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Esteve Fernández

Publications and source records attributed to Esteve Fernández.

At least 19 recordsLinked to original sources
PubMed2006

Social class, education, and smoking cessation: Long-term follow-up of patients treated at a smoking cessation unit.

Our objective was to examine social class and educational differences in long-term smoking cessation success among a cohort of smokers attending a specialized smoking clinic. We studied sustained abstinence after cessation among 1,516 smokers (895 men and 621 women) treated for smoking cessation between 1995 and 2001 at a university teaching hospital in the metropolitan area of Barcelona, Spain. We calculated 1-year and long-term (up to 8-year) abstinence probabilities by means of Kaplan-Meier curves and the hazard ratio of relapse by means of Cox regression, after adjusting for other predictors of relapse. Overall abstinence probability was .277 (95% CI = .254-.301). Men and women in social classes IV-V had significant hazard ratios of relapse after long-term follow-up (men: 1.36, 95% CI = 1.07-1.72; women: 1.60, 95% CI = 1.24-2.06), as compared with patients in social classes I-II. The same independent effect was observed for education: Men and women with primary or less than primary studies had higher hazard ratios of relapse (men: 1.75, 95% CI = 1.35-2.25; women: 1.92, 95% CI = 1.51-2.46), as compared with patients with a university degree. Similar estimates were obtained after adjustment for stage of change, Fagerström score for nicotine dependence, and type of treatment. Patients of lower socioeconomic status are at higher risk of relapse, and this association is independent of other well-known predictors of relapse. Social differences have to be taken into account in the clinical setting when tailoring specific actions to treat smoking dependence.

Adult↗
PubMed2006

Implementing and complying with the Smoke-free Hospitals Project in Catalonia, Spain.

The objective of the study was to describe the implementation of measures for preventing tobacco consumption developed in the Catalan Network of Smoke-free Hospitals. Information from 25 hospitals that are actively involved in the Catalan Network of Smoke-free Hospitals (April 2004) was used. The degree of implementation of the Smoke-free Hospitals Project was analysed by means of the Self-Audit Questionnaire of the European Network for Smoke-free Hospitals; each hospital was analysed globally and according to the duration of its Network membership (<1 year: implementation stage; > or =1 year: consolidation stage). In terms of global indicators, there were high levels of commitment (64.8%), communication (74.7%), tobacco control (77.4%) and implementation of smoke-free environments (81.0%). A lower degree of implementation (<50%) was found in education and training, health promotion and healthy workplaces. According to the duration of Network membership, significant differences were observed for communication, environment, healthy workplaces and follow-up. Deficits were observed in areas such as specialist training and cessation support, and further input is required here. By identifying areas needing attention, providing a guide for policy development and by administering it periodically, one can ensure that progress is kept on track.

Guideline Adherence↗
PubMed2006

Nutrition and cancer risk: an overview.

The role of diet in cancer is a major public health issue Foods associated with a low risk of cancer are those typically included in the so-called Mediterranean diet, which is also associated with low mortality rates from cardiovascular disease. Implementing such a diet would involve increasing the consumption of fruits, vegetables, cereals, whole-grain foods and fish, while reducing the intake of refined carbohydrates and red meat. In addition, olive oil should replace saturated fats. Omega-3 fatty acids found in fish inhibit the growth in vitro of colon, breast and prostate cancers. Fibre can bind bile acids, which produce carcinogenic metabolites, and fermented fibre produces volatile fatty acids that can protect against colon cancer. It has been hypothesized that the anti-cancer actions of olive oil may relate to the ability of its mono-unsaturated fatty acid, oleic acid, to regulate oncogenes.

Diet, Mediterranean↗
PubMed2005

[Observational studies in epidemiology (STROBE)].

Although there are many texts on the quality of epidemiological studies, little effort has been made to evaluate the publication of epidemiological studies and their results (the articles). Concern to improve the reporting of epidemiological studies prompted a working group to launch the STROBE (Strengthening the Reporting of observational studies in Epidemiology Statement). The STROBE checklist contains 22 items organized according to the Title and Abstract, Introduction, Methods, Results, and Discussion structure that can be used for the main epidemiological designs (cohort studies, case-control studies, and cross-sectional studies). It is a checklist to improve the reporting quality of epidemiological studies (generally original articles) and, therefore, to evaluate the quality of this type of publication and facilitate critical reading.

Authorship↗
PubMed2005

Cancer risk perceptions in an urban Mediterranean population.

