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The use of cell phones and video games has transformed rapidly in adolescents, posing a challenge for the scientific community. Using qualitative methodology and a socioconstructivist perspective, we identified perceptions and beliefs about the different uses of cell phones and video games and their relationship with the health and wellbeing of the adolescent population of Barcelona. From an analysis of discussion groups among early adolescents (n = 66 students aged 13–14 years, segmented by gender and socioeconomic level of the school neighborhood), information was obtained on (i) digital devices and their uses, (ii) the determinants of the uses of cell phones and video games, and (iii) the relationship between possible problematic uses and health and wellbeing. Responsible and problematic uses were identified. Problematic use was associated with compensation for social deficits and sometimes with dependency on the device. Differences were identified by gender (boys preferred video games and girls’ social networks). The adolescents were aware of the possible negative impacts on their health associated with problematic use of cell phones and video games and highlighted a lack of critical education in digital skills.

Resumen Introduccion La mortalidad atribuible (MA) al consumo de tabaco es un indicador valioso que permite caracterizar la evolucion y el impacto en la salud poblacional de la epidemia tabaquica. El objetivo de este trabajo es estimar la MA al consumo de tabaco en Espana en 2016 en poblacion ≥ 35 anos utilizando la mejor evidencia disponible. Metodos Se aplico un metodo dependiente de las prevalencias de consumo de tabaco basado en el calculo de fracciones atribuidas poblacionales. Las prevalencias de consumo (fumadores-exfumadores-nunca fumadores) proceden de la estimacion combinada de la Encuesta Nacional de Salud-2016 y la Europea-2014; el exceso de riesgo de morir en fumadores y exfumadores del seguimiento de diferentes cohortes; y la mortalidad observada del Instituto Nacional de Estadistica. Se presenta la estimacion global de MA y en funcion del sexo, grupos de edad y grandes grupos de enfermedades (cancer, cardiometabolicas y respiratorias), acompanadas de las fracciones atribuidas poblacionales. Resultados En 2016 se atribuyeron 56.124 muertes al consumo de tabaco, el 84% sucedieron en hombres (47.000) y el 50% en mayores de 74 anos (27.795). El 50% de la MA fue por tumores (28.281), de los cuales el 65% fueron de pulmon. Una de cada cuatro muertes (13.849) ocurrio antes de los 65 anos. Conclusiones Una de cada siete muertes que ocurrieron en Espana en 2016 se atribuyen al consumo de tabaco. Esta estimacion permite objetivar el gran impacto que el consumo de tabaco tiene en la mortalidad, especialmente por cancer de pulmon y enfermedad pulmonar obstructiva cronica.

Smoke-free policies are effective in preventing secondhand smoke (SHS) exposure, but their adoption at home remains largely voluntary. This study aimed to quantify SHS exposure in homes with residents who smoke in Europe according to households’ characteristics, tobacco consumption habits, and national contextual factors. Cross-sectional study (March 2017–September 2018) based on measurements of air nicotine inside 162 homes with residents who smoke from nine European countries. We installed passive samplers for seven consecutive days to monitor nicotine concentrations. Through self-administered questionnaires, we collected sociodemographic information and the number of individuals who smoke, smoking rules, frequency, location, and quantity of tobacco use in households. Country-level factors included the overall score in the Tobacco Control Scale 2016, the smoking prevalence, and self-reported SHS exposure prevalence. Nicotine concentrations were analyzed as continuous and dichotomous variables, categorized based on the limit of quantification of 0.02 μg/m3. Overall, median nicotine concentration was 0.85 μg/m3 (interquartile range (IQR):0.15–4.42), and there was nicotine presence in 93% of homes. Participants reported that smoking was not permitted in approximately 20% of households, 40% had two or more residents who smoked, and in 79% residents had smoked inside during the week of sampling. We found higher nicotine concentrations in homes: with smell of tobacco smoke inside (1.45 μg/m3 IQR: 0.32–6.34), where smoking was allowed (1.60 μg/m3 IQR: 0.68–7.63), with two or more residents who smoked (2.42 μg/m3 IQR: 0.58–11.0), with more than 40 cigarettes smoked (2.92 μg/m3 IQR: 0.97–10.61), and where two or more residents smoked inside (4.02 μg/m3 IQR: 1.58–11.74). Household nicotine concentrations were significantly higher in countries with higher national smoking prevalence and self-reported SHS exposure prevalence (p < 0.05). SHS concentrations in homes with individuals who smoke were approximately twenty times higher in homes that allowed smoking compared to those reporting smoke-free household rules. Evidence-based interventions promoting smoke-free homes should be implemented in combination with strengthening other MPOWER measures. This project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No 681040. The work of SG was partially supported by the Italian League Against Cancer (LILT, Milan). EF is partly supported by Ministry of Universities and Research, Government of Catalonia (2017SGR319) and by the Instituto Carlos III and co-funded by the European Regional Development Fund (FEDER) (INT16/00211 and INT17/00103), Government of Spain.

