Prevalence and determinants of current and secondhand smoking in Greece: results from the Global Adult Tobacco Survey (GATS) study

Abstract

ObjectivesGreece is one of the leading tobacco-producing countries in European Union, and every year over 19 000 Greeks die from tobacco-attributable diseases. The aim of the present study was to provide nationally representative estimates on current and secondhand smoking prevalence in Greece and their determinants.DesignCross-sectional.SettingGreece.ParticipantsA total of 4359 individuals participated in the Global Adult Tobacco Survey (GATS), a household survey of adults ≥15 years old (overall response rate 69%). They were selected through a multistage geographically clustered sampling design with face-to-face interview.Primary and secondary outcome measuresIn 2013, we investigated the prevalence of current and secondhand smoking and their determinants. Univariate and logistic regression analysis was used in order to identify possible risk factors associated with the prevalence of current and secondhand smoking.ResultsThe prevalence of current smoking was 38.2% (95% CI 35.7% to 40.8%), and the mean number of cigarettes smoked per day was 19.8. Multivariate analysis confirmed that male gender (OR=3.24; 95% CI 2.62 to 4.00), age groups (25–39, OR=4.49; 95% CI 3.09 to 8.46 and 40–54, OR=3.51; 95% CI 1.88 to 5.87) and high school education (OR=1.97; 95% CI 1.41 to 2.74) were independently associated with the current smoking. Remarkably, responders with primary or less education had the lowest prevalence of current smoking (p<0.001). The prevalence of exposure to secondhand smoke at work, home and restaurants, was 52.3%, 65.7% and 72.2%. In total, 90.0% (95% CI 87.8% to 91.9%) of Greek population is exposed to tobacco smoke (current smoking and secondhand smoke).ConclusionsOur results revealed an extremely high prevalence of current smoking and exposure to secondhand smoke among the adult population and a positive gradient between education and current smoking. These findings are alarming and implementation of comprehensive tobacco control and prevention strategies could be impactful in fighting the tobacco epidemic in Greece.

Impact of the financial crisis on COPD burden: Greece as a case study

“…Specifically, the prevalence of smoking was quite low among the population aged ⩾65 years before the crisis and this has not changed in recent years [1]. Furthermore, according to a study conducted in the midst of the crisis, the prevalence of current smoking was found to increase with higher levels of education, especially in women, which is in contrast to the patterns of smoking in the West [67,71]. It is well known that in the western social context smoking is more prevalent among individuals with lower education [67,71].…”

“…However, Greece is a leading tobacco-producing country in the context of the EU. It had the highest rate of tobacco consumption in the EU in 2010 [66,67], at 2458 cigarettes per capita [67]. In subsequent nationwide studies the prevalence of smoking was estimated to be 42.6%, 41%, 38.1% and 38.2% in 2008, 2010, 2011 and 2013, respectively [46,67,68].…”

“…Similarly, according to estimates of the European Commission for 2015, approximately three-quarters of daily Greek smokers revealed high smoking frequency (>15 cigarettes per day), while 24.8% of daily Greek smokers reported smoking ⩾25 cigarettes per day [48,67]. A recently published study has estimated that the prevalence of current smoking in Greece among women (25.7%) is by far the highest among all European countries [67,69] and considerably higher among the youngest age groups [67,70]. Specifically, the prevalence of smoking was quite low among the population aged ⩾65 years before the crisis and this has not changed in recent years [1].…”

“…In subsequent nationwide studies the prevalence of smoking was estimated to be 42.6%, 41%, 38.1% and 38.2% in 2008, 2010, 2011 and 2013, respectively [46,67,68]. Similarly, according to estimates of the European Commission for 2015, approximately three-quarters of daily Greek smokers revealed high smoking frequency (>15 cigarettes per day), while 24.8% of daily Greek smokers reported smoking ⩾25 cigarettes per day [48,67]. A recently published study has estimated that the prevalence of current smoking in Greece among women (25.7%) is by far the highest among all European countries [67,69] and considerably higher among the youngest age groups [67,70].…”

“…It had the highest rate of tobacco consumption in the EU in 2010 [66,67], at 2458 cigarettes per capita [67]. In subsequent nationwide studies the prevalence of smoking was estimated to be 42.6%, 41%, 38.1% and 38.2% in 2008, 2010, 2011 and 2013, respectively [46,67,68]. Similarly, according to estimates of the European Commission for 2015, approximately three-quarters of daily Greek smokers revealed high smoking frequency (>15 cigarettes per day), while 24.8% of daily Greek smokers reported smoking ⩾25 cigarettes per day [48,67].…”