Smoking Behaviour, Involuntary Smoking, Attitudes towards Smoke-Free Legislations, and Tobacco Control Activities in the European Union

Abstract

BackgroundThe six most important cost-effective policies on tobacco control can be measured by the Tobacco Control Scale (TCS). The objective of our study was to describe the correlation between the TCS and smoking prevalence, self-reported exposure to secondhand smoke (SHS) and attitudes towards smoking restrictions in the 27 countries of the European Union (EU27).Methods/Principal FindingsEcologic study in the EU27. We used data from the TCS in 2007 and from the Eurobarometer on Tobacco Survey in 2008. We analysed the relations between the TCS and prevalence of smoking, self-reported exposure to SHS (home and work), and attitudes towards smoking bans by means of scatter plots and Spearman rank-correlation coefficients (rsp). Among the EU27, smoking prevalence varied from 22.6% in Slovenia to 42.1% in Greece. Austria was the country with the lowest TCS score (35) and the UK had the highest one (93). The correlation between smoking prevalence and TCS score was negative (rsp = −0.42, p = 0.03) and the correlation between TCS score and support to smoking bans in all workplaces was positive (rsp = 0.47, p = 0.01 in restaurants; rsp = 0.5, p = 0.008 in bars, pubs, and clubs; and rsp = 0.31, p = 0.12 in other indoor workplaces). The correlation between TCS score and self-reported exposure to SHS was negative, but statistically non-significant.Conclusions/SignificanceCountries with a higher score in the TCS have higher support towards smoking bans in all workplaces (including restaurants, bars, pubs and clubs, and other indoor workplaces). TCS scores were strongly, but not statistically, associated with a lower prevalence of smokers and a lower self-reported exposure to SHS.

Lung cancer mortality in European women: Trends and predictions

“…The control of such an epidemic (particularly in some countries of southern Europe) depends on the implementation of anti-tobacco campaigns to promote smoking cessation in middleaged women and to prevent smoking initiation in adolescents and young women [43][44][45]. Among effective tobacco control measures, there are the increase in price or taxation of cigarettes and other tobacco products, the extension of smoking ban to all public and working spaces, the restrictions of advertising for tobacco products, the increase in media campaigns and health warning against tobacco, and a more widespread access to treatments for smoking cessation [46][47][48][49]. The considerable efforts expended in tobacco control strategies in the USA since the 1950s, and the consequent favorable changes in smoking behaviors, have allowed to avoid over 240,000 lung cancer deaths in women in the period 1975-2000 [50].…”

The Social and Cultural Environment

“…"Policy follows prevalence" said Kenneth Warner, an international tobacco control expert (quoted in D. J. Reid, Killoran, McNeill, and Chambers (1992)), and several ecological studies which used the country as a unit of analysis found that European countries with more stringent tobacco policies have fewer smokers-although the association is not very strong (Martinez-Sanchez et al, 2010;Willemsen, Kiselinova, Nagelhout, Joossens, & Knibbe, 2012). The direction of causality is not clear and obviously goes in two directions, as is captured in the flywheel model.…”

Estrategia individual y poblacional en las intervenciones frente a la epidemia del tabaquismo

“…Además, si se aplicara de manera integral las seis medidas de control de tabaquismo propuestas por el Banco Mundial 23 como una estrategia poblacional se esperaría que a medio o largo plazo la distribución poblacional de la concentración de cotinina en saliva (fumadores y no fumadores) se desplazara hacia la izquierda, tal y como se ilustra en la figura 1 (panel C). Los resultados de un estudio ecológico 42 realizado en 27 países de la Unión Europea apoyan la estrategia poblacional, ya que muestra cómo la prevalencia de consumo de tabaco y de la exposición pasiva al HAT en casa y en el trabajo disminuye en los países con un mayor desarrollo e implementación de políticas de control de tabaquismo. Sin embargo, estas medidas poblacionales tienen un menor impacto en términos de tasas de abandono y de reducción del consumo que las estrategias de "alto riesgo", debido a la sensibilización por parte de la población diana.…”