This study aimed to estimate the number of incident cases and hospital admissions attributable to secondhand smoke (SHS) exposure at home for asthma, otitis media (OM), and lower respiratory infections (LRI) in children in Spain. The burden of respiratory disease caused by SHS exposure was estimated in terms of incident cases and hospitalized cases for asthma, OM, and LRI. Estimates were calculated using the population attributable fraction. The age-specific (0-1 year, 0-4 years, 5-11 years, and 0-11 years) prevalence of SHS exposure in children was estimated through a telephone survey performed in a representative sample of Spanish households with children in 2016. The risk estimates for all diseases were selected from international meta-analyses. The number of hospitalized cases was obtained for each disease from the Hospital Minimum Data Set provided by the Ministry of Health of Spain. Incident cases were obtained from the Global Health Data Exchange. In 2015, SHS exposure caused an estimated total of 136,403 incident cases of the following respiratory diseases: 9058 (8.5%) cases of asthma, 120,248 (8.5%) of OM, and 7097 (13.5%) of LRI in children aged 0–14 years old in Spain. Likewise, SHS exposure caused a total of 3028 hospitalized cases, with 379 (8.5%) for asthma and 167 (8.5%) for OM in children 0–11 years old, and 2482 (11.6%) for LRI in children

Background This study aims to identify sociodemographic characteristics associated with secondhand smoke (SHS) exposure and the adoption of smoking bans in homes with children in Spain Methods We performed, in 2016, a cross-sectional study to a representative sample of Spanish households with children under 12 years old. We administered a telephone survey to the parents asking about smoking patterns at home, children’s SHS exposure and sociodemographic characteristics. Poisson regression models with robust variance were built to assess sociodemographic characteristics associated with household SHS exposure and the adoption of smoking rules. Results In this study participated 2411 families, 25.8% of which reported exposure at home and 84.4% implemented smoking bans. SHS exposure was associated with having one (aPR = 2.09; 95% CI: 1.43–3.04) or two Spanish parents (aPR = 1.71; 95% CI: 1.24–2.36), lower educational attainment (primary: aPR = 1.74; 95% CI: 1.45–2.10; secondary: aPR = 1.37; 95% CI: 1.17–1.60 compared with university studies), a family structure different from two-parent family (aPR = 1.38; 95% CI: 1.14–1.67) and parents between 31 and 40 years (aPR = 0.75; 95% CI: 0.57–0.99) and 41–50 years (aPR = 0.62; 95% CI: 0.47–0.81) compared with 18- to 30-year-old parents. The adoption of smoking bans was associated with two-parent family (aPR = 1.09; 95% CI: 1.01–1.17), living with non-smokers (aPR = 1.46; 95% CI: 1.31–1.62), parents of foreign origin (aPR = 1.09; 95% CI: 1.04–1.14) and younger children (0–3 years: aPR = 1.05; 95% CI: 1.01–1.09) compared with the oldest children (8–11 years). Conclusion The parent’s origin and the family structure were associated with SHS exposure and the adoption of smoking bans at home. Moreover, the number of smokers living at home was relevant for the adoption of smoking bans, and the educational attainment for SHS exposure. These factors should be taken into consideration when designing or implementing smoke-free home programmes.

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., Highlights • 94% of the outdoor premises had nicotine and in 92% there were people smoking. • All outdoor hospitality terraces where smoking was not allowed had smokers. • When >2 smokers were present, SHS levels did not vary with the venue's enclosure. • SHS exposure increased at night and in countries with higher smoking prevalence. • Our data indicate the need for total smoking bans in outdoor hospitality venues.

The design of e-cigarettes (e-cigs) is constantly evolving and the latest models can aerosolize using high-power sub-ohm resistance and hence may produce specific particle concentrations. The aim of this study was to evaluate the aerosol characteristics generated by two different types of electronic cigarette in real-world conditions, such as a sitting room or a small office, in number of particles (particles/cm

