Een rookvrije omgeving in het belang van het kind

Achtergrond: het percentage rokers onder medewerkers van de verslavingszorg is hoger dan onder de Nederlandse bevolking. Voor een succesvolle behandeling van een tabaksverslaving is het van groot belang dat de behandelaar niet rookt. Verslavingszorg Noord Nederland (VNN) streeft ernaar rookvrij te zijn, en daarom richt dit onderzoek zich op het in kaart brengen van barrières die rokende medewerkers ervaren bij het stoppen met roken.Methode: in totaal hebben 39 medewerkers van VNN een vragenlijst ingevuld. Antwoorden van rokende en niet-rokende respondenten zijn met elkaar vergeleken, en verschillen tussen de antwoorden zijn getoetst met een Fisher’s exact test.Resultaten: van de respondenten geeft 41 % aan te roken, van wie ruim 56 % dagelijks. Rokende respondenten lijken de barrières om te stoppen met roken voornamelijk bij zichzelf (dus in de interne context) te zoeken en minder in de omgeving (de externe context).Conclusie: de resultaten van dit onderzoek laten zien dat rokende respondenten door hun verslaving een beperktere blik hebben op de potentiële barrières om te stoppen met roken. Het is dus belangrijk om rokende medewerkers bewust te maken van het feit dat ze door het eigen rookgedrag bij anderen de behoefte aan roken versterken of anderen kunnen aanzetten om te gaan roken.<br/

Mixed evidence for the compression of morbidity hypothesis for smoking elimination

__Background:__ There is debate around the composition of life years gained from smoking elimination. The aim of this study was to conduct a systematic review of the literature to synthesize existing evidence on the effect of smoking status on health expectancy and to examine whether smoking elimination leads to compression of morbidity. __Methods:__ Five databases were systematically searched for peer-reviewed articles. Studies that presented quantitative estimates of health expectancy for smokers and non-/never-smokers were eligible for inclusion. Studies were searched, selected and reviewed by two reviewers who extracted the relevant data and assessed the risk of bias of the included articles independently. __Results:__ The search identified 2491 unique records, whereof 20 articles were eligible for inclusion (including 26 cohorts). The indicators used to measure health included disability/activity limitations (n¼9), health-related quality of life (EQ-5D) (n¼2), weighted disabilities (n¼1), self-rated health (n¼9), chronic diseases (n¼6), cardiovascular diseases (n¼4) and cognitive impairment (n¼1). Available evidence showed consistently that non-/never-smokers experience more healthy life years throughout their lives than smokers. Findings were inconsistent on the effect of smoking on the absolute number of unhealthy life years. Findings concerning the time proportionally spent unhealthy were less heterogeneous: nearly all included articles reported that non-/never-smokers experience relatively less unhealthy life years (e.g. relative compression of morbidity). __Conclusions:__ Support for the relative compression of morbidity due to smoking elimination was evident. Further research is needed into the absolute compression of morbidity hypothesis since current evidence is mixed, and methodology of studies needs to be harmonized

Elevated risk of infection with SARS-CoV-2 Beta, Gamma, and Delta variants compared with Alpha variant in vaccinated individuals

The extent to which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) break through infection- or vaccine-induced immunity is not well understood. We analyzed 28,578 sequenced SARS-CoV-2 samples from individuals with known immune status obtained through national community testing in the Netherlands from March to August 2021. We found evidence of an increased risk of infection by the Beta (B.1.351), Gamma (P.1), or Delta (B.1.617.2) variants compared with the Alpha (B.1.1.7) variant after vaccination. No clear differences were found between vaccines. However, the effect was larger in the first 14 to 59 days after complete vaccination compared with ≥60 days. In contrast to vaccine-induced immunity, there was no increased risk for reinfection with Beta, Gamma, or Delta variants relative to the Alpha variant in individuals with infection-induced immunity.</p