Irish Healthcare Staff - Smoking, Training and Activity in Treatment of Tobacco Dependence - An Online Survey

INTRODUCTION Ireland has strong tobacco control legislation but must get smokers to stop if the national plan of having a smoking prevalence of 5% by the year 2025 is possible. Involving all healthcare staff in this effort is regarded as important. We surveyed the present situation. METHODS An online survey was conducted of 1257 healthcare staff; 520 nurses, 440 doctors, 297 dentists in 2014. The sample was accessed with the help of the Irish Nurses and Midwifes Organisation (INMO), Irish Medical Organisation (IMO) and the Irish Dental Association (IDA). The questionnaire addressed individual smoking habits and attitudes, training and practice with regard to smoking cessation. RESULTS The prevalence in our sample was 8.5%. Nurses had the highest prevalence. Doctors had the highest never smoked rate. Smoking was related to age. Attitudes to treating smoking were positive among all HCP groups. Overall 96.4% of HCPs agreed that they should routinely ask patients about smoking and 94% agreed that they should advise all smokers to quit. 20.7 % of HCPs said they had formal training in smoking cessation and this was correlated to asking or giving advice. 42.9% with training while only 7.6% without training felt well prepared to assist smokers quit (

Does Smoke-free Legislation Work for Teens Too?: a Logistic Regression Analysis of Smoking Prevalence and Gender Among Sixteen Years Old in Ireland Using the 1995-2015 ESPAD School Surveys

Objectives: To assess the role of tobacco control legislation (TCL) in youth smoking in Ireland. To examine the effects of smoke-free legislation in youth. To consider whether TCL contributed to the gender equalisation in prevalence in 16 years old seen between 2003 and 2015. Setting Data are from the 4 yearly European School Survey Project on Alcohol and Other Drugs from 1995 to 2015. Total sample size was 12.394. A logistic regression model on grouped data was used. Dependent variable is whether a student was a smoker in last 30 days. Independent variables are time, gender and the policy indicators, workplace ban on smoking, point-of-sale (POS) display ban, the introduction of graphical images on packs and the average real price of cigarettes. Results Smoking prevalence dropped from 41% in 1995 to 13% in 2015. The effects of policies differed between boys and girls. For girls, estimates for workplace bans, graphical images on packs and a unit real (Consumer Price Index adjusted) price increase reduced prevalence by 7.31% (95%CI 2.94% to 11.68%), 8.80% (95% CI 2.60% to 15.01%) and 5.87 (95% CI 2.96 to 8.79), respectively. The POS ban did not have a significant effect in girls. For boys, estimates for workplace bans and a unit real price increase, reduced prevalence by 8.41% (95% CI 5.16% to 11.66%) and 4.93% (95% CI 0.77% to 9.08%), respectively, POS gave an increase of 7.02% (95% CI 1.96% to 12.40%). The introduction of graphical images had an insignificant effect. Conclusions TC legislation helps to explain the outof-trend reduction in youth smoking prevalence. The estimated differential effects of the workplace ban, POS displays, real price changes and graphical images on packs help to explain the sharper decline in girls than boys. These findings should remind policy-makers to give increased consideration to the possible effects on young people of any legislative changes aimed at adults in TCL

Allen Carr’s Easyway to Stop Smoking - A Randomised Clinical Trial

Objective To determine if Allen Carr’s Easyway to Stop Smoking (AC) was superior to Quit. ie in a randomised clinical trial (RCT). Setting Single centre, open RCT, general populatio

ESPAD 2019 Ireland: Results from the European Schools Project on Alcohol and Other Drugs in Ireland

The ESPAD Ireland 2019 Report is the seventh Irish data-collection wave of the European Schools Project for Alcohol and Other Drugs (ESPAD) carried out in Ireland.Data included in the sample reported here and submitted to ESPAD Europe consists of survey results from 1967 students born in 2003, who were 15-16 years old at the time of the survey which was performed in a sample of Irish schools from March to June 2019. These serial data sets enable us to monitor trends in alcohol, tobacco, gaming, internet usage as well as a number of other behaviors including illicit drug usage such as cannabis. So that now we can examine changes over the past 24 years in a wide number of behaviors.During that time more than a half a million second level European students have answered the ESPAD questionnaire. The first ESPAD report, with data from 1995, included information from 26 countries including Ireland, while the present seventh report scheduled for publication in November 2020 contains results from more than 35 countries. ESPAD is probably the most accessed source of reliable information on young people’s substance use in Europe with participation by countries within and outside the EU

Smoking Cessation Through Optimisation of Clinical Care in Pregnancy: the STOP randomised controlled trial

