Prevalence and determinants of SHS exposure in public and private areas after the 2010 smoke-free legislation in Greece

<div><p>The objective of the present survey was to assess the extent and socio-economic determinants of population exposure to secondhand smoke (SHS) in Greece in 2011. The national household survey Hellas Health IV was conducted in October 2011. SHS exposure was based on self-reported exposure within home, workplace and public places. Thirty-three per cent of the respondents reported living in a smoke-free home. Smokers (<i>p </i><<i> </i>0.001) and single individuals (<i>p </i><<i> </i>0.017) were less likely to prohibit smoking at home. SHS exposure at work, in restaurants and in bars/clubs/cafes was frequently mentioned by 41.6, 84.2 and 90.5%, respectively. SHS exposure in a bar/club/cafe was noted more among single individuals (<i>p </i>=<i> </i>0.004) and those aged 18–34<i> </i>years (<i>p </i>=<i> </i>0.007). Inhabitants of rural areas were more likely to report someone smoking indoors in all the above venues. Public health education and effective enforcement of the nationwide smoke-free legislation are imperative.</p></div

Nursing education and beliefs towards tobacco cessation and control: a cross- sectional national survey (GHPSS) among nursing students in Greece

<p>Abstract</p> <p>Background</p> <p>Within the healthcare system, nurses have the ability to influence their patients' smoking habits through counselling. Therefore, it is of great importance to appropriately train health professionals on smoking cessation strategies with the aim to help them provide advice to their patients. In light of the above, the objective of this study was to assess the association between Greek nursing students' beliefs towards tobacco control/smoking cessation and the professional training received.</p> <p>Methods</p> <p>During February 2009, we conducted a cross sectional national survey among all 3^rdyear nursing students of the two university based nursing departments in Greece (University of Athens, University of the Peloponnese). The Global Health Professional Student Survey (GHPSS) questionnaire was applied and following written informed consent 73% provided a completed questionnaire (n = 192/263 enrolled students).</p> <p>Results</p> <p>Overall, 33% were current active smokers, while 74% reported ever to experiment smoking. In regards to their beliefs towards tobacco control policies, non smokers were more positive in regards to banning smoking in restaurants (94% vs. 61%, p < 0.001), in bars and cafes (82% vs. 34%, p < 0.001), and all public places (93% vs. 51%, p < 0.001) when compared to current smokers. In comparison with students who had not received training on the importance of asking patients about their smoking habits, those that did were more likely to believe that nurses should have a role in smoking cessation and should act as role models for their patients.</p> <p>Conclusions</p> <p>Resources should be invested in improving the quality of undergraduate education in nursing departments in Greece with respect to tobacco control and smoking cessation.</p

Tobacco taxation: the importance of earmarking the revenue to health care and tobacco control

Background: Increases in tobacco taxation are acknowledged to be one of the most effective tobacco control interventions. This study aimed at determining the mediating role of socioeconomical status (SES) and the earmarking of revenue to healthcare and tobacco control, in influencing population support for the adoption of a 2 Euro tobacco tax increase in Greece, amid the challenging economic environment and current austerity measures. Methods: Data was collected from two national household surveys, the “Hellas Health III” survey, conducted in October 2010 and the "Hellas Tobacco survey” conducted in September 2012. Data was analyzed from 694 and 1066 respondents aged 18 years or more, respectively. Logistic regression models were fitted to measure the adjusted relationship between socio-economic factors for the former, and support for increased taxation on tobacco products for the latter. Results: In 2012 amidst the Greek financial crisis, population support for a flat two euro tax increase reached 72.1%, if earmarked for health care and tobacco control, a percentage high both among non-smokers (76%) and smokers (64%) alike. On the contrary, when not earmarked, only 43.6% of the population was in support of the equivalent increase. Women were more likely to change their mind and support a flat two-euro increase if the revenue was earmarked for health care and tobacco control (aOR = 1.70; 95% C.I: 1.22-2.38, p = 0.002). Furthermore, support for an increase in tobacco taxation was not associated with SES and income. Conclusion: Despite dire austerity measures in Greece, support for an increase in tobacco taxation was high among both smokers and non-smokers, however, only when specifically earmarked towards health care and tobacco control. This should be taken into account not only in Greece, but within all countries facing social and economic reform

