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Biomedical subjects

M Nebot

Publications and source records attributed to M Nebot.

At least 19 recordsLinked to original sources
PubMed2005

Environmental tobacco smoke exposure in public places of European cities.

BACKGROUND: Exposure to environmental tobacco smoke (ETS) has important public health implications. The results of the first European multi-centre study that measured ETS exposure in a range of public places (transport, educational settings, and leisure facilities such as bars and restaurants) are presented. METHOD: Nicotine vapour phase was measured using ETS passive samplers containing a filter treated with sodium bisulfate. RESULTS: Bars and discos are the places with the highest concentrations of nicotine from ETS, median ranging from 19 to 122 microg/m(3). Restaurants had the next highest values. Concentrations of nicotine generally range from 0.1-5 microg/m(3) in airports, and from 0.5-10 microg/m(3) in train stations. Nicotine was also found in schools and universities, yet schools tended to have the lowest concentrations compared to all the other public places sampled. In hospitals levels were generally below 5 microg/m(3). CONCLUSIONS: Although there is some variability between cities, this study shows that tobacco smoke is present in most of the studied public places. The study also showed that in areas where smoking is prohibited, concentrations of nicotine are lower than in areas where smoking is allowed but they are not zero. The results of this study indicate that policies should be implemented that would effectively reduce levels of tobacco smoke in public areas.

Air Pollutants↗
PubMed2004

[Changes in tobacco use in the general population of Barcelona, 1983-2000].

OBJECTIVES: To analyze the prevalence trends for smoking and its determinants in the general population of Barcelona from 1983 to 2000. DESIGN: Time series study. SETTING: Health survey based on home interviews of a representative sample of the general population of Barcelona. PARTICIPANTS: In the years 1983, 1992, and 2000 we interviewed 3134, 5004, and 10,000 persons, respectively. MAIN OUTCOME MEASURES AND RESULTS: Between 1983 and 2000 daily tobacco use showed a steady tendency to decrease among men, with a prevalence that decreased from 54.6% to 38.3%, while in women, smoking increased between 1983 and 1992 (from 20.9% to 25.4%) but remained stable in 2000 (24.5%). The proportion of smokers who said they wanted to quit increased in both sexes from 1992 (54.2%) to 2000 (65.7%). During this period the proportion of smokers who said their doctor had advised them to quit increased from 36.1% to 48.1%. The trends for both sexes showed that consumption of tobacco products was greater among less privileged socioeconomic groups. CONCLUSIONS: The results of this study confirm the decrease in the prevalence of daily consumption of tobacco products and the increase in smokers who would like to quit, in parallel with the increase in advice from physicians to quit. However, the trends among younger groups remained stable, a finding that makes it necessary to intensify efforts aimed at this population group.

Adolescent↗
PubMed2004

[Factors associated with smoking onset: 3-year cohort study of schoolchildren].

OBJECTIVE: To analyze the predictors of smoking onset among schoolchildren. METHODS: A cohort study of 1056 children starting in first year secondary school at 44 schools in Barcelona was carried out. Participating children were invited to answer a lifestyle questionnaire every year for 4 years. Each questionnaire carried a personal code to allow the 4 questionnaires to be matched. Matching questionnaires were found for 729 children, 70% of the initial sample. RESULTS: Over the study period, the prevalence of regular smokers increased from 1.7% to 22% among boys and from 1.6% to 38.2% among girls. The predictors of smoking onset among boys were scoring high on the pro-smoking attitudes index (odds ratio [OR]=1.2; 95% confidence interval [CI], 1.1-1.3), intention to smoke in the future (OR=2.2; 95% CI, 1.0-4.9), low self-efficacy in resisting pressures to smoke (OR=0.98; 95% CI, 0.96-0.99), having siblings that smoke (OR=2.5; 95% CI, 1.2-5.4), and spending some free time in bars (OR=2.4; CI, 1.1-4.9). Among girls, the predictors were having low self-esteem (OR=0.94; 95% CI, 0.88-0.99), scoring low on the anti-tobacco attitudes index (OR=0.92; 95% CI, 0.88-0.97), having siblings who smoke (OR=2.5; 95% CI, 1.2-5.5), spending some free time in discotheques (OR=4.5; 95% CI, 1.9-11.8), and living in high socioeconomic-status neighborhoods (OR=3.1; 95% CI, 1.4-10.9). CONCLUSIONS: The results show the importance of cognitive variables as well as a variety of environmental variables, particularly the pattern of free time use and the influence of sibling models. Prevention programs must take into account smoking onset risk factors as a whole.