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER) Altres ajuts: Italian League Against Cancer (LILT) Introduction: Secondhand smoke (SHS) causes morbidity and mortality among non-smokers. Objectives: To investigate SHS presence in outdoor areas from 12 European countries and its association with country-level characteristics. Methods: Cross-sectional study performed in 2017-2018 within the TackSHS project. We conducted a face-to-face survey on a representative sample of the population aged 15 years and older from 12 European countries: Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania, and Spain. Out of 11,902 participants, 8,562 were non-smokers. SHS presence was assessed in selected outdoor areas and defined as respondents viewing someone smoking the last time they visited each setting within the last 6 months. A ranking score for outdoor SHS presence was assigned to each country based on the SHS presence in each setting. We used Spearman's correlation (r) and the Chi-squared tests to assess the relationship between SHS presence and country-level characteristics. Results: Except for children's playgrounds (39.5%; 95% confidence interval, CI: 37.6%-41.3%), more than half of non-smokers reported SHS presence in outdoor areas: schools (52.0%; 95%CI: 50.2%-53.7%), stadia (57.4%; 95%CI: 55.4%-59.4%), parks (67.3%; 95%CI: 66.0%-68.5%), hospitals (67.3%; 95%CI: 65.8%-68.7%), public transport stops (69.9%; 95%CI: 68.6%-71.2%), bar/restaurant terraces (71.4%; 95%CI: 70.2%-72.6%), and beaches (72.8%; 95%CI: 71.4%-74.1%). Residents in Latvia showed the highest overall outdoor SHS presence rank, followed by Greece, and Portugal. Outdoor SHS presence was directly correlated to the country's smoking prevalence (r = 0.64), and inversely correlated to the Tobacco Control Scale 2016 overall score (r = −0.62), the socio-demographic index 2017 (r = −0.56), and Gross Domestic Product per capita 2018 (r = −0.47) (p < 0.001). Conclusions: SHS presence is high in most outdoor areas in Europe, especially in countries with higher smoking prevalence and lower tobacco control performance. To address outdoor SHS exposure, our findings require considering smoking bans along with other strategies to reduce smoking prevalence.

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER) Altres ajuts: Italian League Against Cancer (LILT) Introduction: Tobacco presence in outdoor children's playgrounds is concerning not only because it leads to secondhand smoke (SHS) exposure, but also cigarette butt pollution and tobacco normalization. Objectives: This study aimed to assess SHS exposure in children's playgrounds, according to area-level socioeconomic status (SES), smoke-free regulations, national smoking prevalence, and SHS exposure prevalence in playgrounds (2017-2018). Methods: We monitored vapor-phase nicotine concentration and tobacco-related variables in 20 different playgrounds in 11 European countries (n = 220 measurements) from March 2017 to April 2018. Playgrounds were selected according to area-level SES. Data on the number of people smoking, and cigarette butts inside the playground and on playground surroundings (

To analyze the patterns of alcohol and cannabis consumption, and their associated factors, in young people aged 16 and 21 in a context of vulnerability.Cross-sectional study based on a pre-test questionnaire from an evaluation study, administered to a convenience sample of 365 young people from Social Guarantee Programs (SGP), or who attended activities of community entities from disadvantaged neighborhoods in Barcelona. Dependent variables were experimental, regular, and problematic alcohol and cannabis consumption, while independent variables were impulsivity, sensation seeking, expectations, and beliefs regarding drug use, social skills, and contextual variables. Associations were established using multivariate logistic regression models.The prevalence of intensive alcohol consumption (24.2% for binge drinking and 33.3% for binge drinking) and experimental (51.1%) and problematic cannabis use (12.9%) was higher in SGP students than entity youth. Likewise, they presented higher scores on the impulsivity scales, sensation seeking, expectations and beliefs favorable to alcohol consumption. In general, the prevalence of experimental alcohol consumption was higher in girls than in boys. Regular binge drinking was associated with intense sensations seeking (adjusted odds ratio [aOR]: 1.06; 95% confidence interval [95%CI]: 1.01-1.12), while attending SGP was associated with problematic cannabis use (aOR: 2.73; 95%CI: 1.26-5.89). Positive expectations to alcohol and cannabis use were associated with problematic substance use.Individual risk, linked to the higher risk trajectories of SGP students, is associated with a higher problematic consumption of alcohol and cannabis than in young people from community entities exposed to an environmental risk of high frequency of consumption.