This is a pragmatic randomised controlled trial of a dedicated smoking cessation clinic versus routine antenatal care as an intervention to reduce cigarette smoking behaviour. Smoking mothers randomised to the Smoking cessation Through Optimisation of clinical care in Pregnancy (STOP) clinic will have all antenatal care provided by a team comprising an obstetrician, a midwife, and a smoking cessation practitioner. This intervention includes ultrasound screening for fetal growth restriction. The control arm comprises two groups: one receiving standard care with ultrasound screening for fetal growth restriction, and one receiving standard care with ultrasound screening for growth restriction only if clinically indicated by their healthcare provider. Four hundred and fifty women will be recruited and randomised to either intervention or control arms stratifying for age, parity, and history of fetal growth restriction

Prevalence of Illicit Tobacco use and Tobacco Tax Avoidance in Pregnancy

Background Smoking during pregnancy is associated with adverse maternal and fetal outcomes. Tobacco tax avoidance and tax evasion undermine the effectiveness of tobacco tax policies, resulting in cheaper prices for smokers and increased tobacco usage. Aims The purpose of this study was to explore the purchasing habits of pregnant smokers with regard to tobacco expenditure anduse of illicit tobacco. Methods Prospective cohort study. Face to face interviews were conducted with 90 attendees (age range 18–42 years; mean age28 years) of a smoking cessation antenatal clinic in a large Irish tertiary level maternity hospital. Information regarding smoking habits, quantity of tobacco smoked, and location of purchase of tobacco was collected in addition to socioeconomic details. Tobacco products were examined to establish whether these were purchased from legitimate sources. Results 76.6% of women smoked 10 or fewer cigarettes per day. The mean weekly spend on tobacco was €39. Seventeen women (18.8%) smoked roll-your-own tobacco. One woman (1.1%) currently possessed a pack of illicit tobacco, while another 5.5% ofparticipants had purchased illicit tobacco in the past. Four women (4.4%) practiced tobacco tax avoidance by purchasing tobacco abroad or in Duty Free.Conclusions Use of illicit tobacco is low and only a minority of women engaged in tobacco tax avoidance. As the average price of tobacco in Ireland increases, weekly expenditure on tobacco products is a significant financial impact on low-income women. Smoking cessation would deliver significant financial gains in addition to health benefit

Smoking characteristics of Polish immigrants in Dublin

<p>Abstract</p> <p>Background</p> <p>This study examined two main hypotheses: a) Polish immigrants' smoking estimates are greater than their Irish counterparts (b) Polish immigrants purchasing cigarettes from Poland smoke "heavier" (≥ 20 cigarettes a day) when compared to those purchasing cigarettes from Ireland. The study also set out to identify significant predictors of 'current' smoking (some days and everyday) among the Polish immigrants.</p> <p>Methods</p> <p>Dublin residents of Polish origin (n = 1,545) completed a previously validated Polish questionnaire in response to an advertisement in a local Polish lifestyle magazine over 5 weekends (July–August, 2007). The Office of Tobacco Control telephone-based monthly survey data were analyzed for the Irish population in Dublin for the same period (n = 484).</p> <p>Results</p> <p>Age-sex adjusted smoking estimates were: 47.6% (95% Confidence Interval [CI]: 47.3%; 48.0%) among the Poles and 27.8% (95% CI: 27.2%; 28.4%) among the general Irish population (p < 0.001). Of the57% of smokers (n = 345/606) who purchased cigarettes solely from Poland and the 33% (n = 198/606) who purchased only from Ireland, 42.6% (n = 147/345) and 41.4% (n = 82/198) were "heavy" smokers, respectively (p = 0.79). Employment (Odds Ratio [OR]: 2.89; 95% CI: 1.25–6.69), lower education (OR: 3.76; 95%CI: 2.46–5.74), and a longer stay in Ireland (>24 months) were significant predictors of current smoking among the Poles. An objective validation of the self-reported smoking history of a randomly selected sub-sample immigrant group, using expired carbon monoxide (CO) measurements, showed a highly significant correlation coefficient (r = 0.64) of expired CO levels with the reported number of cigarettes consumed (p < 0.0001).</p> <p>Conclusion</p> <p>Polish immigrants' smoking estimates are higher than their Irish counterparts, and particularly if employed, with only primary-level education, and are overseas >2 years.</p

Lung function changes in patients with chronic obstructive pulmonary disease (COPD) and asthma exposed to secondhand smoke in outdoor areas