Adolescent↗
PubMed2004

[Exposure to smoking during pregnancy: Barcelona (Spain) 1994-2001].

BACKGROUND: Exposure to smoking during pregnancy is an important risk factor for child health. In the last few decades, the prevalence of smoking among fertile women has increased in Spain. OBJECTIVES: To assess fetal exposure to smoking in a representative sample of pregnant women and its trends. METHODS: The prevalence of smoking and smoking cessation were analyzed in a representative sample of women who gave birth in the city of Barcelona, extracted from a population-based registry of birth defects. The sample consisted of 1,801 women and covered the period 1994 to 2001. RESULTS: Among pregnant women, 43.4 % smoked before pregnancy, and 42.2 % of these quit. At the time of giving birth, 25.2 % of the women were smokers. Over the period studied the prevalence of smoking among pregnant women clearly decreased. Although the proportion of cessations showed no significant changes, fetal exposure to tobacco decreased. CONCLUSIONS: The prevalence of smoking among pregnant women was high, although many quit during pregnancy. Over the period studied, fetal exposure to smoking decreased. There is a need for more systematic interventions.

Environmental Exposure↗
PubMed2004

[Changing epidemiology of smoking: Barcelona, 2000-2001].

CONTEXT: In recent years various initiatives of prevention and social changes have been carried out that should have an effect on epidemiology of smoking in our area. Their real effect is little known, however, because of methodological changes in the existing population surveys. In this work the data on smoking in the last city of Barcelona health survey (ESBA 2000-01) are analyzed, with reference to the cumulative information obtained along 18 years from the first survey in 1983. METHOD: ESBA 2000-01 is an interview health survey carried out on a weighted sample with 10,030 people. Data relative to tobacco use are showed for people 15-year-old or older included in the survey, stratified by age, sex, and class. Consumption context variables are also showed, and the tobacco consumption quitting among people who have smoked is analyzed. RESULTS: The proportion of daily smokers in the population over 14 years of age is 29 %, while that of former smokers is 21 % and 2.2 % in this population are occasional smokers. The prevalence is maximum in the 35-44 year-old group, and the prevalence is reduced drastically after this age. Stratified analysis by age, sex, and occupational category shows interesting differences among daily smokers. A strong gradient is observed according to occupational category in males. The situation is more complex in women. The typical smoker began when 17-year-old, and now consumes 16 cigarettes a day. Consumption is somewhat higher in males and is maximum in the 35-44 year-old group. Two-third of the smokers (65.7 %) want to quit smoking and more than one third (36 %) has attempted it along the last year. Almost half of smokers (48.1 %) have received advice to quit smoking from their physician. One of every four (24.9 %) smokers has been warned for smoking in some places. Almost half smokers are the only smoker in their home, and barely a third are the only smokers at work. The proportion of quitting increases with age in both sexes, and nowadays the differences in the probability of quitting smoking are few when the data are stratified by age groups. CONCLUSIONS: These results show the changing pattern of tobacco epidemiology in Barcelona: smoking is no longer the main behavior in no age and sex group, and the only social group in which more than half of its members smoke are 25-44 year-old not qualified worker males. This situation has occurred because of two processes: an important proportion of early quitting (demonstrated even in young adults) and a decrease in the beginning of the habit. Real differences are not observed between males and females with regard to the probability of quitting smoking. These data correct recent estimates that could be influenced by methodological changes in the instruments used.

Adolescent↗
PubMed2003

[Nicotine measurement as an airborne marker of environmental tobacco smoke].

