Deconstructing myths, building alliances: a networking model to enhance tobacco control in hospital mental health settings

AbstractLife expectancy for people with severe mental disorders is up to 25 years less in comparison to the general population, mainly due to diseases caused or worsened by smoking. However, smoking is usually a neglected issue in mental healthcare settings. The aim of this article is to describe a strategy to improve tobacco control in the hospital mental healthcare services of Catalonia (Spain). To bridge this gap, the Catalan Network of Smoke-free Hospitals launched a nationwide bottom-up strategy in Catalonia in 2007. The strategy relied on the creation of a working group of key professionals from various hospitals —the early adopters— based on Rogers’ theory of the Diffusion of Innovations. In 2016, the working group is composed of professionals from 17 hospitals (70.8% of all hospitals in the region with mental health inpatient units). Since 2007, tobacco control has improved in different areas such as increasing mental health professionals’ awareness of smoking, training professionals on smoking cessation interventions and achieving good compliance with the national smoking ban. The working group has produced and disseminated various materials, including clinical practice and best practice guidelines, implemented smoking cessation programmes and organised seminars and training sessions on smoking cessation measures in patients with mental illnesses. The next challenge is to ensure effective follow-up for smoking cessation after discharge. While some areas of tobacco control within these services still require significant improvement, the aforementioned initiative promotes successful tobacco control in these settings

Deconstructing myths, building alliances: a networking model to enhance tobacco control in hospital mental health settings

Life expectancy for people with severe mental disorders is up to 25 years less in comparison to the general population, mainly due to diseases caused or worsened by smoking. However, smoking is usually a neglected issue in mental healthcare settings. The aim of this article is to describe a strategy to improve tobacco control in the hospital mental healthcare services of Catalonia (Spain). To bridge this gap, the Catalan Network of Smoke-free Hospitals launched a nationwide bottom-up strategy in Catalonia in 2007. The strategy relied on the creation of a working group of key professionals from various hospitals the - early adopters - based on Rogers' theory of the Diffusion of Innovations. In 2016, the working group is composed of professionals from 17 hospitals (70.8% of all hospitals in the region with mental health inpatient units). Since 2007, tobacco control has improved in different areas such as increasing mental health professionals' awareness of smoking, training professionals on smoking cessation interventions and achieving good compliance with the national smoking ban. The working group has produced and disseminated various materials, including clinical practice and best practice guidelines, implemented smoking cessation programmes and organised seminars and training sessions on smoking cessation measures in patients with mental illnesses. The next challenge is to ensure effective follow-up for smoking cessation after discharge. While some areas of tobacco control within these services still require significant improvement, the aforementioned initiative promotes successful tobacco control in these settings. (C) 2016 SESPAS. Published by Elsevier Espana, S.L.U

Mortalitat atribuïble al tabaquisme en la població de Catalunya (1998, 2002 i 2006)

Mortalitat; Tabaquisme; Catalunya; Mortality; Tobacco habit; Catalonia; Mortalidad; Tabaquismo, CataluñaEl Departament de Salut de Catalunya ha dut a terme un estudi sobre la mortalitat atribuïble al tabaquisme en la població de Catalunya en el període 1998-2006 per conèixer-ne l’evolució els últims anys, ja que s’hi ha observat un canvi important de tendència

