José Precioso

Exposure to secondhand smoke in terraces and other outdoor areas of hospitality venues in eight European countries.

Background Outdoor secondhand smoke (SHS) concentrations are usually lower than indoor concentrations, yet some studies have shown that outdoor SHS levels could be comparable to indoor levels under specific conditions. The main objectives of this study were to assess levels of SHS exposure in terraces and other outdoor areas of hospitality venues and to evaluate their potential displacement to adjacent indoor areas. Methods Nicotine and respirable particles (PM2.5) were measured in outdoor and indoor areas of hospitality venues of 8 European countries. Hospitality venues of the study included night bars, restaurants and bars. The fieldwork was carried out between March 2009 and March 2011. Results We gathered 170 nicotine and 142 PM2.5 measurements during the study. The median indoor SHS concentration was significantly higher in venues where smoking was allowed (nicotine 3.69 µg/m3, PM2.5: 120.51 µg/m3) than in those where smoking was banned (nicotine: 0.48 µg/m3, PM2.5: 36.90 µg/m3). The median outdoor nicotine concentration was higher in places where indoor smoking was banned (1.56 µg/m3) than in venues where smoking was allowed (0.31 µg/m3). Among the different types of outdoor areas, the highest median outdoor SHS levels (nicotine: 4.23 µg/m3, PM2.5: 43.64 µg/m3) were found in the semi-closed outdoor areas of venues where indoor smoking was banned. Conclusions Banning indoor smoking seems to displace SHS exposure to adjacent outdoor areas. Furthermore, indoor settings where smoking is banned but which have a semi-closed outdoor area have higher levels of SHS than those with open outdoor areas, possibly indicating that SHS also drifts from outdoors to indoors. Current legislation restricting indoor SHS levels seems to be insufficient to protect hospitality workers – and patrons – from SHS exposure. Tobacco-free legislation should take these results into account and consider restrictions in the terraces of some hospitality venues to ensure effective protection.

First exploratory descriptive study on adherence to and compliance with the Portuguese smoke-free law in the leisure-hospitality sector

The ‘smoke-free law’ in Portugal was introduced on 1 January 2008,1 with the aim of making virtually all enclosed public places and workplaces smoke-free. However, this law could potentially be ineffective in creating smoke-free environments, particularly in the leisure-hospitality sector, since it permits the creation of identified smoking areas. These have to be separated from non-smoking areas by physical barriers or have separate ventilation systems which are (supposedly) able to prevent smoke spreading to adjacent areas. In either case, the removal of exhaust air to the outside has to be guaranteed, in order to …

Poluição do ar interior provocada pelo fumo do cigarro em locais públicos de Portugal

OBJETIVO: Poucos tem sido os estudos para conhecer o grau de poluicao pelo fumo do tabaco a que estao sujeitas as pessoas em varios lugares publicos e privados. O objectivo do estudo foi quantificar o nivel de poluicao do ar provocada pelo fumo do cigarro em locais de trabalho e de lazer. METODOS: O estudo foi realizado no concelho de Braga, Portugal, em 2005. A medicao dos teores de nicotina no ar interior foi realizada com monitores passivos contendo um filtro de 37 mm de diâmetro tratado com bissulfato sodico no seu interior. Os monitores foram colocados em lugares publicos, de trabalho e de lazer, pre-definidos. Para cada um dos locais, calculou-se a mediana da nicotina. RESULTADOS: A presenca de nicotina foi detectada em 85% das amostras. Foram encontrados valores elevados de contaminacao do ar nas discotecas, com mediana de 82,26 µg/m³, variando entre os 5,79 e os 106,31 µg/m³.Os locais de trabalho da administracao publica e da universidade apresentaram os valores mais baixos de nicotina. CONCLUSOES: Os dados confirmam a necessidade de reforcar a implemen-tacao e sobretudo, o cumprimento de politicas sem fumo nos locais de trabalho e de lazer, em beneficio da saude dos trabalhadores e como medida reforcadora de um ambiente que facilite aos fumadores o abandono do fumo do tabaco.

