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Introduction: Lung cancer accounts for nearly 2 million deaths per year worldwide, the majority of cases due to smoking as the main risk factor associated. The aim of this study was to assess the relation between the level of implementation of tobacco control policies and the population at high risk of lung cancer in the European Union (EU)., Methods: The Special Eurobarometer 458 "Attitudes of Europeans towards tobacco and electronic cigarettes", conducted in 2017, and the Tobacco Control Scale (TCS) 2010, 2013, and 2016 were the sources of our data. High risk of lung cancer was defined by the inclusion criteria in the National Lung Screening Trial (NLST) and the Dutch-Belgian Lung Cancer Screening Trial (NELSON), the largest lung cancer screening trials carried out in the US and the EU. We calculated Spearman's rank correlation coefficients (r sp ) and fitted multilevel generalized linear mixed models using the quasi-Poisson family to assess the correlation at the national level and analyze the association at the individual level, respectively, between the scores in the TCS (higher scores means better implementation of tobacco control policies) and the proportion of individuals at high risk of lung cancer in member states of the EU., Results: The scores in the TCS 2010 were statistically negatively correlated with the current proportion of ever and former smokers at high risk according to NELSON criteria (-0.41; 95%CI -0.68, -0.04 and -0.49; 95%CI -0.73, -0.13, respectively). We observed statistically significant inverse associations between the scores in the TCS 2010 for the highest quartiles and the proportion of individuals at high risk of lung cancer according to both criteria. Non-statistically significant negative correlations and inverse associations were observed with other TCS., Conclusion: There is a lag between the implementation of tobacco control policies and the reduction of the rates of high risk of lung cancer. Member states should reinforce comprehensive tobacco control policies to reduce the population at high risk of lung cancer in the EU., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: To know the support of tobacco regulation is a very important issue to advance in the tobacco control policies and reduce the passive exposure to tobacco. The aim of this study was to describe the attitudes towards forbidding smoking in private vehicles and public outdoor spaces., Methods: This is a cross-sectional study of a representative sample (n=736) of the adult population (24+ years old) from Barcelona, Spain in 2013-2014. We calculated the percentages of individuals who had a favourable attitude towards smoking regulation in private vehicles and public outdoor spaces, their adjusted Odds ratios (aOR) and their 95% confidence intervals (95%CI) according to sex, age, educational level and smoking status through logistic regression. We used weighted data for all analyses in order to keep the representativeness of the population of Barcelona in 2013-2014., Results: 61.7% of participants supported forbidding smoking in private vehicles and 89.5% supported forbidding it only in the presence of minors. The support to smoking regulation in public outdoor spaces varied from 42.5% to 84.7% in different settings. Smokers showed a less favourable attitude towards an extension of the smoking regulation to other settings: outdoor areas of university centres, outdoor areas of shopping centres and beaches and outdoor pools., Conclusions: A wide support exists to extend the smoking regulation to private vehicles, especially in the presence of children, and public outdoor spaces. This wide support could favour the extension of smoking regulation to these places to improve the population's health and to contribute to denormalise tobacco use among the population.

Background: In Spain, two smoke-free laws have been passed after the approval of the WHO-FCTC. This study assesses the impact of these Spanish smoking legislations on the active and passive smoking through a population cohort in Barcelona (Spain)., Methods: This is a longitudinal study before and after the implementation of two national smoking bans in Spain in a representative sample (n=1245) of adults (≥16years old) from Barcelona (Spain) surveyed in 2004-2005 and followed-up in 2013-2014. The final sample analyzed was 736 individuals. Both questionnaires (before and after the two laws) included the same variables about active and passive smoking. We calculated the prevalence and the prevalence ratio (PR, with their 95% confidence intervals, 95% CI) of smoking cigarettes and hand-rolled tobacco and also the prevalence of exposure to secondhand smoke (SHS) at home, work, public transport, leisure time and at any setting after vs. before Spanish legislations., Results: After the implementation of the two Spanish smoke-free bans, a significant decrease was observed in the smoking prevalence (from 34.5% to 26.1%, PR=0.76, p<0.001), in the average cigarettes per day (median from 15.2 to 10.0, p<0.001), and in the percentage of conventional tobacco consumption (from 92.6% to 74.4%, PR=0.80, p<0.001). Furthermore, a significant increase in the use of hand-rolled tobacco (from 6.1% to 30.9%, PR=5.07, p<0.001) and other tobacco products (from 17.1% to 32.8%, PR=1.92, p<0.001) was observed. In addition, a significant decrease in the self-reported SHS exposure was observed in all the assessed settings (home, work, transport, and leisure time)., Conclusions: The implementation of the two smoke-free legislations in Spain is related to a reduction in smoking prevalence and SHS exposure. However, the smoking of other tobacco products, particularly hand-rolled tobacco, has increased among young population., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