Introduction: breast cancer is the most common cancer in women and its relationship with dietary factors particularly dairy products, has been investigated trough several studies but up to now there are still not enough results to confirm the association between breast cancer and dairy products. Objective: the purpose of this systematic review was to expand the number of systematic reviews that to date exist on the relationship between dairy products consumption and risk of breast cancer. A comprehensive search of the PubMed, Scopus and Embase was performed from September 2005 to September 2018 in which one case control and cohorts' studies were included. Results: Eighteen studies were finally selected for the review (10 case-control and 8 cohorts' studies). These studies reported several statistically significant associations (OR, HR, RR) between dairy product consumption and the risk of breast cancer. Seven case-control and four cohorts' studies showed that dairy product consumption was inversely associated with the risk of breast cancer, on the other hand, a positive association was found in two case-control and non- significant association was found between dairy product consumption and the risk of breast cancer in the remaining studies (one case-control and four cohorts' studies) Conclusion: Although an inverse association was observed in most studies, it's difficult to draw conclusions when the methodology methods to collect the dairy product intake and the servings or portions measurements were different in each study. On the other hand, not all studies used the same confounding variable to estimate risk.Introducción: el cáncer de mama es de los más comunes en mujeres, y su relación con los factores dietéticos y, en particular, con los productos lácteos, ha sido investigada a través de varios estudios, pero hasta ahora no hay resultados suficientes que confirmen la asociación entre cáncer de mama y productos lácteos. Objetivo: ampliar y actualizar el número de revisiones sistemáticas que hasta día de hoy existen sobre la relación entre el consumo de productos lácteos y el cáncer de mama. Metodología: se realizó una búsqueda exhaustiva en las bases de datos PubMed, Scopus y Embase entre septiembre de 2005 y septiembre de 2018 en la que se incluyeron estudios de casos y controles y estudios de cohortes. Resultados: se seleccionaron 18 estudios (10 estudios de casos-controles y 8 estudios de cohorte). Siete casos-controles y cuatro estudios de cohorte mostraron que el consumo de productos lácteos tenía una asociación inversa con el riesgo de cáncer de mama y, por otro lado, en dos estudios de casos-controles se observó una asociación positiva. No se encontró una asociación significativa entre el consumo de productos lácteos y el cáncer de mama en los restantes estudios (1 caso-control y 4 cohortes). Conclusión: aunque se observó una asociación inversa en la mayoría de los estudios, es difícil sacar conclusiones cuando los métodos metodológicos para recolectar la ingesta de lácteos y las porciones o las mediciones de las porciones fueron diferentes en cada estudio. Por otro lado, no todos los estudios tienen en cuenta las mismas variables de confusión.

Objective: To estimate the prevalence of moderate and vigorous physical activity (MVPA), as defined by the World Health Organisation (WHO), and associated factors among teenagers from Barcelona in 2012. Methods: Cross-sectional survey to assess risk factors in a representative sample of secondary school students (aged 13-16 years, International Standard Classification of Education [ISCED]2, n = 2,162; and 17-18 years, ISCED 3, n = 1016) in Barcelona. We estimated MVPA prevalence overall, and for each independent variable and each gender. Poisson regression models with robust variance were fit to examine the factors associated with high-level MVPA, and obtained prevalence ratios (PR) and 95% confidence intervals (95%CI). Results: Only 13% of ISCED 2 and 10% of ISCED 3 students met the WHO physical activity recommendations. This percentage was lower among girls at both academic levels. MVPA was lower among ISCED 3 compared to ISCED 2 students, and among students with a lower socioeconomic status. Physical activity was associated with positive self-perception of the health status (e.g., positive self-perception of health status among ISCED 2 compared to ISCED 3 students: PR = 1.31 [95%CI: 1.22-1.41] and 1.61 [95%CI: 1.44-1.81] for boys and girls, respectively]. Conclusions: The percentage of teenagers who met WHO MVPA recommendations was low. Strategies are needed to increase MVPA levels, particularly in older girls, and students from low socioeconomic backgrounds. (C) 2016 SESPAS. Published by Elsevier Espana, S.L.U.

