Montse García

Prevalencia del consumo de tabaco en España entre 1945 y 1995. Reconstrucción a partir de las Encuestas Nacionales de Salud

Fundamento y objetivo: Analizar la evolucion del consumo de cigarrillos en Espana entre 1945 y 1995. Material y metodo: A partir de la informacion individual sobre consumo de tabaco recogida en las Encuestas de Salud de Espana de 1993, 1995 y 1997 se ha reconstruido la prevalencia de fumadores de cigarrillos diarios para el periodo 1945-1995. Resultados: En los varones, la prevalencia de tabaquismo en 1945 fue del 42,4% (intervalo de confianza [IC] del 95%, 40,1-44,7%), aumento hasta llegar al 59,1% en 1975 (IC del 95%, 58,0-60,2%), se estabilizo a continuacion durante la decada 1975-1985 y disminuyo hasta la actualidad hasta el 48,9% (IC del 95%, 48,1-49,7%) en 1995. En las mujeres, la prevalencia de tabaquismo fue inferior al 5% hasta la decada de los setenta, momento en que empieza a aumentar de manera sostenida hasta el final del periodo de estudio, con una prevalencia en 1995 del 22,5% (IC del 95%, 21,9-23,1%). Conclusiones: Este analisis permite apreciar la diferente dinamica de la epidemia de tabaquismo entre varones y mujeres en Espana.

Barriers and challenges for tobacco control in a smoke-free hospital.

The study aimed to identify the extent of smoking, compliance with tobacco restrictions, and attitudes toward smoking and tobacco control measures among the employees in a Comprehensive Cancer Center from 2001 to 2006 where a smoke-free policy was progressively introduced. Four cross-sectional surveys were conducted from 2001 to 2006. Survey items include smoking status, smoking history, environmental tobacco exposure, and agreement with tobacco initiatives. The prevalence of smoking has declined from 34.5% in 2001 to 30.6% in 2006. The decrease was present in all professional groups: Doctors from 20.0% in 2001 to 15.2% in 2006 and administrative clerks from 56.0% in 2001 to 37.0% in 2006 reduced the most. Among nurses, the prevalence of smoking was still high with a 2-point percent reduction (from 34.0% in 2004 to 32.6% in 2006). Other changes of the pattern of smoking were apparent: a reduction on the number of cigarettes smoked, decrease of daily smokers, and increase of smoking abstinence during the hospital duty. Compliance with smoke-free areas increased. We observed a very significant decrease of the perception of exposure to environmental tobacco exposure at work. The Smoke Free project helped to achieve a healthy work environment. Tailored smoking cessation programs should be designed to help healthcare professionals to stop smoking. In addition, healthcare professionals should play a key role in promoting a healthy smoke-free lifestyle.

Correlates of exposure to second-hand smoke in an urban Mediterranean population

BackgroundTo describe the socio-demographic factors associated with exposure to second-hand smoke (SHS) in different settings (home, leisure, and workplace).MethodsWe analysed cross-sectional data on self-reported SHS exposure in 1059 non-daily smokers interviewed in the Cornellà Health Interview Survey Follow-up Study in 2002. We calculated age-adjusted prevalence rates and prevalence rate ratios of SHS exposure at home, at the workplace, during leisure time, and in any of these settings.ResultsThe age-standardized prevalence rate of SHS exposure in any setting was 69.5% in men and 62.9% in women. Among men, 25.9% reported passive smoking at home, 55.1% during leisure time, and 34.0% at the workplace. Among women, prevalence rates in these settings were 34.1%, 44.3% and 30.1%, respectively. Overall exposure to SHS decreased with age in both men and women. In men, SHS exposure was related to marital status, physical activity, smoking, and alcohol intake. In women, SHS exposure was related to educational level, marital status, occupational status, self-perceived health, smoking-related illness, and alcohol intake.ConclusionThe prevalence of SHS exposure in this population was high. The strongest association with exposure were found for age and occupational status in men, and age and educational level in women.

