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Biomedical subjects

E Saltó

Publications and source records attributed to E Saltó.

18 recordsLinked to original sources

[Smoking cessation in a population-based cohort study].

OBJECTIVE: To study the incidence rates and the determinants of smoking cessation in a population-based cohort. MATERIAL AND METHODS: We used data from the Cornellà Health Interview Survey Follow-up Study. Subjects who declared they were daily smokers at baseline (1994) and had complete follow-up, with information on smoking status in 2002, entered into analysis. We calculated incidence rates and the relative risks of cessation (with 95% confidence intervals) using the Cox model. RESULTS: Out of 353 daily smokers, 100 quit smoking during the follow-up period (cumulative incidence of 28.3%). The incidence rate of cessation was higher among men (42.34 per 1000 person-years) than among women (24.97 per 1000 person-years), with a relative risk of cessation of 1.69 (95% confidence interval, 1.02-2.79) for men. Age and level of education were associated with a higher relative risk of quitting in men. CONCLUSIONS: The main determinants for smoking cessation are sociodemographic (sex, age, and level of education).

Adult↗

East-west differences in reported preventive practices. A comparative study of six European areas of the WHO-CINDI programme.

BACKGROUND: Differences have been reported in life expectancy and mortality between Eastern and Western European countries. Also, disparities have been found among different European countries or populations concerning the implementation of preventive practices by health professionals. This study analysed the patterns of reported preventive practices in three Eastern European areas and three Western ones. METHODS: Health surveys were carried out in particular geographical area of six countries participating in the project (three Eastern European countries; Russia, Poland and Hungary and three Western European countries; Finland, Germany and Spain). All of them are partners in the WHO-CINDI (Countrywide Integration Non-communicable Diseases Intervention) Programme. Three preventive practices are analysed: reported blood pressure and blood cholesterol measurements and reported antismoking counseling during the last year. Data are presented separately for the general population and for people reporting specific chronic conditions (cardiovascular disease, respiratory disease and/or diabetes mellitus). RESULTS: Blood pressure measurement and antismoking counseling are more frequently reported to be carried out by primary health care physicians in the Eastern European areas while blood cholesterol measurement is more frequently reported in Western European countries. All these preventive activities are more frequently reported to be done among people with chronic conditions than in the population as a whole. CONCLUSIONS: Major differences have been found in reported preventive practices between Eastern and Western European countries. Great potential exists for chronic disease prevention among them.

Blood Pressure↗

Age at starting smoking and number of cigarettes smoked in Catalonia, Spain.

BACKGROUND: Few studies have investigated the association between age at starting smoking and the average number of cigarettes smoked per day in adulthood. To provide further evidence on this issue, we analyzed data from the Catalan Health Interview Survey (CHIS). METHODS: The CHIS was conducted in 1994 on a randomly selected sample (N = 15,000) of the population of Catalonia, Spain. A total of 4,897 current or exsmokers (3,276 males and 1,621 females) were included for analysis. Age-standardized proportions of subjects smoking <15, 15-24, and >/=25 cigarettes/day, age-standardized mean number of cigarettes smoked per day, and multivariate odds ratios (OR) of being a heavy smoker (>/=25 cigarettes/day) according to age at starting smoking (<15, 15-17, 18-19, >/=20 years) were computed. RESULTS: Men who started smoking before the age of 15 smoked on average 5.5 cigarettes more than those who started at age 19 or over. Women who started smoking early in life smoked, on average, 6.8 cigarettes/day more than women who started later. The proportion of smokers of <15 cigarettes/day was higher among subjects who started smoking later. Both for males and for females, the OR of being a heavy smoker significantly increased with decreasing age at starting smoking (OR = 2.4 for males and 4.5 for females who started at age <15 versus >/=20 years). The level of education did not modify the relationship in males, whereas the association with age at starting was only apparent for more educated women. CONCLUSIONS: This study confirms that age at starting smoking is inversely and strongly associated to the number of cigarettes smoked per day. Thus, actions aimed at the prevention or delay of smoking onset among adolescents would have an important beneficial effect.

Adolescent↗

[The process of change and sex as predictors of the quitting of tobacco consumption].

BACKGROUND: Combining drug and behavioral therapy has proved useful in helping smokers quit. One of the main predictive factors for relapse is a smoker's level of motivation. This study evaluates results in a cohort of smokers in function of motivation and sex. PATIENTS AND METHODS: This prospective study enrolled 1,045 smokers examined at a specialist unit between September 1993 and September 1997. All patients gave information about smoking history and were classified in one of three levels of motivation. Abstinence was determined by CO exhaled. Twelve months later, we compared the success rates of men and women and of subjects with different levels of motivation. Variables predicting relapse were assessed using logistical regression analysis. RESULTS: Abstinence had been achieved by 24.5% of the 1,045 patients 12 months later, the rate for men being 25% and the rate for women 23.8% (p = 0.1). No smoker in the complacent phase was abstinent at 12 months. The rates were 24.3% and 32.4%, respectively, for smokers in the contemplation and action phases (p < 0.001). Only age and degree of motivation were independently related to failure to quit. CONCLUSIONS: Strategies that combine drug treatment, behavioral therapy and follow-up achieve good rates of success among patients who are motivated to quit smoking.