Portuguese children's exposure to second-hand tobacco smoke in the family car

OBJECTIVES To assess the prevalence of childrens exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. METHODS In 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N=3187, mean age 9.5 ± 0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. RESULTS Of the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Childrens exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p<.001). Therefore, children with smoking parents were 5.44 times more likely to be exposed. CONCLUSIONS Childrens exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard.

Smoking trends in Portuguese school – Aged children and aproaches for a control – An analysis based on the Health Behaviour in School – Aged Children (HBSC) data

While smoking has negative health consequences for children and adolescents, the major risk of smoking onset by these age groups is tobacco dependence, in most cases for the rest of their lives, which can later lead to the suffering of diseases related to smoking. This fact shows the importance of smoking prevention in teens to avoid the negative health, economic and environmental effects related to smoking. Although Portugal does not have a National Smoking Prevention Programme, some schools have developed prevention campaigns to control the spread of the tobacco epidemic. To determine the efficacy of smoking prevention campaigns developed in Portuguese schools we compared the data of smoking prevalence provided by Health Behaviour in School-Aged Children (HBSC) (11-15 years old) from 1997/98 and 2002. The results show the rise of smoking prevalence in students on both sexes, especially among girls. Data supports the conclusion that Portuguese schools are not effective in smoking prevention and in Portugal it is necessary to continue smoking prevention campaigns aimed at the younger children.

Prevalência do consumo de tabaco em adolescentes escolarizados portugueses por sexo: podemos estar otimistas?

INTRODUCTION According to the MPOWER approach adopted in 2008 by the WHO, monitoring smoking epidemics is necessary in order to assess the effectiveness of the preventive measures used in smoking control in adolescents and adults. OBJECTIVES To determine the prevalence of smoking in Portuguese school-aged adolescents by region. MATERIAL AND METHODS The sample is made up of 8764 students, 4060 boys and 4704 girls, and is representative of the Portuguese students in regular public education. The data was collected in the 2008/2009 academic year, through a quantitative self-report questionnaire. RESULTS In the total sample, 10.2% of boys and 9.1% of girls are regular smokers. Smoking increases with age. At 15 years old 12.3% of the boys and 8.6% of the girls are regular smokers and 6.1% of the boys and 4.0% of the girls are occasional smokers. Looking at prevalence by region, the highest prevalence of regular smoking is found in Alentejo (14.7%), followed by Azores (11.8%) and the lowest is found in Algarve (4.1%). CONCLUSIONS The prevalence of smokers among Portuguese school-aged adolescents varies within the several regions of the country, similar to what happens in the adult Portuguese population.

Prevalence of secondhand smoke exposure in asthmatic children at home and in the car: A cross-sectional study.

OBJECTIVE To compare secondhand smoke exposure (SHSe) prevalence at home and inside the car between asthmatic and non-asthmatic Portuguese children. MATERIALS AND METHODS This is a cross-sectional study that assessed childrens SHSe in a representative sample of nine Portuguese cities. A validated self-reported questionnaire was administered to a random sample of 4th grade students during the school year of 2010/2011. The asthma prevalence was defined by the answers to three questions regarding asthma symptoms, medication and inhaler use. We performed chi-square tests and analysed frequencies, contingency tables, confidence intervals, and odd-ratios. RESULTS The self-reported questionnaire was administered to 3187 students. Asthma prevalence was 14.8% (472 students). Results showed that 32.3% of non-asthmatic children and 32.4% of asthmatic children were exposed to secondhand smoke as at least one of their household members smoked at home. The prevalence of parental smoking, smoking among fathers and smoking among mothers at home was also similar in both groups (asthmatic and non-asthmatic children). SHSe inside the car was 18.6% among non-asthmatic children and 17.9% among asthmatic children. CONCLUSIONS Asthmatic and non-asthmatic children were equally exposed to secondhand smoke, because no significant differences were found between the two groups concerning the prevalence of SHSe at home and inside the car. These findings highlight the need to include SHSe brief advice in paediatric asthma management.