ESCA

Enquesta de salut; Estadística mèdica; CatalunyaHealth survey; Medical statistics; CataloniaEncuesta de salud; Estadística médica; CataluñaLes enquestes de salut de Catalunya són un instrument del Departament de Salut que aporta informació poblacional rellevant per a l’establiment i les avaluacions de la política sanitària explicitades en el Pla de salut de Catalunya. A partir de la realització d'entrevistes domiciliàries, l’ESCA obté informació sobre l'estat de salut, els estils de vida i l’ús dels serveis sanitaris de la població de Catalunya. L'ESCA és una estadística oficial prevista en el Pla estadístic de Catalunya vigent, la qual cosa comporta una garantia de confidencialitat de les dades, que es troben emparades pel secret estadístic (Llei 23/1998, de 30 de desembre, d'estadísticaHealth surveys are an instrument of Catalonia Health Department that provides population data relevant to the establishment and evaluation of health policy spelled out in the Health Plan of Catalonia. After conducting home interviews, ESCA get information about the state of health, the lifestyle and the use of health services to the population of Catalonia. The ESCA is an official statistic provided in the Statistical Plan of Catalonia in force, which means a guarantee of confidentiality of data, which are protected by statistical secrecy (Law 23/1998 of 30 December, statistical Catalonia). ESCA anonymous microdata can be requested for purposes of scientific researchLas encuestas de salud de Cataluña son un instrumento del Departamento de Salud que aporta información poblacional relevante para el establecimiento y las evaluaciones de la política sanitaria explicitadas en el Plan de Salud de Cataluña. A partir de la realización de entrevistas domiciliarias, la ESCA obtiene información sobre el estado de salud , los estilos de vida y el uso de los servicios sanitarios de la población de Cataluña. La ESCA es una estadística oficial prevista en el Plan estadístico de Cataluña vigente, lo que conlleva una garantía de confidencialidad de los datos, que se encuentran amparadas por el secreto estadístico (Ley 23/1998, de 30 de diciembre, de estadística de Cataluña). Los microdatos anónimas de la ESCA se pueden solicitar para fines de investigación científica

Perception of electronic cigarettes in the general population: does their usefulness outweigh their risks?

Objective: To describe and compare the perceptions of the general population about the harmful effects of electronic cigarettes (e-cigarettes) on users and on those passively exposed to e-cigarettes and the perceptions about e-cigarette usefulness for reducing or eliminating tobacco smoking. Design, setting, and participants: We analysed cross-sectional data from a longitudinal study of a representative sample of the general adult (≥16 years) population of Barcelona, Spain (336 men and 400 women). The fieldwork was conducted between May 2013 and February 2014. We computed the percentages, adjusted OR and their corresponding 95% CI among participants with some awareness of e-cigarettes (79.2% of the sample). Primary and secondary outcome measures: We assessed the perception about harmfulness for e-cigarette users and for passively exposed non-e-cigarette users, as well as the perception of usefulness for smokers of cigarette cessation and reduction

Secondhand smoke in outdoor settings: smokers' consumption, non-smokers' perceptions, and attitudes towards smoke-free legislation in Spain

Objective: to describe where smokers smoke outdoors, where non-smokers are exposed outdoors to secondhand smoke (SHS), and attitudes towards smoke-free outdoor areas after the implementation of national smoke-free legislation. Design: this cross-sectional study was conducted between June 2011 and March 2012 (n=1307 participants). Setting: Barcelona Participants: representative, random sample of the adult (≥16 years) population. Primary and secondary outcomes: proportion of smoking and prevalence of exposure to SHS in the various settings according to type of enclosure. Percentages of support for outdoor smoke-free policies according to smoking status. Results: smokers reported smoking outdoors most in bars and restaurants (54.8%), followed by outdoor places at work (46.8%). According to non-smokers, outdoor SHS exposure was highest at home (42.5%) and in bars and restaurants (33.5%). Among non-smoking adult students, 90% claimed exposure to SHS on university campuses. There was great support for banning smoking in the majority of outdoor areas, which was stronger among non-smokers than smokers. Over 70% of participants supported smoke-free playgrounds, school and high school courtyards, and the grounds of healthcare centres. Conclusions: extending smoking bans to selected outdoor settings should be considered in further tobacco control interventions to protect non-smokers from SHS exposure and to establish a positive model for youth. The majority of public support for some outdoor smoke-free areas suggests that it is feasible to extend smoking bans to additional outdoor settings