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Objectives The aim of this study was to describe the smoking prevalence, the smoking pattern, and the risk of lung cancer among women who participated in a cancer screening (breast, cervical and colorectal) in Spain. Methods We used data from the Spanish National Health Survey of 2011–12, a cross-sectional study of the adult Spanish population from women in the age of participation in the population cancer screening. We used two definitions of the high risk of lung cancer according to the National Lung Screening Trial (NLST) criteria and the NELSON criteria. Results Participation in screening was 76.6% in breast cancer, 6.6% in colorectal cancer, and 70.3% in cervical cancer. The percentage of current smokers was 17.1 of women who participated breast cancer, 15.4 of women who participated colorectal cancer, and 26.1 of women who participated cervical cancer. According to NLST criteria, the percentage of current smokers women who had a high risk of lung cancer was 23.1 for breast cancer, 23.5 for colorectal cancer and 4.5 for cervical cancer. These figures were higher with the NELSON criteria. Conclusion At least 250 000 women in Spain have a high risk of lung cancer and are participating in a cancer screening programme. These programmes might be an opportunity for implementing specific interventions aiming to reduce this risk. [ABSTRACT FROM AUTHOR]

The objective of this work is to describe the acceptability of some tobacco products regulations and to explore their relation with tobacco control legislation levels in Europe. We used data on tobacco control activities in Europe in 2007, 2010 and 2013 measured by the Tobacco Control Scale (TCS) and data regarding attitudes about tobacco control regulations (i.e. adding picture health warnings on all packages of tobacco products or increasing taxes on tobacco products) from the Special Eurobarometer of 2009, 2012 and 2014 (n = 80,831). We calculated the prevalence ratio of favorable attitudes towards tobacco products restrictions in the reference year 2009 vs. the most current year (i.e. 2009 vs 2014), and the effect of previous TCS scores on the attitudes towards tobacco products regulations adjusted for sociodemographic variables. Strong support for the studied tobacco products regulations, which modestly increased over time, was observed. A positive relation was generally observed between TCS scores and support for the studied tobacco products regulations at both the ecological and individual level. A positive correlation was found between TCS scores and support for increasing taxes on tobacco products (rsp:0.29; 95%CI: 0.10, 0.48) at the ecological level, while at the individual level, the positive association was more remarkable in the case of support for adding large health warning labels to packaging. In conclusion, support for the studied tobacco products regulations were positively related with European tobacco control levels of implementation both at the ecological and individual level. [ABSTRACT FROM AUTHOR]