Abandono del consumo de tabaco en una cohorte de base poblacional

Objetivo: Estudiar la tasa de incidencia del abandono del consumo de tabaco en una cohorte de base poblacional, asi como determinar las caracteristicas asociadas a este. Material y metodos: Los datos proceden del Estudio de Seguimiento de la Encuesta de Salud de Cornella del Llobregat (ES.ESC). Los analisis se restringieron a los fumadores diarios identificados en la entrevista basal (ano 1994) y con informacion completa en la encuesta de seguimiento (2002). Se calcularon las tasas de incidencia de abandono y el riesgo relativo (con su intervalo de confianza) de abandono del consumo de tabaco mediante un modelo de Cox. Resultados: De los 353 fumadores diarios, 100 dejaron de fumar durante el periodo de seguimiento (incidencia acumulada del 28,3%). La tasa de incidencia de abandono fue mayor en los varones (42,34/1.000 personas-ano) que en mujeres (24,97/1.000 personas-ano), con un riesgo relativo de abandono para los varones de 1,69 (intervalo de confianza del 95%, 1,02-2,79). La edad y el nivel educativo se asociaron a un riesgo relativo de abandono mayor en los varones. Conclusiones: Los principales determinantes del abandono del consumo de tabaco son sociodemograficos (sexo, edad y nivel de estudios).

Mortalidad por cáncer en España, 1955-1994

Fundamento Se analiza la mortalidad en las8 principales localizaciones tumorales envarones y mujeres en Espana entre 1955y 1994. Material Y metodos Se han calculado las tasasde mortalidad estandarizadas por edad. Resultados En varones destaca el aumentoen la mortalidad por cancer de pulmon y enel resto de localizaciones, excepto el cancerde estomago. En las mujeres, la mortalidadpor cancer de mama, ovario y pancreas siguetambien en aumento. Conclusiones Espana presenta un patron demortalidad por cancer desfavorable que requiereintervenciones decididas. Background To analyze the mortality fromthe eight main cancer sites in men and womenfrom Spain between 1955-1994. Material and Methods Age-standardized mortalityrates were computed. Results In men, an increase in lung cancermortality as well as in the other 8 sites wasregistered, except for stomach cancer. Inwomen, breast, ovary, and pancreas cancermortality continue to increase. Conclusions Cancer mortality in Spain hasdismal trends. This fact implies the need ofstrong interventions.

The Cornella Health Interview Survey Follow-Up (CHIS.FU) Study: design, methods, and response rate

BackgroundThe aim of this report is to describe the main characteristics of the design, including response rates, of the Cornella Health Interview Survey Follow-up Study.MethodsThe original cohort consisted of 2,500 subjects (1,263 women and 1,237 men) interviewed as part of the 1994 Cornella Health Interview Study. A record linkage to update the address and vital status of the cohort members was carried out using, first a deterministic method, and secondly a probabilistic one, based on each subjects first name and surnames. Subsequently, we attempted to locate the cohort members to conduct the phone follow-up interviews. A pilot study was carried out to test the overall feasibility and to modify some procedures before the field work began.ResultsAfter record linkage, 2,468 (98.7%) subjects were successfully traced. Of these, 91 (3.6%) were deceased, 259 (10.3%) had moved to other towns, and 50 (2.0%) had neither renewed their last municipal census documents nor declared having moved. After using different strategies to track and to retain cohort members, we traced 92% of the CHIS participants. From them, 1,605 subjects answered the follow-up questionnaire.ConclusionThe computerized record linkage maximized the success of the follow-up that was carried out 7 years after the baseline interview. The pilot study was useful to increase the efficiency in tracing and interviewing the respondents.

Implementing and complying with the Smoke-free Hospitals Project in Catalonia, Spain.