Background Further evidence is needed on the effects that short- and long-term exposure to secondhand smoke (SHS) have on the respiratory health of patients with lung disease. Within the TackSHS project we aimed to assess the acute respiratory effects in lung function that result from short-term SHS exposure among patients with asthma and chronic obstructive pulmonary disease (COPD). Methods The study design was an intervention trial with measurements before/after exposure to SHS in legal outdoor smoking areas. We studied patients with asthma or COPD from Czechia, Ireland, and Spain. Forced spirometry, peak flow and carbon monoxide (CO) measurements were performed pre- and 24 h post- exposure. Results Overall, 60 patients were studied, 30 with asthma, and 30 with COPD; 35 (58.3%) were female. There were no significant differences observed in exhaled CO between pre- and 24 h post-exposure neither in women (p = 0.210), nor in men (p = 0.169). A statistically significant decrease in forced vital capacity (FVC) was seen, overall, in asthma participants (p = 0.02) and in forced expiratory volume in the first second (FEV1), (p = 0.02), FVC (p = 0.04) and peak expiratory flow rate (PEFR) (p = 0.04) in female asthmatic participants. The observed decreases in respiratory measurements in COPD were not significant. There were no reported increases in symptoms, respiratory medication, or use of health services 24 h after the exposure. Conclusion We conclude that acute, short-term SHS exposure had a statistically significant effect on spirometry in female asthma patients but did not significantly modify spirometric indices 24 h later in COPD patients

Secondhand smoke exposure and other signs of tobacco consumption at outdoor entrances of primary schools in 11 European countries

Introduction Although smoking restrictions at child-related settings are progressively being adopted, school outdoor entrances are neglected in most smoke-free policies across Europe. Objectives To describe secondhand smoke (SHS) exposure and tobacco-related signs in outdoor entrances of primary schools in Europe according to area-level socioeconomic status (SES), smoke-free policy, national smoking prevalence, and geographical region. Methods In this cross-sectional study we monitored vapor-phase nicotine concentrations at 220 school outdoor entrances in 11 European countries (March 2017–October 2018). To account for nicotine presence, we used the laboratory's limit of quantification of 0.06 μg/m3 as point threshold. We also recorded the presence of smell of smoke, people smoking, cigarette butts, and ashtrays. Half of the schools were in deprived areas. We grouped countries according to their Tobacco Control Scale (TCS) score, smoking prevalence (2017–2018), and United Nations M49 geographical region. Results There were detectable levels of nicotine in 45.9% of the outdoor entrances, in 29.1% smell of smoke, in 43.2% people smoking, in 75.0% discarded butts, and in 14.6% ashtrays. Median nicotine concentration was below the laboratory's limit of quantificationAdditional co-authors: Vergina K. Vyzikidou, Giuseppe Gorini, Angel López-Nicolás, Joan B. Soriano, Gergana Geshanova, Joseph Osman, Ute Mons, Krzysztof Przewozniak, José Precioso, Ramona Brad, Maria J. López, and the TackSHS project Investigator

Secondhand smoke exposure assessment in outdoor hospitality venues across 11 European countries

Objective Due to partial or poorly enforced restrictions secondhand tobacco smoke (SHS) is still present in outdoor hospitality venues in many European countries. This study aimed to assess SHS concentrations in outdoor hospitality venues across Europe and identify contextual exposure determinants. Methods Cross-sectional study. We measured airborne nicotine and evidence of tobacco use in terraces of bars, cafeterias, and pubs from 11 European countries in 2017-2018. Sites were selected considering area-level socioeconomic indicators and half were visited during nighttime. We noted the smell of smoke, presence of smokers, cigarette butts, ashtrays, and number of physical covers. Contextual determinants included national smoke-free policies for the hospitality sector, the Tobacco Control Scale score (2016), and the national smoking prevalence (2017-2018). We computed medians and interquartile ranges (IQR) of nicotine concentrations and used multivariate analyses to characterize the exposure determinants. Results Nicotine was present in 93.6% of the 220 sites explored. Overall concentrations were 0.85 (IQR:0.30-3.74) μg/m3 and increased during nighttime (1.45 IQR:0.65-4.79 μg/m3), in enclosed venues (2.97 IQR:0.80-5.80 μg/m3), in venues with more than two smokers (2.79 IQR:1.03-6.30 μg/m3), in venues in countries with total indoor smoking bans (1.20 IQR:0.47-4.85 μg/m3), and in venues in countries with higher smoking prevalence (1.32 IQR:0.49-5.34 μg/m3). In multivariate analyses, nicotine concentrations were also positively associated with the observed number of cigarette butts. In venues with more than two smokers, SHS levels did not significantly vary with the venues’ degree of enclosure. Conclusions Our results suggest that current restrictions in outdoor hospitality venues across Europe have a limited protective effect and justify the adoption of total smoking bans in outdoor areas of hospitality venues.Additional co-authors: Vergina K. Vyzikidou, Giuseppe Gorini, Angel López-Nicolás, Joan B. Soriano, Gergana Geshanova, Joseph Osman, Ute Mons, Krzysztof Przewozniak, José Precioso, Ramona Brad, Maria J. López