculated overall tobacco prevalence and investigated associations with participant and center characteristics. We performed multiple polytomous and multilevel logistic regression analyses to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustments for potential confounders. RESULTS In all, 20.5% (95% CI: 18.1–23.0) of hospitalized patients were smokers. Smoking was most common among men (aOR=7.47; 95% CI: 4.88–11.43), young age groups (18–64 years), and individuals with primary or less than primary education (aOR=2.76; 95% CI: 1.44–5.28). Of the smokers, 97.2% were daily consumers of whom 44.9% had medium nicotine dependence. Of all smokers, three-quarters expressed a wish to quit, and one-quarter admitted to consuming tobacco during hospitalization. CONCLUSIONS Our findings indicate the need to offer smoking cessation interventions among hospitalized patients in all units and service areas, to avoid infringements and increase patient safety, hospital efficiency, and improve clinical outcomes. Hospitalization represents a promising window for initiating smoking interventions addressed to all patients admitted to smoke-free hospitals, specially after applying a smoke-free campus ban.
Collapse
Affiliation(s)
- Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain.,Nursing Research Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain.,Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Nursing Science, Gimbernat School, Barcelona, Spain.,Department of Nursing Science, University of Girona, Girona, Spain.,Fundació Althaia, Barcelona, Spain
| | - Anna Riccobene
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain
| | - Paz Fernández
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Nursing Research Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain
| | - Sandra Cabrera
- Nursing Research Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain
| | - Eva Gavilan
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Montse Puig-Llobet
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Pilar Fuster
- Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Javier Montes
- Department of Nursing Science, Gimbernat School, Barcelona, Spain
| | - Joan Maria Estrada
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Carmen Moreno
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Jordi Galimany
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Cecilia Brando
- Department of Nursing Science, Gimbernat School, Barcelona, Spain
| | - Rosa Suñer-Soler
- Department of Nursing Science, University of Girona, Girona, Spain
| | | | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | | |
Collapse
|
49
|
Feliu A, Baena A, Yared W, Lipponen S, Saltó E, Joossens L, Fernández E. Tobacco Control Scale website: a new tool for tobacco control advocates and researchers. Tob Induc Dis 2018. [DOI: 10.18332/tid/84085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
50
|
Feliu A, Joossens L, Filippidis FT, Fong GT, Vardavas CI, Castellano Y, Martinez C, Fernández E. Impact of tobacco control policies on smoking prevalence and quit ratios in 27 European Union countries from 2006 - 2014. Tob Induc Dis 2018. [DOI: 10.18332/tid/83951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|