Adult↗

Management of the hypertensive patient who smokes.

Smoking and arterial hypertension are highly prevalent at the community level. While the coexistence of both risk factors is less frequent, the potentiation of cardiovascular risk when both are present makes the association highly relevant in terms of a preventive approach. There are many interrelationships between smoking and high blood pressure at the clinical, epidemiological and pathophysiological levels. Those demonstrable links compel us to review the usual explanation of the influence of smoking on blood pressure. Pharmacological treatment of the hypertensive patient who smokes must be adapted to the patient's risk profile, using the most efficacious antihypertensive agents. With the exception of nonselective beta-blockers, all the available antihypertensive drugs can be prescribed. Minimal intervention and nicotine replacement constitute the most well tested interventions in helping smokers to quit their habit. Nicotine replacement is currently a well tolerated intervention, even in patients with cardiovascular disease.

Adolescent↗

[Smoking prevalence trends in Catalonia, Spain, 1982-1994].

BACKGROUND: Smoking prevalence trends from 1982 to 1994 of adult population in Catalonia (Spain) are described. SUBJECTS AND METHODS: Four population surveys have been carried out periodically using the same questionnaires and definitions for smoking status. Surveys in 1982, 1986 and 1990 have been implemented taking samples of Catalonia population through a multistage sampling with random stratified selection by province and habitat. Individuals were chosen through a random route process. In 1994, a survey with a complex probabilistic sample design with 8 geographical areas (health regions) and 2 basic units (towns and individuals) was implemented. RESULTS: Among the 15-64 years old adults, a decrease of 6.9% in smoking prevalence has been observed. The initial prevalence in 1982 was 37.9% (CI 95%: 35.4; 40.3); in 1994 this prevalence was 35.3% (CI 95%: 34.4; 36.2). In 1994, the prevalence of current smokers in population over 14 years old was 30.6% (CI 95%: 29.8; 31.4). We have observed a significant decrease in smoking prevalence in all age groups among male population (-20.6% for the 12-year period) whereas prevalence has increased among female (+28.0%) mainly among those between 25 and 54 years old. The main percentual decrease in smoking prevalence has been observed among young people aged 15-24 years old for both genders. The proportion of former smokers has remained stable (11.4% in 1982, 12.9% in 1994) during the period studied. The proportion of former smokers increases with age among man over 25 years. CONCLUSIONS: Smoking habit is still very prevalent in Catalonia, even higher than in other Western European countries. In spite of the increase among women, the significant dectines of smoking prevalence among men and youngsters (of both genders) could represent encouraging findings in order to pursue the efforts aimed at reducing the morbi-mortality burden of smoking in our society.

Adolescent↗

Cigarette smoking as a risk factor for tuberculosis in young adults: a case-control study.

SETTING: The association between smoking and pulmonary tuberculosis has not often been studied. OBJECTIVE: To assess the influence of cigarette smoking on the development of active pulmonary tuberculosis in young people who were close contacts of new cases of smear-positive pulmonary tuberculosis. DESIGN: A case-control study in which 46 'cases' (patients with active pulmonary tuberculosis: isolation of Mycobacterium tuberculosis or clinical and/or radiographic evidence of current pulmonary tuberculosis, with a positive tuberculin skin test) and 46 'controls' (persons with positive tuberculin reaction, negative bacteriological test and without clinical and/or radiological evidence of pulmonary tuberculosis) were included. Smoking habits were investigated by questionnaire. Univariate and multivariate analysis was performed, and odds ratio (OR) was adjusted for age, gender and socio-economic status. RESULTS: Statistically significant differences were found in active smokers (occasional and daily smokers) (OR: 3.65; 95% CI, 1.46 and 9.21; P < 0.01), daily smokers (OR: 3.53; 95% CI, 1.34 and 9.26; P < 0.05), and individuals who were both passive and active smokers (OR: 5.10; 95% CI, 1.97 and 13.22; P < 0.01) and passive and daily smokers (OR: 5.59; 95% CI, 2.07 and 15.10; P < 0.001). There was a dose-response relationship between the number of cigarettes smoked daily and the risk of active pulmonary tuberculosis. CONCLUSIONS: The data studied show that cigarette smoking is a risk factor for pulmonary tuberculosis in young people, with a dose-response relationship with the number of cigarettes consumed daily.

Adolescent↗

Passive smoking and risk of pulmonary tuberculosis in children immediately following infection. A case-control study.