The objective of the study was to describe the implementation of measures for preventing tobacco consumption developed in the Catalan Network of Smoke-free Hospitals. Information from 25 hospitals that are actively involved in the Catalan Network of Smoke-free Hospitals (April 2004) was used. The degree of implementation of the Smoke-free Hospitals Project was analysed by means of the Self-Audit Questionnaire of the European Network for Smoke-free Hospitals; each hospital was analysed globally and according to the duration of its Network membership (<1 year: implementation stage; ≥1 year: consolidation stage). In terms of global indicators, there were high levels of commitment (64.8%), communication (74.7%), tobacco control (77.4%) and implementation of smoke-free environments (81.0%). A lower degree of implementation (<50%) was found in education and training, health promotion and healthy workplaces. According to the duration of Network membership, significant differences were observed for communication, environment, healthy workplaces and follow-up. Deficits were observed in areas such as specialist training and cessation support, and further input is required here. By identifying areas needing attention, providing a guide for policy development and by administering it periodically, one can ensure that progress is kept on track.

Cancer risk perceptions in an urban Mediterranean population.

The objective of our study was to analyze the perceived (belief) or adopted (behavior) measures to reduce cancer risk in a Spanish population. We used cross‐sectional data from the Cornella Health Interview Survey Follow‐up Study (CHIS.FU). We analyzed 1,438 subjects who in 2002 answered questions about risk perceptions on cancer and related behavior (668 males and 770 females). The benefits of avoiding cigarette smoking (95.8%), sunlight exposure (94.9%) and alcohol (81.0%) were widely recognized. On the other hand, electromagnetic fields (92.1%), food coloring and other food additives (78.4%) or pesticides (69.4%), whose role in cancer occurrence, if any, remain unproven, were clearly considered as cancer risk factors in this population. Compared to men, women more frequently reported healthy behaviors, and the role of exogenous factors (i.e., environmental risk factors) were widely popular. There was a socioeconomic gradient on cancer risk perception with respect to several lifestyle or dietary factors. Individuals with higher educational level scored lower in several risk factors than those with primary or less than primary school education. Smokers reported adopting fewer healthy behaviors than former or never smokers. How people perceive health issues and risk or make choices about their own behavior does not always follow a predictable or rational pattern.

Prevalencia de la exposición al humo ambiental del tabaco en un área urbana

Fundamento y objetivo Evaluar la prevalencia de la exposicion al humo ambiental del tabaco (HAT) en general y en los diferentes ambientes de exposicion (domestico, laboral y de tiempo libre). Sujetos y metodo Se ha realizado un estudio transversal de los datos sobre exposicion al HAT en 1.059 participantes no fumadores del Estudio de Seguimiento de la Encuesta de Salud de Cornella (ES-ESC). Se ha determinado la prevalencia estandarizada por edad de la exposicion al HAT en general asi como en los diferentes ambientes. Resultados El 69,5% (intervalo de confianza [IC] del 95%, 64,5-74,4%) de los varones y el 62,9% (IC del 95%, 58,1-67,6%) de las mujeres de la muestra estudiada estuvieron expuestos en general al HAT. Se observo una tendencia decreciente de la exposicion con la edad en ambos sexos. La prevalencia estandarizada por edad de la exposicion al HAT segun el ambiente y el sexo fue: un 25,9% (IC del 95%, 21,8-30,1%) en el domicilio, un 55,1% (IC del 95%, 50,8-59,4%) durante el tiempo libre y un 34,0% (IC del 95%, 23,5-45,6%) en el lugar de trabajo en los varones, y un 34,1% (IC del 95%, 29,8-38,5%), un 44,3% (IC del 95%, 40,5-48,2%) y un 30,1% (IC del 95%, 18,9-41,3%), respectivamente, en las mujeres. Conclusiones Mas de la mitad de la poblacion no fumadora de este estudio esta expuesta al HAT.

Autoría y presentación de resultados según el género en cuatro revistas biomédicas españolas

Resumen Objetivo Describir la autoria segun el genero de los articulos publicados en cuatro revistas espanolas de medicina general y salud publica, y analizar la manera de presentar los resultados en relacion con el sexo de los sujetos del estudio. Metodos Se han examinado 423 articulos procedentes de cuatro revistas cientificas espanolas publicados en 1998. Resultados El 70,7% de los articulos revisados tenian como primer autor a un varon. La diferencia entre sexos es evidente en los editoriales (un 12,4% de mujeres frente a un 29,8% de varones; p Conclusiones Existen desigualdades de genero en la publicacion de articulos cientificos en el campo de la medicina y la salud publica.