Passive Exposure To E-cigarette Emissions: Immediate Respiratory Effects

INTRODUCTION The present work examined the effect of passive exposure to electronic-cigarette (e-cigarette) emissions on respiratory mechanics and exhaled inflammatory biomarkers. METHODS A cross-over experimental study was conducted with 40 healthy nonsmokers, 18-35 years old with normal physical examination and spirometry, with body mass index < 30 kg/m(2), who were exposed to e-cigarette emissions produced by a smoker, according to a standardized protocol based on two resistance settings, 0.5 ohm and 1.5 ohm, for e-cigarette use. All participants underwent a 30-minute control (no emissions) and two experimental sessions (0.5 and 1.5 ohm exposure) in a 35 m(3) room. The following Impulse Oscillometry (IOS) parameters were measured at pre and post sessions: impedance, resistance, reactance, resonant frequency (fres), frequency dependence of resistance (fdr=R5-R20), reactance area (AX), and fractional exhaled nitric oxide (FeNO). Differences between pre and post measurements were compared using t-tests and Wilcoxon signed rank tests, while analysis of variance (ANOVA) was used for comparisons between experimental sessions (registered under ClinicalTrials.gov ID: NCT03102684). RESULTS IOS and FeNO parameters showed no significant changes during the control session. For IOS during the 1.5 ohm exposure session, fres increased significantly from 11.38 Hz at baseline to 12.16 Hz post exposure (p=0.047). FeNO decreased significantly from 24.16 ppb at baseline to 22.35 ppb post exposure in the 0.5 ohm session (p=0.006). CONCLUSIONS A 30-minute passive exposure to e-cigarette emissions revealed immediate alterations in respiratory mechanics and exhaled biomarkers, expressed as increased fres and reduced FeNO

Immediate post-operative effects of tracheotomy on respiratory function during mechanical ventilation

INTRODUCTION: Tracheotomy is widely performed in the intensive care unit after long-term oral intubation. The present study investigates the immediate influence of tracheotomy on respiratory mechanics and blood gases during mechanical ventilation. METHODS: Tracheotomy was performed in 32 orally intubated patients for 10.5 ± 4.66 days (all results are means ± standard deviations). Airway pressure, flow and arterial blood gases were recorded immediately before tracheotomy and half an hour afterwards. Respiratory system elastance (E(rs)), resistance (R(rs)) and end-expiratory pressure (EEP) were evaluated by multiple linear regression. Respiratory system reactance (X(rs)), impedance (Z(rs)) and phase angle (φ(rs)) were calculated from E(rs )and R(rs). Comparisons of the mechanical parameters, blood gases and pH were performed with the aid of the Wilcoxon signed-rank test (P = 0.05). RESULTS: E(rs )increased (7 ± 11.3%, P = 0.001), whereas R(rs )(-16 ± 18.4%, P = 0.0003), X(rs )(-6 ± 11.6%, P = 0.006) and φ (rs )(-14.3 ± 16.8%, P = <0.001) decreased immediately after tracheotomy. EEP, Z(rs), blood gases and pH did not change significantly. CONCLUSION: Lower R(rs )but also higher E(rs )were noted immediately after tracheotomy. The net effect is a non-significant change in the overall R(rs )(impedance) and the effectiveness of respiratory function. The extra dose of anaesthetics (beyond that used for sedation at the beginning of the procedure) or a higher FiO(2 )(fraction of inspired oxygen) during tracheotomy or aspiration could be related to the immediate elastance increase

Burden of disease from breast cancer attributable to smoking and second‐hand smoke exposure in Europe

Smoking and second-hand smoke (SHS) exposure have been recently linked to a higher risk of breast cancer in women. The aim of this work is to estimate the number of deaths and disability-adjusted life years (DALYs) from breast cancer attributable to these two risk factors in the European Union (EU-28) in 2017. The comparative risk assessment method was used. Data on prevalence of smoking and SHS exposure were extracted from the Eurobarometer surveys, relative risks from a recent meta-analysis, and data on mortality and DALYs from breast cancer were estimated from the Global Burden of Disease, Injuries and Risk Factors Study. In 2017, 82 239 DALYs and 3354 deaths from breast cancer in the EU-28 could have been avoided by removing exposure to these two risk factors (smoking and SHS exposure). The proportion of DALYs from breast cancer lost respectively from smoking and SHS exposure was 2.6% and 1.0%, although geographically distributed with significant heterogeneity. These results represent the first estimates of breast cancer burden in women attributable to smoking and SHS exposure for the EU-28. It is important to increase awareness among women, health professionals and wider society of the association between smoking, SHS exposure and breast cancer, a relationship that is not widely recognised or discussed

Who smokes in Europe? Data from 12 European countries in the TackSHS survey (2017-2018)

Background: Population data on tobacco use and its determinants require continuous monitoring and careful inter-country comparison. We aimed to provide the most up-to-date estimates on tobacco smoking from a large cross-sectional survey, conducted in selected European countries. Methods: Within the TackSHS Project, a face-to-face survey on smoking was conducted in 2017-2018 in 12 countries: Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania and Spain, representing around 80% of the 432 million European Union (EU) adult population. In each country, a representative sample of around 1,000 subjects aged 15 years and older was interviewed, for a total of 11,902 participants. Results: Overall 25.9% of participants were current smokers (31.0% among men and 21.2% among women, pAdditional co-authors: Gergana Geshanova, Giuseppe Gorini, Sheila Keogan, Hristo Ivanov, Maria-José Lopez, Angel Lopez-Nicolas, José Precioso, Krzysztof Przewozniak, Cornel Radu-Loghin, Ario Ruprecht, Joan B Soriano, Polina Starchenko, Marta Trapero-Bertran, Olena Tigova, Anna S Tzortzi, Constantine Vardavas, Vergina K Vyzikidou, Paolo Colombo, Esteve Fernandez, The TackSHS Project Investigator