Changes in the prevalence of tobacco consumption and the profile of Spanish smokers after a comprehensive smoke-free policy

A partial smoke-free regulation in Spain was introduced on January 1, 2006, which was sub-sequently amended to introduce a comprehensive smoke-free policy from 2 January 2011 onward. The objective of this study was to compare the prevalence of tobacco consumption in Spain and the profile of smokers before (2006) and after (2011) the comprehensive smoking ban passed in 2010

Conflicts Of Interest In Research On Electronic Cigarettes

INTRODUCTION The tobacco control community has raised some concerns about whether studies on electronic cigarettes (e-cigarettes) published in scientific journals hide conflicts of interest (COI) and whether such reports are biased. This study assessed potential COI in the e-cigarette scientific literature. METHODS Cross-sectional study was conducted on e-cigarette publications indexed in PubMed up to August 2014. We extracted information about the authors (affiliations, location, etc.), publication characteristics (type, topic, subject, etc.), results and conclusions, presence of a COI statement, and funding by and/or financial ties to pharmaceutical, tobacco, and/or e-cigarette companies. An algorithm to determine the COI disclosure status was created based on the information in the publication. Prevalence ratios (PRs) and confidence intervals (CIs) were calculated to identify associations with COI disclosure, controlling for several independent variables. RESULTS Of the 404 publications included in the analysis, 37.1% (n=150) had no COI disclosure statement, 38.6% declared no COI, 13.4% declared potential COI with pharmaceutical companies, 3.0% with tobacco companies, and 10.6% with e-cigarette companies. The conclusions in publications with COI, which were mainly tied to pharmaceutical companies, were more likely to be favourable to e-cigarette use (PR=2.23; 95% CI: 1.43-3.46). Publications that supported the use of e-cigarettes for both harm reduction (PR= 1.81; 95% CI: 1.14-2.89) and smoking cessation (PR= 2.02; 95% CI: 1.26-3.23) were more likely to have conclusions that were favourable to e-cigarettes. CONCLUSIONS One-third of the publications reporting studies on e-cigarettes did not have a COI disclosure statement, and this proportion was even higher in news articles, editorials and other types of publications. Papers with conclusions that were favourable to e-cigarette use were more likely to have COI. Journal editors and reviewers should consider evaluating publications, including funding sources, to determine whether the results and conclusions may be biased

Burden of respiratory disease attributable to secondhand smoke exposure at home in children in Spain (2015)

This study aimed to estimate the number of incident cases and hospital admissions attributable to secondhand smoke (SHS) exposure at home for asthma, otitis media (OM), and lower respiratory infections (LRI) in children in Spain. The burden of respiratory disease caused by SHS exposure was estimated in terms of incident cases and hospitalized cases for asthma, OM, and LRI. Estimates were calculated using the population attributable fraction. The age-specific (0-1 year, 0-4 years, 5-11 years, and 0-11 years) prevalence of SHS exposure in children was estimated through a telephone survey performed in a representative sample of Spanish households with children in 2016. The risk estimates for all diseases were selected from international meta-analyses. The number of hospitalized cases was obtained for each disease from the Hospital Minimum Data Set provided by the Ministry of Health of Spain. Incident cases were obtained from the Global Health Data Exchange. In 2015, SHS exposure caused an estimated total of 136,403 incident cases of the following respiratory diseases: 9058 (8.5%) cases of asthma, 120,248 (8.5%) of OM, and 7097 (13.5%) of LRI in children aged 0-14 years old in Spain. Likewise, SHS exposure caused a total of 3028 hospitalized cases, with 379 (8.5%) for asthma and 167 (8.5%) for OM in children 0-11 years old, and 2482 (11.6%) for LRI in children <2 years old. The high burden of respiratory disease attributed to SHS exposure supports the need to improve protection of children against SHS exposure by extending smoke-free regulations to homes and cars