Resumen: Objetivo: El objetivo principal del estudio es analizar la relación entre la exposición al humo ambiental de tabaco (HAT) en niños/as y el asma, las sibilancias y la salud percibida. Método: Estudio transversal mediante encuesta telefónica a una muestra representativa de 2411 menores de 12 años de España. Se describió la exposición al HAT en el ámbito privado y en el ámbito público, así como la prevalencia de asma, sibilancias y mala salud percibida autodeclaradas. La asociación entre los indicadores de salud y la exposición al HAT se analizó mediante modelos multivariados de regresión de Poisson con variancia robusta según edad y nivel de estudios. Resultados: La prevalencia de exposición al HAT en menores fue del 29,2% en el ámbito privado y del 42,5% en el ámbito público. No se observó asociación entre la exposición al HAT y el asma, las sibilancias y la mala salud percibida en menores de 5 años. En menores de 6-11 años con padres/madres con estudios primarios o secundarios, presentar asma (razón de prevalencia ajustada [RPa]: 2,1; intervalo de confianza del 95% [IC95%]: 1,2-3,8) y una peor salud percibida (RPa: 1,6; IC95%: 1,1-2,1) se asociaron positivamente con la exposición al HAT en el ámbito privado. En menores con progenitores o tutores con estudios universitarios se observó una asociación negativa entre presentar asma (RPa: 0,3; IC95%: 0,1-0,7) y sibilancias (RPa: 0,3; IC95%: 0,1-0,8) y la exposición al HAT. Conclusiones: Existen diferencias en la asociación entre la exposición al HAT y el asma, las sibilancias y una peor salud percibida según el nivel de estudios. Se deberían planificar intervenciones con perspectiva de equidad dirigidas a disminuir la exposición al HAT en la infancia. Abstract: Objective: This study aimed to estimate the association between second-hand smoke (SHS) exposure in children and asthma, wheezing and perceived health. Method: A cross-sectional study based on a telephone survey was performed on a representative sample of 2411 children under 12 years old in Spain. Exposure to SHS in private and public settings, and the prevalence of asthma, wheezing and perceived poor health were described. The association between health indicators and SHS exposure was analyzed using multivariate Poisson regression models with robust variance according to age and educational level. Results: The prevalence of SHS exposure in children was 29.2% in private settings and 42.5% in public settings. There was no association between SHS exposure and asthma, wheezing and perceived poor health in children ≤5 years. In children aged 6-11 years with parents with primary/secondary education, presenting asthma (adjusted prevalence ratio [aPR]: 2.1; 95% confidence interval [95%CI]: 1.2-3.8) and worse perceived health (aPR: 1.6; 95%CI: 1.1-2.1) were positively associated with SHS exposure in private settings. In children with parents with university studies, a negative association between SHS exposure and asthma (aPR: .3; 95%CI: 0.1-0.7) and wheezing (aPR: 0.3; 95%CI: 0.1-0.8) was observed. Conclusions: There are differences in the association between SHS exposure and asthma, wheezing and poor perceived health according to educational level. Interventions with an equity perspective aimed at reducing SHS exposure in childhood should be implemented.

Risky alcohol consumption among adolescents has health and social consequences. Evidence identifying the school context that determines alcohol consumption among rural and urban adolescents is lacking. This study aimed to describe the contextual school and town factors determining risky alcohol consumption among rural and urban 10th-grade adolescents (15-17 years old) from Catalonia (northeastern Spain). The study had a cross-sectional design. Cluster sampling with the class as the sampling unit was used, and a total of 1268 10th-grade adolescents from Catalonia nested in 26 high schools participated in the study. A computerized and self-administrated questionnaire was used to collect individual variables. Contextual variables were collected from the Catalan police registers, geocoded sources, and governmental internet databases, and by aggregation of answers from the self-administrated questionnaire. The prevalence of risky alcohol consumption was calculated, and a multilevel Poisson regression analysis with robust variance was conducted with data from adolescents nested within high schools. The results show that risky alcohol consumption is higher among rural adolescents (59.3%) than among urban youth (51.1%) (p < 0.005). Positive expectancies, drunkenness of siblings and friends, and most of the variables indicating accessibility are associated with risky alcohol consumption at the individual level. At the contextual level, the sports center rate and the high school's percentage of risky student alcohol consumption are strongly associated with individual risky alcohol consumption. The town environment (rural or urban), the unemployment rate, and the number of pubs and nightclubs lost their significance after adjustment by the individual and mediating variables. In conclusion, individual factors, such as the influence of drinking patterns of siblings and friends, and more alcohol access opportunities, are associated with adolescents' risky alcohol consumption. The associated contextual factors are the sports center rate and the percentage of risky classmate alcohol consumers. Interventions targeting adolescents should focus at community and high school levels, trying to reduce adolescents' accessibility to alcohol. (C) 2019 Elsevier Inc. All rights reserved.