Opinions on a car smoking ban: a needed guide for public health decision-makers

This study was supported through FEDER from the Operational Programme Factors of Competitiveness COMPETE and through national funding from the Foundation for Science and Technology FCT (Portuguese Ministry of Education and Science) (FCOMP-01-0124-FEDER-009117).

Plano global de prevenção do tabagismo do Município de Braga

In spite of its negative impacts on health, in the society, in the economy and in the environment, smoking is a behaviour spread national and internationally. The data collected in 1999 by the Health National Inquire about smoking prevalence in people from 15 and over, in Portugal mainland, show that 29,3% of men and around 7,9% of women were daily smokers, which means a total of 1,626.597 smokers (1,248.212 men and 378,385 women). If we analyse the data from other sources (Health National Inquires and Eurobarometer) we can see that the tobacco epidemy is growing among both gender but in a particulary alarming way in the female group. It is necessary and urgent to take some primary prevention measures especially addressed to young people and women and at the same time give all the smokers the chance of treatment. Bearing in mind the idea of the Ecologist Movement «thinking globally, acting locally» we defend the implementation of global but local actions as the best approach to control smoking. In this article we describe the state and the trends of smoking in Portugal as well as The Global Prevention Programme of Tobacco Consumption in Braga (North of Portugal). This action plan is intended to solve in a decisive way the tobacco consumption in Braga and at the same time to be taken as an example for the elaboration of a National Plan for Prevention the Tobacco Consumption. REV PORT PNEUMOL 2004; X (4): 269-285

Traffic risk behaviour: an observational study of drivers’ behaviour in Braga (Portugal)

Traffic accidents are a serious public health problem which causes a high number of deaths and injuries. In Portugal, 32,299 traffic accidents involving victims (accidents involving at least one injured person), 554 accidents involving deaths and 2148 accidents involving severe injuries occurred in 2016.1 The use of cell phones and tobacco consumption cause traffic accidents, whose consequences are aggravated if passengers fail to use seat belts.2 Using a cell phone while driving (whether it is used with or without a hands-free system) causes visual, auditive, physical and cognitive distraction. Tobacco consumption negatively affects the health of the driver and the other passengers in the vehicle (particularly children) by the high concentrations of tobacco smoke inside the car, and it is also a distracting factor that compromises driving.3 Several studies have shown that using a seat belt is associated to a drastic reduction on the number of accidents and injuries. Many traffic accidents could be avoided by modifying these behaviors. The present study aimed to describe drivers’ risk behaviors in the city of Braga (Portugal), namely the use of cell phone, tobacco consumption and failure to use seat belts while driving. This is an observational study conducted between December 2016 and January 2017 which followed the validated methodology of Martínez-Sánchez et al.4 The observers registered the behavior of the first five drivers who stopped at a red light traffic in Avenida João XXI, Avenida 31 de Janeiro, Rua da Estrada Nova, and EN 103 (Braga, Portugal). Motorcycles, mopeds and non-motor vehicles were excluded from the study. The observation focused on the use of cell phones, tobacco consumption (lit cigarettes), and failure to use seat belts by the driver of the vehicle. Descriptive analysis was performed. Among the 705 conductors observed, 70 (9.8%) used a cell phone, 50 (7.1%) did not use a seat belt, and 39 (5.5%) smoked while driving. There is still a significant percentage of drivers who adopt risk behaviors while driving. Greater police attention is needed to prevent non-compliance with the law regarding the use of cell phones and driving without seat belts. However, it still does not exist a ban on smoking inside the cars in Portugal. Car smoking bans should be similar to other restrictions on drivers’ behavior that are critical for public health and safety, such as the driving ban under the influence of alcohol or other drugs. Studies show that over 90% of respondents agree with a car smoking ban, especially with children on board.5 Creating campaigns to highlight the importance of banning tobacco consumption inside the car would be useful, not only to increase awareness about the negative effects of smoking on the driver’s health and on the road traffic safety, but also as a way to collect signatures to present this ban at the Portuguese Parliament.