Social inequalities in secondhand smoke exposure in children in Spain

Introduction: Children are particularly vulnerable to the health effects of secondhand smoke (SHS). The objectives of this study are to describe SHS exposure of children younger than 12 years in Spain and to identify potential social inequalities associated with SHS exposure. Material and Methods: A cross-sectional study was conducted in a representative sample of the population younger than 12 years in Spain. A computerassisted telephone interview was conducted with parents or legal guardians in 2016, to assess the children's SHS exposure at home, in the car, at school and at the nursery gates, in public transport, and during leisure time. The socio-demographic variables included were the child's age and sex, the highest educational attainment at home, and occupational social class. Prevalence and 95% confidence intervals were calculated for SHS exposure in each setting and for overall exposure. Results: In all, 71.8% of the children were exposed to SHS: 25.8% were exposed at home, 4.6% in the car, 8.2% in public transport, 31.9% at outdoor nursery or school gates, and 48% during leisure time. The higher the educational attainment at home, the lower the exposure (38.8% for primary school or lower, 28.7% for secondary school and 20.8% university level). The more deprived the social class, the higher the exposure (21.7% class I-II, 23.4% class III-IV and 31.1% class V-VII). SHS exposure in cars and overall exposure also decreased with higher educational achievement. Conclusions: In Spain, a large proportion of children are still exposed to SHS. Furthermore, there are clear social inequalities. To reduce SHS exposure, there is an urgent need for evidence-based interventions with an equity perspective

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Changes in the prevalence of tobacco consumption and the profile of Spanish smokers after a comprehensive smoke-free policy

A partial smoke-free regulation in Spain was introduced on January 1, 2006, which was sub-sequently amended to introduce a comprehensive smoke-free policy from 2 January 2011 onward. The objective of this study was to compare the prevalence of tobacco consumption in Spain and the profile of smokers before (2006) and after (2011) the comprehensive smoking ban passed in 2010

Morbidity attributable to secondhand smoke exposure in children under 5 years old in Spain, 2015

Background: Children are especially vulnerable to the detrimental health effects of secondhand smoke (SHS), which has been widely linked to asthma and otitis media (OM), among other diseases. This study aimed to estimate hospital admissions and disability-adjusted life years (DALY) attributable to SHS exposure in terms of asthma and OM among children under 5 years old in Spain during the year 2015. Methods The prevalence of SHS exposure in children under 5 was estimated through a telephone survey performed in 2016 in a representative sample of Spanish households with children. The Rate risks for asthma and otitis media were selected from different published international meta-analysis. The number of hospital admissions were obtained for each disease from the Minimum Basic Data Set provided by the Ministry of Health of Spain. Information about DALYs were obtained from estimations made by the World Health Organization. Both hospital admissions and DALYs attributable to SHS exposure were calculated using the population attributable fraction (PAF). Results 25.7% of children under 5 are exposed to SHS at home (any household member reported smoking either inside or on balconies or terraces). According to the literature, SHS exposure increases the risk of both asthma and OM by 1.32. The estimated percentage of children presenting each disease attributable to SHS exposure at home is 7.6%. In 2015, the number of children with at least one hospital admission for asthma (n=2,451) and OM (n=1,226) attributable to SHS exposure was 186 and 93, respectively. Likewise, attributable DALYs were 273 for asthma and 159 for OM. Conclusions 7.6% of burden disease for asthma and OM among young children is due to SHS exposure at home. This figure highlights the need of implementing smoke-free home interventions to reduce hospital admissions and DALYs for asthma and OM

Social inequalities in exposure to secondhand smoke in households with children under 12 in Spain

Background: Children are particularly vulnerable to the effects of secondhand smoke (SHS), mainly due to presenting a respiratory and immune systems in development and a faster respiratory rate. The objective of this study is to describe the potential social inequalities in SHS exposure in households with children under 12 in Spain. Methods: Cross-sectional study in a representative sample of population under 12 years of age in Spain. The sample size was 2,411 individuals, being proportional by regions, size of municipality of residence, sex and age groups. A telephone survey was administered to parents or legal tutors in 2016. It included sociodemographic variables and variables related to SHS exposure at home. A descriptive bivariate analysis of the main SHS exposure variables according to educational level and social class (based on occupation) was carried out. Results: 25.8% of children are exposed to SHS at home (smoking reported either inside or on balconies or terraces). An exposure gradient is observed according to the level of studies of the household's main earner, being the prevalence of exposure higher as the educational level decreases (37.9% in primary studies or lower, 27.8% in secondary studies and 20% in university studies, p < 0.05). This reverse gradient is maintained by social class (31.1% in class V-VII (most deprived), 23.4% in class III-IV and 21.7% in class I-II (most affluent), p < 0.05). There are no significant differences according to the sex of the child. Conclusions: In Spain, one out of every four children is exposed to SHS at home. This exposure presents a clear socioeconomic gradient, being children living in more deprived families at higher risk of SHS exposure. Interventions aiming to reduce SHS exposure in children, with a perspective of equity, are urgently needed