espanolObjetivo: evaluar la efectividad de una intervencion de promocion de la salud para personas de edad avanzada, con el objetivo de promover la adopcion de habitos saludables y de mejorar la calidad de vida relacionada con la salud (CVRS), la salud mental y el apoyo social. Metodo: se llevo a cabo un estudio de evaluacion con diseno pre/post, no-experimental. Se trataba de captar a mayores de 65 anos, residentes en la comunidad, de dos barrios de nivel socioeconomico desfavorecido de la ciudad de Barcelona. La intervencion consistio en un taller estructurado en ocho sesiones cuyo objetivo era la adopcion de habitos saludables. Se obtuvo informacion sobre la actividad fisica, CVRS, habitos dieteticos, salud mental y apoyo social a partir de cuestionarios validados (IPAQ, SF-36, PREDIMED, GHQ-12, MOS y NSHAP, respectivamente). Se analizaron diferencias antes y despues de la intervencion mediante los test de McNemar, t de Student y de Wilcoxon para datos apareados segun correspondiese. Resultados: la muestra se compuso de 22 adultos. Tras la intervencion, la mediana de actividad fisica se incremento en 842,5 MET/semana. La CVRS tambien mejoro: las puntuaciones para dimension mental se incrementaron en un 30% y las de la dimension fisica un 22%. No se observaron cambios en la dieta o en la salud mental. Conclusiones: las intervenciones de promocion de la salud, orientadas a personas mayores pueden jugar un papel clave en la mejora de la calidad de vida y el bienestar. EnglishObjective: to assess the efficacy of a health promotion intervention for persons of advanced age, with the objective of promoting the adoption of healthy habits and improving health-related quality of life (HRQoL), mental health, and social support. Methods: an evaluation study was conducted with pre/post, non-experimental design. The objective was to recruit >65-year-old persons living in the community, from two areas in the city of Barcelona with underprivileged socioeconomic levels. The intervention consisted in a workshop structured into eight sessions, with the objective of adopting healthy habits. Information was collected about physical activity, HRQoL, diet habits, mental health, and social support, through validated questionnaires (IPAQ, SF-36, PREDIMED, GHQ-12, MOS and NSHAP, respectively). Any differences before and after the intervention were analyzed through the McNemar, Student’s t and Wilcoxon tests for paired data, as relevant. Results: the sample included 22 adults. After the intervention, there was an increase in the median physical activity of 842.5 MET/week. There was also an improvement in HRQoL: the scores for the mental dimension increased by 30% and the physical dimension by 22%. No changes were observed in diet or mental health. Conclusions: health promotion interventions, oriented to elderly persons, can play a key role in the improvement of QoL and wellbeing.

Smoke-free legislation reduced second-hand smoke (SHS) exposure in public places, and indirectly promoted private smoke-free settings. Nevertheless, a large proportion of adults is still exposed to SHS at home. The aim of this paper is to quantify the burden of disease due to home SHS exposure among adults in the 28-European Union (EU) countries for year 2017. The burdens by gender from lung cancer, chronic obstructive pulmonary disease (COPD), breast cancer, ischemic heart disease (IHD), stroke, asthma, and diabetes were estimated in an original research analysis using the comparative risk assessment method. Relative risks of death/diseases by gender for adults exposed to SHS at home compared to not exposed ones were estimated updating existing meta-analyses. Prevalence of home SHS exposure by gender was estimated using a multiple imputation procedure based on Eurobarometer surveys. Data on mortality and disability adjusted life years (DALYs) were obtained from the Global Burden of Disease, Injuries and Risk Factors Study. In 2017, 526,000 DALYs (0.36% of total DALYs) and 24,000 deaths (0.46% of total deaths) were attributable to home SHS exposure in the 28-EU countries, mainly from COPD and IHD. South-Eastern EU countries showed the highest burden, with proportion of DALYs/deaths attributable to SHS exposure on total higher than 0.50%/0.70%, whereas northern EU-countries showed the lowest burden, with proportions of DALYs/deaths lower than 0.25%/0.34%. The burden from SHS exposure is still significant in EU countries. More could be done to raise awareness of the health risks associated with SHS exposure at home.

Although smoking restrictions at child-related settings are progressively being adopted, school outdoor entrances are neglected in most smoke-free policies across Europe.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.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/mThere 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 quantification0.06 μg/mSmoking at school outdoor entrances is a source of SHS exposure in Europe. These findings support the extension of smoking bans with a clear perimeter to the outdoor entrances of schools.

Introduction Secondhand smoke (SHS) is a widespread health hazard. Smoke-free policies have commonly focused on locations that are more relevant for adults, neglecting SHS exposure at children areas. This study aimed to assess SHS exposure in children playgrounds, according to socioeconomic status (SES). Methods We monitored airborne nicotine concentration and tobacco-related variables in 20 different playgrounds in 11 European countries (N=220 measurements). The fieldwork was carried out between March 2017 and April 2018. Playgrounds were selected according to the SES (half of them belonging to the most deprived neighborhoods and half of them to the least deprived neighborhoods). Vapor-phase nicotine levels were measured using active sampling. Furthermore, self-perceived wind, number of smokers, and butts inside playground and on playground surroundings were collected through a form. Nicotine concentrations were later dichotomized using the limit of detection (LOD) as a cut-off point (0.06 μg/m3). Results Detectable levels of nicotine were found in 40.9% of the playgrounds. Median nicotine concentration was