To compare tobacco-specific nitrosamines (TSNAs) measured in saliva according to different types of tobacco smoked in a sample of smokers of the city of Barcelona (Spain). We used data from a cross-sectional study of a sample of the adult smoking population of Barcelona, Spain in 2013–2014 (n = 165). We classified smokers in five groups according to the type of tobacco smoked: a) manufactured cigarettes only, b) roll-your-own (RYO) cigarettes only, c) dual smokers (both manufactured and RYO cigarettes), d) manufactured plus other types of tobacco products different from RYO and e) other types of tobacco products different from manufactured and RYO cigarettes. We calculated the geometric mean (GM) and geometric standard deviation (GSD) of TSNAs concentration in saliva (pg/mL), including N'-nitroaonornicotine (NNN), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) according to the five tobacco groups. We also described all TSNAs concentration in each tobacco group stratified by the number of cigarettes smoked per day. Smokers from the RYO cigarette group had higher TSNAs concentration than smokers from the manufactured cigarette group: 13 pg/mL vs 4.9 pg/mL of NNN, 1.9 pg/mL vs 1.7 pg/mL in NNK and 1.1 pg/mL vs 0.9 pg/mL of NNAL. There were significant differences in NNN concentrations between smokers of RYO vs manufactured cigarettes. The higher the number of cigarettes smoked, the higher the TSNAs concentrations. After adjusted by number of cigarettes smoked, there were not statistically significant differences in TSNAs between RYO and manufactured cigarettes. Our data shows that RYO cigarette is at least as hazardous as manufactured cigarettes. Regulating RYO tobacco prices could be an effective strategy to control tobacco use. • We compare TSNAs in saliva according to type of tobacco. • TSNAs concentrations increase with the number of cigarettes smoked. • RYO cigarette smokers have higher TSNAs than manufactured cigarette smokers. • Increase RYO cigarette's price should be done in order to be more strictly regulated. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to assess the impact of the Spanish tobacco control legislation on smoking behavior and salivary cotinine concentration among smokers.Methods: We used data from a longitudinal study, before (2004-2005) and after (2013-2014) the implementation of the two national smoking bans (in 2006 and 2011), in a representative sample of adults (≥16 years old) from Barcelona (Spain). We only analyzed a subsample of continuing smokers (n = 116). We conducted a survey on smoking behavior and obtained saliva sample for cotinine analyses. For this report, we analyzed a subsample of continuing smokers (n = 116). We calculated geometric means (GM).Results: Among continuing smokers, salivary cotinine concentration significantly increased by 28.7% (GM from 91.7 ng/ml to 117.3 ng/ml, p = 0.015) after the implementation of the two Spanish smoke-free bans. Nonetheless, no pattern of change was observed in the self-reported number of cigarettes smoked daily.Conclusions: Our study shows a significant increase in the salivary cotinine concentration among adult continuing smokers after both Spanish legislations. This increase could be due to differences in smoking topography (increase in the depth of inhalation when smoking) along with changes in the type of tobacco smoked (increase in smoking roll-your-own cigarettes or mixed use of roll-your-own and manufactured cigarettes). Our results suggest the need to extend tobacco control policies, focusing on the reduction of use of any type of tobacco product and implementing better treatment to help smokers stop smoking. [ABSTRACT FROM AUTHOR]

Objective To describe the voluntary adoption of smoke-free homes and social attitudes in Spain towards banning smoking in vehicles in which children are present. Methods Cross-sectional study of a representative sample of the adult Spanish population age range, 18–75 years (n=1036). The field work was conducted via a computer-assisted telephone survey in March and April 2016. Survey respondents answered questions about smoking rules at home and attitudes towards a smoking ban in cars with or without children. Home smoking rules were defined as complete (smoking not allowed anywhere in the house), partial (smoking allowed in some areas inside the house) or absent (smoking allowed everywhere). Results Most (83.0%) of the surveyed population had some type of smoking restriction in place at home (45.6% complete and 37.5% partial). There were significant differences between groups according to age group (the highest prevalence was 86.1% from 66 to 75 years and the lowest prevalence was 77.8% from 46 to 65 years) and smoking status (the highest prevalence was 89.4% in people who had never been smokers and the lowest prevalence was 75.0% in current smokers) with regards to the prevalence of smoke-free homes (p<0.05), with partial bans more prevalent in smoking households (49.0%). Most (61.6%) of the population favored banning smoking in cars, and 90.1% supported a ban in cars carrying minors. Attitudes towards smoking regulation in cars (with or without children) varied significantly by age group (the highest prevalence was 81.9% from 66 to 75 years and the lowest prevalence was 54.5% from 18 to 45 years) and smoking status (the highest prevalence was 71.4% in people who had never been smokers and the lowest prevalence was 46.0% in current smokers). However, no significant differences were found with regard to attitudes towards smoking regulation in cars carrying children, regardless of sex, age, social class, or smoking status. Conclusion Approximately half of the adult population in Spain have implemented a complete smoke-free rule at home. More than 9 out of 10 adults favor regulating smoking in cars in the presence of minors. These findings support the expansion of smoke-free regulations to include private vehicles, particularly when minors are in the car. [ABSTRACT FROM AUTHOR]