The objective of our study was to analyze the perceived (belief) or adopted (behavior) measures to reduce cancer risk in a Spanish population. We used cross-sectional data from the Cornella Health Interview Survey Follow-up Study (CHIS.FU). We analyzed 1,438 subjects who in 2002 answered questions about risk perceptions on cancer and related behavior (668 males and 770 females). The benefits of avoiding cigarette smoking (95.8%), sunlight exposure (94.9%) and alcohol (81.0%) were widely recognized. On the other hand, electromagnetic fields (92.1%), food coloring and other food additives (78.4%) or pesticides (69.4%), whose role in cancer occurrence, if any, remain unproven, were clearly considered as cancer risk factors in this population. Compared to men, women more frequently reported healthy behaviors, and the role of exogenous factors (i.e., environmental risk factors) were widely popular. There was a socioeconomic gradient on cancer risk perception with respect to several lifestyle or dietary factors. Individuals with higher educational level scored lower in several risk factors than those with primary or less than primary school education. Smokers reported adopting fewer healthy behaviors than former or never smokers. How people perceive health issues and risk or make choices about their own behavior does not always follow a predictable or rational pattern.

Cross-Sectional Studies↗
PubMed2005

[Probability of developing and dying of cancer in Catalonia during the period 1998-2001].

BACKGROUND AND OBJECTIVE: We intended to estimate the probability of developing and dying from cancer in Catalonia during the period 1998-2001. PATIENTS AND METHOD: We used a Bayesian model which incorporates data from the Tarragona and Girona Cancer Registries and from the Catalonia Mortality Registry. The probability of developing and dying from cancer has been calculated using a competitive risk-based methodology. RESULTS: Lifetime probability of developing cancer in Catalonia is almost 1 out of 2 (43.7%) for men and 1 out of 3 (32.1%) in women. The probability of dying from cancer is 29.1% for men and 17.9% in women. 67% of men and 56% of women diagnosed with cancer will die from this disease. One out of 14 men will develop a lung cancer during his life and 1 out of 11 women will develop breast cancer. CONCLUSIONS: The observed rising in the probability of developing cancer in Catalonia over the last ten years highlights even more than ever the importance of this health problem.

Adolescent↗
PubMed2005

Associations between individual and contextual factors and smoking in 13,293 Mexican students.

OBJECTIVE: Factors correlated with cigarette smoking in young people have yet to be documented in most developing countries. This study assesses the correlates of smoking in Mexican young people. METHODS: School-based, cross-sectional study in the central Mexican state of Morelos during the 1998-1999 school year of 13,293 public school students aged 11 to 24 years. Multinomial logistic regression models were constructed with smoking as the dependent variable. RESULTS: Regular smoking (one or more cigarettes daily) prevalence was 13.1% (95% confidence interval [CI]=12.2-13.9) in males, and 6.1% (95% CI=5.6-6.6) in females. Frequent alcohol intoxication was strongly associated with regular smoking (females, odds ratio [OR]=68.5, 95% CI=37.6-125.2; males, OR=34.5, 95% CI=22.6-52.7). Regular smoking was associated with illegal drug use and smoking by both parents in females, and with illegal drug use in males (males, OR=4.9, 95% CI=3.7-6.5). Also associated with tobacco smoking were high socioeconomic status, low academic achievement, illegal drug use by peers, marijuana use by parents, and depression in adolescents. CONCLUSIONS: This study documents a strong correlation between tobacco smoking and other health risk behaviors, especially alcohol and drug abuse. In young women especially, the risk of tobacco use increased with alcohol abuse and higher socioeconomic status. School-based interventions are needed that focus on preventing smoking and also take into account other unhealthy behaviors.

Adolescent↗
PubMed2005

Converging patterns of colorectal cancer mortality in Europe.

Trends in mortality rates from colorectal cancer during the second half of the 20th century were analysed for 21 European countries and grouped in three broad European regions. For each gender, age-standardised (world standard population) mortality rates were computed by the direct method, and joinpoint analysis was used to identify significant changes in rates. A favourable pattern in colorectal cancer mortality for both genders was observed in most European countries from the 1990s onwards. Colorectal cancer mortality rates were still in the upward direction in some Eastern European countries, as well as in some Mediterranean countries. Mortality rates tended to converge at around 20/100000 in men and around 11/100000 in women. This converging pattern is even clearer when colorectal mortality rates are examined in three broad European regions. Similar mortality rates over recent calendar years have been reached by countries where mortality has been decreasing in recent decades and in those countries (mainly Eastern European and Mediterranean countries) which have experienced a recent levelling-off and decrease. If recent trends are maintained, colorectal cancer mortality is likely to decline further in Europe in the current decade.

