Geo-Epidemiology of Tobacco Smoking in Europe and the impact of Twelve Tobacco Control Measures

Abstract

Abstract:Background: Tobacco use is one of the major causes of premature death worldwide. The purpose of the present study is to examine which of the known evidence-based control measures actually work, and indentify their preventive or risky effects, in order to determine the various risk areas for any daily tobacco use in Europe. This is a cross-sectional geoepidemiological study using secondary database data from the World Health Organization. Methods: Data from 2009 were used for all European countries. Daily smoking of any tobacco product (DSTP) and 12 other factors referring to tobacco control, comprise the main under study parameters. The final sample consisted of subjects from 45 European countries. First, the data management was fulfilled. Then, spatial statistics were performed in Arcmap 10 (GIS). Moran's I and OLS spatial regression model were applied for the detection of spatial correlations and the high risk areas. Results: High spatial heterogeneity was demonstrated through the DSTP distribution. Greece and Austria have the highest rates (38-49%), Bulgaria, Albania, Bosnia Herzegovina, and Russia follow with 30-37%. Three out of the twelve factors examined were found to be random. The rest of them were used in the regression model, highlighting the high risk areas. Greece presented the highest risk (Exp B= 2.9; 95% CI= 2.183-3.326), Bulgaria, Turkey, Serbia and other countries followed (Exp B= 2.7; 95% CI= 1.937-3.013), whereas Finland, Norway and UK proved to be of no present risk (Exp B= 0.76; 95% CI= 0.258-0.936). Conclusions: Geo-epidemiology of tobacco usage monitors the phenomenon's dynamics, effectively. It offers an insight in applying measures, co-examining for the first time, the effects of twelve measures of tobacco control as possible preventive or risk factors.