Cambios en la prevalencia del tabaquismo en los adolescentes en España

ResumenObjetivoAnalizar la información sobre consumo de tabaco en adolescentes a partir de diversas encuestas escolares.DiseñoSe extraen de diversos estudios los datos relativos a prevalencia de fumadores diarios al final de la escuela secundaria obligatoria por sexo, analizando tendencias.EmplazamientoSe revisan los 5 estudios representativos de adolescentes en España: Encuesta Estatal sobre Uso de Drogas en Estudiantes de Secundaria (ESTUDES); Estudio de Comportamientos de los Escolares Relacionados con la Salud (ECERS-HBSC); Sistema de Vigilancia de Factores de Riesgo asociados a Enfermedades No Transmisibles dirigido a población Juvenil (SIVFRENT-J); estudio de Factores de Riesgo en Estudiantes de Secundaria (FRESC); Estudio de Monitorización de las Conductas de Salud de los Adolescentes (EMCSAT).ResultadosLa prevalencia de fumadores diarios varía entre estudios, en varones entre 8,5 y 13,3% y en chicas entre 12,7 y 16,4%. Aunque se aprecian oscilaciones en algunos estudios, la tendencia entre 1993 y 2008 es de descenso. Con los datos más recientes se puede estimar un declive anual ponderado de la prevalencia de tabaquismo en la adolescencia del 6,47% anual para los varones y 6,96% para las chicas.ConclusionesHay un patrón de descenso de la prevalencia de fumadores diarios adolescentes en España a partir de los diversos estudios existentes, que ofrecen datos consistentes, aunque hay que mantener la vigilancia debido a la existencia de oscilaciones. Esto concuerda con la información derivada de las ventas y de encuestas en población adulta. En cualquier caso, sería deseable que el ritmo de cambio fuera más acentuado y constante.AbstractObjectiveTo analyse information on adolescent use of tobacco in Spain from different school surveys.DesignData on daily smoking prevalence by sex at the end of compulsory education is extracted and figures are compared, analysing trends.SettingThe five representative studies on adolescents in Spain are reviewed: The National Survey on Drug Use in Secondary School Children (Encuesta estatal sobre uso de drogas en estudiantes de secundaria (ESTUDES); Survey of Health Behaviour in School-aged Children (HBSC-ECERS); Surveillance System of Risk Factors Associated With Non-Transmittable diseases in the Young Population (Sistema de Vigilancia de Factores de Riesgo Asociados a Enfermedades No Transmisibles dirigido a población Juvenil)(SIVFRENT-J); Study of Risk Factors in Secondary School Children (Estudio de factores de riesgo en estudiantes de secundaria) (FRESC); Surveillance Study of Health Behaviour in Adolescents (Estudio de Monitorización de las Conductas de Salud de los Adolescentes) (EMCSAT).ResultsThe prevalence of daily smokers varies among studies, in boys from 8.5 to 13.3% and in girls from 12.7 to 16.4%. Although some series show variations, the trend from 1993 to 2008 is downwards. With data from recent years, weighted annual declines in smoking prevalence in adolescence can be estimated to be 6.47% for boys and 6.96% for girls.ConclusionsThere is a decreasing pattern in adolescent daily smoking prevalence in Spain from the different existing studies, which provide consistent data, although surveillance must be kept due to fluctuations. This is in agreement with tobacco sales statistics and health surveys in the adult population. However, the pace of change should be more rapid and constant

Guia pas a pas per deixar de fumar

Deixar de fumar; Quitting smoking; Dejar de fumarAquesta guia conté informació d'utilitat per deixar de fumar

Attitudes towards Electronic Cigarettes Regulation in Indoor Workplaces and Selected Public and Private Places: A Population-Based Cross-Sectional Study

Background: Currently, there is an intensive debate about the regulation of the use of electronic cigarettes (e-cigarettes) in indoor places. The aim of this study was to assess the attitudes toward e-cigarette use in indoor workplaces and selected public and private venues among the general population in Barcelona (Spain) in 2013–2014. Methods: This is a cross-sectional study of a representative sample of the population of Barcelona (n = 736). The field work was conducted between May 2013 and February 2014. We computed the prevalence and the adjusted odds ratios (OR) derived from multivariable logistic regression models. Results: The awareness of e-cigarettes was 82.3%. Forty five percent of respondents did not agree with the use of e-cigarettes in public places and 52.3% in workplaces. The proportion of disapproval of the use of e-cigarettes in indoor places was higher at 71.5% for schools and 65.8% for hospitals and health care centers; while the prevalence of disapproval of e-cigarette use in homes and cars was lower (18.0% and 32.5%, respectively). Respondents who disagreed on the use of e-cigarettes in indoor workplaces were more likely to be older (OR = 1.64 and 1.97 for groups 45–64 and ≧65 years old, respectively), those with a high educational level (OR = 1.60), and never and former smokers (OR = 2.34 and 2.16, respectively). Increased scores in the Fagerström test for cigarette dependence were also related to increased support for their use. Conclusions: Based on this population based study, half of the general population of Barcelona does not support the use of e-cigarettes in indoor workplaces and public places, with the percentage reaching 65% for use in schools, hospitals and health care centers. Consequently, there is good societal support in Spain for the politicians and legislators to promote policies restricting e-cigarettes use in workplaces and public places, including hospitality venues