Adult↗
PubMed2004

[Prevalence of exposure to environmental tobacco smoke in a urban population].

BACKGROUND AND OBJECTIVE: We decided to assess the overall prevalence of exposure to environmental tobacco smoke (ETS) both in general and according to the settings of exposure (home, workplace and leisure time). SUBJECTS AND METHOD: We analyzed cross-sectional data of ETS exposure in 1,059 non-smokers included in the Cornellà Health Interview Survey Follow-up (CHIS-FU) study. We calculated the crude and age-standardized prevalence of ETS exposure in general and in the different settings. RESULTS: 69.5% (confidence interval [CI] 95%, 64.5%-74.4%) of men and 62.9% (CI 95%, 58.1%-67.6%) of women of the sample studied were exposed to ETS. We observed a decreasing trend of ETS exposure by age in both sexes. The age-standardized prevalence rates of ETS exposure according to the environment and sex were: 25.9% (95% CI, 21.8%-30.1%) at home, 55.1% (95% CI, 50.8%-59.4%) during leisure time and 34.0% (95% CI, 23.5%-45.6%) in the workplace in men, and 34.1% (95% CI, 29.8%-38.5%), 44.3% (95% CI, 40.5%-48.2%) and 30.1% (95% CI, 18.9%-41.3%), respectively, in women. CONCLUSION: In this study, more than half of non-smokers were exposed to ETS.

Adolescent↗
PubMed2004

Cigarette advertising and female smoking prevalence in Spain, 1982-1997: case studies in International Tobacco Surveillance.

BACKGROUND: Compared with northern Europe and the U.S., the widespread initiation of cigarette smoking began 20-40 years later among young women in Spain because of strong cultural prohibitions against female smoking. In this study, the authors examined the correlation between the rapid increase in female smoking prevalence and tobacco industry cigarette marketing practices in Spain during a period of rapid social liberalization. METHODS: The authors examined age-specific, period-specific, and birth cohort-specific increases in cigarette smoking among young women in Spain in relation to internal documents from Philip Morris beginning in 1971, cigarette advertising from 1982 to 1997, and the increase in the market share of blond tobacco and "light" cigarettes preferred by women. RESULTS: Some increase in cigarette smoking occurred among Spanish women before 1970, but the increase was substantially smaller and occurred later than in many Western countries. However, after 1970, the prevalence of cigarette smoking increased rapidly in Spanish women of all ages < 50 years. The rapid increase in female smoking coincided with massive increases in television advertising, especially to women, and increases in the market share of blond tobacco, "light cigarettes," and international tobacco brands. CONCLUSIONS: The increase in cigarette smoking among young Spanish women illustrates how aggressive marketing can exploit periods of social liberalization and rapidly increase cigarette smoking among women, even in countries in which female smoking traditionally has been unacceptable. Strategies are needed to prevent similar increases in smoking by women elsewhere.

Adolescent↗
PubMed2004

An adaptation of Charlson comorbidity index predicted subsequent mortality in a health survey.

OBJECTIVE: The Catalan Health Interview Survey Follow-up Study analyzed survival differences according to comorbidity, using an adaptation of the Charlson's index. STUDY DESIGN AND SETTING: Vital status was ascertained by record linkage with death certificates 5 years after interview. Three thousand one hundred five men and 3,536 women aged 40-84 years old were included in the analysis. Proportional hazards models with age as time scale were used to calculate relative risk (RR) and 95% confidence interval adjusted for potential confounders. RESULTS: The adjusted RR of death in men was 1.02 (0.73-1.41) for a comorbidity index of 1-2; the RR was 1.51 (1-2.30) for an index of 3-4, and 2.64 (1.43-4.89) for an index of >4 composed to an index of 0. In women, for the same comorbidity index categorization, the RR of death were 0.83 (0.55-1.24), 1.71 (1.09-2.72) and 2.65 (1.47-4.77). CONCLUSION: This result confirms the relation between comorbidity and the risk of death based on a comorbidity index that takes into account severity and number of self-declared chronic diseases with mortality.

Adult↗
PubMed2003

[Smoking in Spain, 1945-1995. A retrospective analysis based on the Spanish National Health Interview Surveys].