SETTING: Passive smoking-related respiratory disorders in children. OBJECTIVES: To assess the effect of passive smoking on the development of active pulmonary tuberculosis (PTB) in children immediately following infection by Mycobacterium tuberculosis within the family. DESIGN: An unmatched case-control study in which 93 contacts who became cases (active PTB diagnosed) and 95 contacts who did not became cases (tuberculin-positive children without evidence of active disease) were included. All were household contacts of a new case of pulmonary bacillary tuberculosis. Smoking habits were investigated by a questionnaire. Urinary cotinine was analysed. Odds Ratio (OR) was adjusted for age and socio-economic status using multiple logistic regression analysis. RESULTS: Passive smoking was a risk factor for PTB (OR: 5.29; 95% confidence interval (CI): 2.33-12.82; P < 0.00005). The adjusted OR was 5.39 (95% CI: 2.44-11.91; P < 0.00001). The risk increased when contacts were passive smokers both at home and outside the home within the family (OR: 6.35; 95% CI: 3.20, 12.72; P < 0.00001). Contacts 0-4 and 5-9 years old showed a significantly higher risk than those aged > or = 10. There was a dose-response relationship between the risk of developing active PTB immediately following infection and the number of cigarettes smoked daily by the household adults (P < 0.001). Mean (SD) urinary continine detectable concentrations (ng/ml) were different between disease contacts (119.46 [68.61]) and non diseased contacts (91.87 [73.10]). The difference was statistically significant (P < 0.001). CONCLUSIONS: Passive exposure to tobacco smoke in children was associated with an increased risk of developing pulmonary tuberculosis immediately following infection. This is an association of great concern requiring health education programmes and antitobacco medical advice.

Adolescent↗

[Determinants of quitting smoking in Catalonia, Spain].

OBJECTIVE: While trends in the prevalence of smoking and ex-smoking in Catalonia, Spain have been monitored, the characteristics of those smokers who quit have not been investigated. The aim of this investigation was to analyze the prevalence of cessation, or quit ratio, in Catalonia and to study its sociodemographic, life-style, and smoking correlates. SUBJECTS AND METHODS: We analyzed data collected in the Catalan Health Interview Survey conducted in 1994. This is a cross-sectional study based on a representative sample of the non-institutionalized population of Catalonia. We included for analysis a total of 5,424 subjects (3,649 males and 1,775 females) who declared to be current smokers (2,335 males and 1,331 females) or past smokers (1,314 males and 444 females). We computed the crude and age-standardized quit ratios (QR) or prevalence of cessation, as well as the odds ratio (OR) of quitting smoking, according to gender and the variables studied. RESULTS: The age-standardized QR was 31. 8% for males and 30.9% for females and increased with age. The QR was, both in males and females, greater among married subjects, with higher socioeconomic status, and with healthy life-styles (moderate and heavy leisure physical activity and moderate alcohol consumption). The OR of quitting smoking was higher in heavy smokers (OR = 2.9; 95% CI: 2.2-3.8; smokers of > 30 cigarettes/day vs. 1-10 cigarettes/day) in males, while it was < 1 for females of medium intensity, conforming a shaped curve rather than a linear trend (OR = 1.7; 95% CI: 1.0-2.9, in heavy smokers). CONCLUSIONS: This study confirms a positive association in males and females between quitting smoking and increasing age, a higher socioeconomic level, heavy smoking, and healthy life-styles. The identification of these groups should facilitate the planning of successful interventions. Further effort is also necessary to target groups with low cessation rates, such as individuals in disadvantaged social classes and light smokers.

Cross-Sectional Studies↗

[Evaluation of a community intervention program ("Quit and Win") for smoking cessation].

OBJECTIVES: In recent years community intervention plans for motivating smokers to stop smoking have been developed. One of these programs is the < > initiative of the World Health Organization. Our study evaluated the impact of this intervention in a sample of persons who participated in the 1996 edition of the program in Barcelona, Spain. METHODS: One year after the contest, a telephone follow-up survey was carried out in one-third of the participants. Subjects were questioned about their current smoking status and their participation in the contest, including motivation and whether they had remained abstinent throughout the contest. RESULTS: A total of 941 valid cards were received from Barcelona residents, equivalent of 0.23% of all smokers. A selection was made of 307 persons for follow-up, 18 of which were excluded because they were former smokers. From the remaining 289 participants, we obtained valid responses from 196, 82 (41.8%) of which were abstinent when the survey was made. Participating in the contest with the intention to stop smoking permanently and continued abstinence throughout the contest period (one month) were significantly associated with abstention one year later. The overall agreement between participants' statements and the statements of a subsample (n=18) was 81.3%. CONCLUSIONS: One year after the intervention the proportion of abstinent smokers was higher than in earlier studies. However, self-selection by the participation who responded to the follow-up questionnaire could have contributed to the final result. Overall, such initiatives could be useful in motivating predisposed persons to stop smoking.

Adolescent↗