El pla director de malalties de lʼaparell respiratori

Atenció sanitària; Promoció de la salut; Malalties respiratòriesHealth care; Health promotion; Respiratory diseasesAtención sanitaria; Promoción de la salud; Enfermedades respiratoriasReduir la incidència i la mortalitat de totes les malalties respiratòries ha de ser un dels reptes principals de salut de la nostra societat. Per fer-hi front, lʼany 2010 el Departament de Salut va crear el Pla director de malalties de lʼaparell respiratori (PDMAR) i en el DOGC del 30 de novembre dʼaquell any es va publicar lʼAcord de Govern pel qual sʼaprovava. Aquest Pla neix com a resultat del compliment dʼun dels objectius fixats pel Pla de salut de Catalunya a lʼhoritzó 2010. El Pla director proposa un model dʼabordatge integral per a lʼatenció a les malalties de lʼaparell respiratori, que va des de la promoció i la prevenció fins a la rehabilitació, i que considera el principi dʼequitat davant de desigualtats territorials o de gènere. La voluntat és garantir a tots els pacients de Catalunya lʼaccés i la qualitat de les mesures preventives i diagnòstiques sota una perspectiva dʼavaluació de resultats, amb un èmfasi especial en les malalties que causen una càrrega alta de morbimortalitat i que generen un impacte negatiu en la qualitat de vida dels pacients, com poden ser lʼasma de difícil control, la malaltia pulmonar obstructiva crònica (MPOC), la síndrome dʼapnea del son obstructiva (SASO) o malalties minoritàries com la hipertensió arterial pulmonar primària.Reducir la incidencia y la mortalidad de todas las enfermedades respiratorias debe ser uno de los retos principales de salud de nuestra sociedad. Para hacerle frente, el año 2010 el Departamento de Salud creó el Plan director de enfermedades del aparato respiratorio (PDMAR) y en el DOGC del 30 de noviembre de ese año se publicó el Acuerdo de Gobierno por el que se aprobaba. Este Plan nace como resultado del cumplimiento de uno de los objetivos fijados por el Plan de Salud de Cataluña en el horizonte 2010. El Plan Director propone un modelo de abordaje integral para la atención a las enfermedades del aparato respiratorio, que va desde la promoción y la prevención hasta a la rehabilitación, y que considera el principio de equidad ante desigualdades territoriales o de género. La voluntad es garantizar a todos los pacientes de Cataluña el acceso y la calidad de las medidas preventivas y diagnósticas bajo una perspectiva de evaluación de resultados, con especial énfasis en las enfermedades que causan una carga alta de morbimortalidad y que generan un impacto negativo en la calidad de vida de los pacientes, como pueden ser el asma de difícil control, la enfermedad pulmonar obstructiva crónica (EPOC), el síndrome de apnea del sueño obstructiva (SASO) o enfermedades minoritarias como la hipertensión arterial pulmonar primaria.Reduce the incidence and mortality of all respiratory diseases should be a major health challenges of our society. To cope with it, the year 2010 the Department of Health created thePla director de malalties de lʼaparell respiratori (PDMAR) and the DOGC 30th November at the same year was published the approving in a Governmental agreement. This plan is the result of the fulfillment of one of the objectives set by the Health Plan of Catalonia horizon 2010. The Plan proposes a model of comprehensive approach to care for respiratory diseases, ranging from promotion and prevention to rehabilitation, and considers the principle of equality before territorial or gender inequalities. The aim is to ensure all patients in Catalonia the access and quality of preventive and diagnostic from a standpoint of results evaluation, with special emphasis on diseases that cause a high load of morbidity and generate a negative impact on quality of patients life, such as difficult to control asthma, chronic obstructive pulmonary disease, obstructive sleep apnea syndrome or rare diseases such as primary pulmonary hypertension