BACKGROUND AND OBJECTIVE: To analyse trends in cigarette consumption in Spain between 1945 and 1995. MATERIAL AND METHODS: Prevalence rates of daily cigarette smoking were derived from the individual information collected in the Spanish National Health Interview Surveys (1993, 1995 and 1997) for the period 1945-1995. RESULTS: In males, the prevalence rate in 1945 was 42.4% (95% confidence interval [CI], 40,1-44,7%), increased till 59.1% in 1975 (95% CI, 58,0-60,2%), levelled-off during the decade 1975-1985, and decreased till 48.9% in 1995 (95% CI, 48,1-49,7%). In females, the prevalence rate of cigarette smoking was less than 5% till the 1970s, and it begun to steadily increase till the end of the study period (22,5%; 95% CI, 21,9-23,1%). CONCLUSIONS: This analysis shows the different dynamics of the smoking epidemic among men and women in Spain.

Adolescent↗
PubMed2002

Subjective health of male ex-smokers: relationship with time since smoking cessation, intensity and duration of tobacco consumption.

BACKGROUND: To examine the relationship of subjective health with time since smoking cessation and amount and duration of tobacco consumption among male ex-smokers. METHODS: Pooled analysis of three household interview surveys conducted in 1993 (n = 8,494), 1995 (n = 2,556), and 1997 (n = 2,624) on samples representative of the noninstitutionalized population aged 16 and over in Spain. RESULTS: After controlling for the main confounders, ex-smokers with smoking burden < or =13 pack-years had a lower frequency of suboptimal health (fair, poor, or very poor) than current smokers (OR, 0.59; 95% Cl, 0.38-0.91) during the first year after cessation; thereafter, it reached a value similar to that of never-smokers 11 years or more after cessation. Among those with burden >13 pack-years, frequency of suboptimal health during the first year after cessation was higher than in current smokers (OR, 1.28; 95% CI, 1.00-1.63). Afterwards, it fell progressively, approaching the value of never-smokers 11 years or more after cessation. Frequency of suboptimal health in ex-smokers increased with duration (years) of smoking (P linear trend = 0.045), but did not vary with the number of cigarettes smoked. CONCLUSIONS: Suboptimal health declined with time since smoking cessation, to reach the frequency of never-smokers. Longer duration of tobacco consumption is associated with worse subjective health.

Adolescent↗
PubMed2002

[Epidemiology of smoking in Europe].

Tobacco is the most important preventable cause of mortality in European countries, accounting for over half a million deaths per year. A review is presented on the epidemiology of tobacco smoking in Europe, using a comprehensive approach on the health effects of smoking, the prevalence of tobacco consumption, and its evolution in the past decade. Tobacco industry efforts to promote and maintain smoking through production and pricing are also reviewed. Thirty out of every 100 European adults smoke everyday and one of every ten adults smokers will die from tobacco smoking; a higher ratio of 1:15 is found in Eastern Europe. The prevalence of smokers is decreasing among young adults in some European countries, while it is increasing among young women in Southern and Eastern Europe. Smoking cessation and prevention interventions should be implemented, such as banning smoking in public areas, banning direct and indirect advertising of tobacco products, crop reduction, and rising cigarette prices. These interventions should be designed, coordinated, and developed by and among the different sectors involved in tobacco control initiatives, together with social network at the local, regional, and national levels, with the support of national and international organizations.

Adolescent↗
PubMed2002

[Prevalence of smoking and low school performance, among students 11-24 years of age in the state of Morelos, Mexico].

OBJECTIVE: To assess the association between self-reported academic performance and tobacco experimentation and established tobacco use among adolescents and young adults in Morelos State, Mexico. MATERIAL AND METHODS: A population-based, cross-sectional study was carried out in 72 administrative areas from all 33 municipalities of Morelos State (urban, semi-urban and rural areas). A total of 13,293 adolescents and young adults aged 11 to 24 years were randomly selected from public schools. Data were collected using a self-administered questionnaire. Multinomial logistic regression models were fitted with smoking habit as the dependent variable with three categories (never a smoker, occasional smoker, and regular smokers). RESULTS: The prevalence of occasional smokers was 14.9% (95% CI: 14.1-15.7) among females and 27.3% (95% CI: 26.1-28.4) among males. The corresponding figures for females and males for established smokers were 6.1% (95% CI: 5.6-6.6) and 13.1% (95% CI: 12.2-13.9), respectively. Academic performance self-reports were found to be inversely proportional to occasional or regular tobacco use. In women, the association with current tobacco consumption was 5.1 times higher (95% CI: 2.5-10.4) in women with a yearly grade average of six or less, in comparison to those with scores of ten or nine. The same pattern was observed in men (OR = 4.2; 95% CI: 2.7-6.7), with a significant linear trend both in both women and men. CONCLUSIONS: These results evidence that tobacco consumption is related to low academic performance. This relationships is determined by complex lifestyle patterns of adolescents.

Adolescent↗