Conflicts of interest in research on electronic cigarettes: a cross-sectional study

Introduction The tobacco control community has raised some concerns about whether studies on electronic cigarettes (e-cigarettes) published in scientific journals hide any conflicts of interest (COIs) and whether such reports are biased. This study assessed potential COIs in the e-cigarette scientific literature. Methods We analysed all e-cigarette publications indexed in PubMed up to August 2014. We extracted information about the authors (affiliations, location, etc.), publication characteristics (type, topic, subject, etc.), results and conclusions, the presence of a COI statement (yes/no), and funding by and/or financial ties to pharmaceutical, tobacco, and/or e-cigarette companies. An algorithm to determine the COI disclosure status was created based on the information in the publication. Prevalence ratios (PRs) were calculated to identify associations with COI disclosure, controlling for several independent variables. Results Of the 404 publications included in the analysis, 37.1% (n=150) had no COI disclosure statement, 13.4% had declared potential COIs with pharmaceutical companies, 3.0% with tobacco companies, and 10.6% with e-cigarette companies. The conclusions in publications with COIs, which were mainly ties to pharmaceutical companies, were more likely to be favourable to e-cigarettes (PR=2.23; 95%CI:1.43–3.46). Publications that supported the use of e-cigarettes for harm reduction (PR=1.81; 95%CI:1.14–2.89) or as a tool for smoking cessation (PR=2.02; 95%CI:1.26–3.23) were more likely to have conclusions that were favourable to e-cigarettes. Conclusions One-third of the publications reporting studies on e-cigarettes did not have a COI disclosure statement, and this proportion was even higher in news articles, editorials, and other types of publications. Papers with conclusions that were favourable to e-cigarettes were more likely to have COIs. Journal editors and reviewers should consider evaluating publications, including the funding sources, to determine whether the results and conclusions may be biased and to determine whether there are any relationships with PTEC_COs. Funding The group and this study is partially funded by the Spanish Society of Epidemiology

Conflicts Of Interest In Research On Electronic Cigarettes

INTRODUCTION The tobacco control community has raised some concerns about whether studies on electronic cigarettes (e-cigarettes) published in scientific journals hide conflicts of interest (COI) and whether such reports are biased. This study assessed potential COI in the e-cigarette scientific literature. METHODS Cross-sectional study was conducted on e-cigarette publications indexed in PubMed up to August 2014. We extracted information about the authors (affiliations, location, etc.), publication characteristics (type, topic, subject, etc.), results and conclusions, presence of a COI statement, and funding by and/or financial ties to pharmaceutical, tobacco, and/or e-cigarette companies. An algorithm to determine the COI disclosure status was created based on the information in the publication. Prevalence ratios (PRs) and confidence intervals (CIs) were calculated to identify associations with COI disclosure, controlling for several independent variables. RESULTS Of the 404 publications included in the analysis, 37.1% (n=150) had no COI disclosure statement, 38.6% declared no COI, 13.4% declared potential COI with pharmaceutical companies, 3.0% with tobacco companies, and 10.6% with e-cigarette companies. The conclusions in publications with COI, which were mainly tied to pharmaceutical companies, were more likely to be favourable to e-cigarette use (PR=2.23; 95% CI: 1.43-3.46). Publications that supported the use of e-cigarettes for both harm reduction (PR= 1.81; 95% CI: 1.14-2.89) and smoking cessation (PR= 2.02; 95% CI: 1.26-3.23) were more likely to have conclusions that were favourable to e-cigarettes. CONCLUSIONS One-third of the publications reporting studies on e-cigarettes did not have a COI disclosure statement, and this proportion was even higher in news articles, editorials and other types of publications. Papers with conclusions that were favourable to e-cigarette use were more likely to have COI. Journal editors and reviewers should consider evaluating publications, including funding sources, to determine whether the results and conclusions may be biased