Our aim was to provide a systematic review of studies on the burden of disease due to second-hand smoke (SHS) exposure, reviewing methods, exposure assessment, diseases causally linked to SHS, health outcomes, and estimates available to date. A literature review of studies on the burden of disease from SHS exposure, available in PubMed and SCOPUS, published 2007–2018 in English language, was carried out following the PRISMA recommendations. Overall, 588 studies were first identified, and 94 were eligible. Seventy-two studies were included in the systematic review. Most of them were based on the comparative risk assessment approach, assessing SHS exposure using mainly surveys on exposure at home/workplaces. Diseases more frequently studied were: lung cancer, ischemic heart disease, stroke, chronic obstructive pulmonary disease, asthma and breast cancer in adults; lower respiratory tract infection, otitis media, asthma, sudden infant death syndrome and low birth weight in children. The SHS exposure assessment and the reported population attributable fractions (PAF) were largely heterogeneous. As an example, the PAF from lung cancer varied between 0.6% and 20.5%. Moreover, PAF were estimated applying relative risks and SHS exposures with no consistent definitions or with different age classes. The research gap on the SHS exposure burden is shrinking. However, estimates are not yet available for a number of countries, particularly the Middle Eastern and African countries, and not all diseases with the strongest evidence of causation, such as sudden infant death syndrome, have been explored. Moreover, in some cases the applied methodology revealed relatively low quality of data. info:eu-repo/semantics/acceptedVersion

While progress has been made to create smoke-free airports, sales of e-cigarettes at airports and airplanes and the presence of advertisements might detract from these smoke-free policies. The objective of this study is to describe the presence of policies, advertising, sales and use of e-cigarettes in airports and on flights in Europe and the US.A cross-sectional study was conducted between March-May, 2014. The study included 21 large and mid-sized airports of Europe and the US as well as 19 flights. A standardised protocol was used to observe points of sales and advertisements and to collect information on the implementation of policies on e-cigarette use. In addition, a series of questions were developed to obtain policy details from airport personnel and flight attendants.Retail outlets selling e-cigarettes in airports were present in approximately 20% and 40% of the observed pre and post-security areas, respectively. In post-security, 27.8% of the airport staff reported that the use of e-cigarettes indoors was not allowed, 22.2% reported that they did not know, 27.8% reported that it was only allowed in the smoking room, and 22.2% reported that it was allowed anywhere. Smoking ban announcements were made on all flights. However, only 15.8% of the flights made a specific announcement regarding the ban of using e-cigarettes. Conclusions. In light of our results, it seems necessary to reinforce in-flight e-cigarette smoking ban announcements and to instruct airport employees about the existence of e-cigarette smoking policies. Furthermore, airports themselves should also be encouraged to adopt smoke-free policies.Antecedentes. Pese a los avances en las políticas libres de humo en los aeropuertos, las ventas de cigarrillos electrónicos en aeropuertos y aviones y la presencia de publicidad pueden suponer un paso atrás en la implementación de dichas políticas. El objetivo de este estudio es describir la presencia de políticas, publicidad, ventas y el uso de cigarrillos electrónicos en aeropuertos y en vuelos de Europa y los EE.UU.Métodos. Estudio transversal realizado entre marzo y mayo del año 2014. El estudio incluyó 21 aeropuertos grandes y medianos de Europa y los EE.UU., así como 19 vuelos. Se utilizó un protocolo estandarizado para observar puntos de venta y publicidad y se recogió información sobre la implementación de políticas sobre el uso de cigarrillos electrónicos. Además, obtuvo información más detallada del personal del aeropuerto y de los asistentes de vuelo sobre las políticas de uso de cigarrillo electrónicos.Resultados. Los puntos de venta de cigarrillos electrónicos en los aeropuertos estaban presentes en aproximadamente el 20% y el 40% de las áreas observadas antes y después del control de seguridad, respectivamente. Después del control, el 27,8% del personal del aeropuerto declaró que no estaba permitido el uso los cigarrillos electrónicos en el interior, el 22,2% declaró que no sabía si se podían usar, el 27,8% declaró que sólo estaba permitido en el área de fumadores y el 22,2% declaró que se podía fumar en cualquier parte. Todos los vuelos anunciaron la prohibición de fumar. Sin embargo, sólo el 15,8% de los vuelos específicamente anunció la prohibición de usar cigarrillos electrónicos.Conclusiones. Nuestros resultados muestran que sería necesario reforzar los avisos de prohibición del uso de cigarrillos electrónicos durante los vuelos y de instruir a los empleados del aeropuerto sobre la existencia de políticas sobre el uso de cigarrillos electrónicos. Además, también se debería promover políticas libres de humo sin excepciones en todos los aeropuertos.

Introduction To estimate the economic impact in the Spanish Healthcare System of secondhand smoking on children in Spain in 2015. Material and Methods The cost has been estimated for primary care, outpatient care and hospital admissions for Spanish population of children (0-14 years old) in 2015. The Population Attributable Fraction (PAF) has been calculated from OR's to children exposed to household smoking and the number of real events has been obtained from the Ministry of Healthcare of Spain. To estimate the cost of primary care consultations, the price by consultation has been calculated as a mean of the public prices published by all the regions of Spain. The prices for each outpatient consultation and hospital admission have been obtained from the Spanish Healthcare System. Results The attributable cost of secondhand smoking in children for the Spanish Healthcare system in 2015 was around 27M€ (27.162.048€): 19.300.383€ due to primary care, 360.360€ was spent providing outpatient care and 7.501.305€ for hospitals admissions. Conclusions The reducible percentage of the total budget of Spanish Healthcare System expended in 2015 due to children were exposed to passive smoking is around 0,041%, calculated in terms of hospital cost, outpatient care and primary care admissions. This amount could totally disappear just adopting better and stronger policies forbidding smoking in front of children. Funding European Union. Tackling secondhand tobacco smoke and e-cigarette emissions: exposure assessment, novel interventions, impact on lung diseases and economic burden in diverse European populations. The TackSHS project

This study aimed to estimate the association between second-hand smoke (SHS) exposure in children and asthma, wheezing and perceived health.A cross-sectional study based on a telephone survey was performed on a representative sample of 2411 children under 12 years old in Spain. Exposure to SHS in private and public settings, and the prevalence of asthma, wheezing and perceived poor health were described. The association between health indicators and SHS exposure was analyzed using multivariate Poisson regression models with robust variance according to age and educational level.The prevalence of SHS exposure in children was 29.2% in private settings and 42.5% in public settings. There was no association between SHS exposure and asthma, wheezing and perceived poor health in children ≤5 years. In children aged 6-11 years with parents with primary/secondary education, presenting asthma (adjusted prevalence ratio [aPR]: 2.1; 95% confidence interval [95%CI]: 1.2-3.8) and worse perceived health (aPR: 1.6; 95%CI: 1.1-2.1) were positively associated with SHS exposure in private settings. In children with parents with university studies, a negative association between SHS exposure and asthma (aPR: .3; 95%CI: 0.1-0.7) and wheezing (aPR: 0.3; 95%CI: 0.1-0.8) was observed.There are differences in the association between SHS exposure and asthma, wheezing and poor perceived health according to educational level. Interventions with an equity perspective aimed at reducing SHS exposure in childhood should be implemented.

Introduction: Children are particularly vulnerable to the health effects of secondhand smoke (SHS). The objectives of this study are to describe SHS exposure of children younger than 12 years in Spain and to identify potential social inequalities associated with SHS exposure. Material and Methods: A cross-sectional study was conducted in a representative sample of the population younger than 12 years in Spain. A computerassisted telephone interview was conducted with parents or legal guardians in 2016, to assess the children’s SHS exposure at home, in the car, at school and at the nursery gates, in public transport, and during leisure time. The socio-demographic variables included were the child’s age and sex, the highest educational attainment at home, and occupational social class. Prevalence and 95% confidence intervals were calculated for SHS exposure in each setting and for overall exposure. Results: In all, 71.8% of the children were exposed to SHS: 25.8% were exposed at home, 4.6% in the car, 8.2% in public transport, 31.9% at outdoor nursery or school gates, and 48% during leisure time. The higher the educational attainment at home, the lower the exposure (38.8% for primary school or lower, 28.7% for secondary school and 20.8% university level). The more deprived the social class, the higher the exposure (21.7% class I-II, 23.4% class III-IV and 31.1% class V-VII). SHS exposure in cars and overall exposure also decreased with higher educational achievement. Conclusions: In Spain, a large proportion of children are still exposed to SHS. Furthermore, there are clear social inequalities. To reduce SHS exposure, there is an urgent need for evidence-based interventions with an equity perspective. This study was funded by the Instituto Carlos III (PN I+D+I 2013–2016) and co-funded by the European Regional Development Fund (FEDER) under grant PI13/02734. The study was also partially funded by the Ministry of Universities and Research of Catalonia (AGAUR) under grant 2014 SGR 1373 SI

The current study examined symptoms of irritation reported by non-smokers passively exposed to e-cigarette aerosols and their timing and association with the concentrations of volatile organic compounds (VOCs) produced.40 healthy non-smoking adults were exposed to e-cigarette aerosols for 30 min in a 35 m20 males and 20 females, with a mean age of 24.6 years (SD = 4.3) and exhaled CO 7 ppm participated. PM concentrations in both experimental sessions were higher than the Control (p 0.001). The most commonly reported symptoms were burning, dryness, sore throat, cough, breathlessness and headache. During both experimental sessions, ocular, nasal, throat-respiratory symptoms and general complaints increased significantly (p 0.05). Ocular and nasal symptoms returned to baseline by tA 30-min exposure to SHA provoked symptoms of sensory irritation and general complaints that lasted up to 30 min after the exposure and were positively associated with the concentrations of the VOC mixture emitted.