INTRODUCTION: Several studies have demonstrated the relationship between environmental tobacco smoke (ETS) and different types of health risk. Despite this evidence, measurement of ETS was highly inaccurate until a few years ago. The objective of this study was to review different studies using nicotine as an ETS airborne marker. METHODS: We reviewed the various methods used in ETS measurement, especially the use of nicotine as an airborne marker. Nicotine was compared with other markers, and data from different studies measuring airborne nicotine concentration in public places and workplaces were collected. RESULTS: Nicotine has all the desirable characteristics of an ETS marker. Several studies using nicotine as an airborne marker of ETS reported a wide range of values. In cafeterias and restaurants the concentration varied from 2.3 to 6.8 microg/m3. In workplaces without smoking regulations the concentration ranged from 3.4 to 14 microg/m3, whereas in places with smoking bans the concentration ranged from 0.09 to 0.7 microg/m3. Pubs and nightclubs had the highest concentrations, with values higher than 65 microg/m3. DISCUSSION: The use of nicotine as an airborne marker provides an objective measurement of ETS exposure. The values obtained in studies using this marker show that in places with smoking restrictions or bans, ETS exposure is much lower than in places without smoking restrictions.

Nicotine↗
PubMed2002

[Impact of medical counselling on giving up smoking during pregnancy].

OBJECTIVE: Women s tobacco consumption has increased in Spain in recent years, especially among women of reproductive age. This study aims to evaluate the impact of medical counselling integrated into pre-natal care on tobacco consumption during pregnancy and the period after delivery. DESIGN: Quasi-experimental intervention study.Setting. Hospital del Mar, Barcelona. PATIENTS: 219 patients who attended the Hospital del Mar for delivery during 1996 (control group) and 169 patients seen during their pregnancies at the same hospital in 1997 (intervention group). INTERVENTIONS: The control group patients had received normal care. The pregnant women in the intervention group received systematic structured counselling on giving up smoking, backed up by a special brochure composed for this purpose. MEASUREMENTS AND RESULTS: The intervention and control groups showed no statistically significant differences either in their social or demographic variables or in their tobacco consumption. In both groups the evolution of their smoking during pregnancy was determined during their pre-natal visits and six months after delivery through a telephone interview. 44 of the women in the control group (20.1%) gave up smoking before their first pre-natal visit, and 11 (5%) gave up during pregnancy. In the intervention group 26 (17.7%) had given up spontaneously and 16 (10.9%) gave up during pregnancy. Of those who gave up completely during pregnancy, 36.4% of women in the control group and 64.3% in the intervention group remained abstinent at six months (P=.002). CONCLUSIONS: Counselling at pre-natal check-ups to give up smoking lightly increases the number of women who give up and reduces significantly the number of post-delivery backsliders.

Adult↗
PubMed2001

[Lung cancer mortality in Barcelona: evidence for an initial decline in men].

BACKGROUND: Tobacco use in Spain is still high, with many smoking related deaths. However, a decrease in smoking prevalence in men has been observed in recent years, with a stabilisation or an increase among women. This paper studies the evolution of cancer mortality in Barcelona city (Catalonia, Spain) according to age and sex over the period 1984-1998. SUBJECTS AND METHOD: The evolution of annual mortality by age and sex was calculated. Specific mortality rates were estimated by age and sex strata; crude and standardized death rates for each year were also determined. Finally, for the 35-64 years population, specific mortality rates were estimated for each 5-year period (1984-1988, 1989-1993, and 1994-1998). RESULTS: Mortality rates do not change for men aged 35-39, 50-54 and 55-59 years. There was a decrease in lung cancer mortality rates in the 1994-1998 period compared to the first period for those men in the 60-64 years group. In men in the 40-44 and 45-49 years groups, rates increased in the second and stabilize in the last period. Global rates in men in the 35-64 years group, both crude and adjusted, were in the first and last 5-year periods. Among women, rates are much lower, although there was a significant increase in the 35-39 and 45-49 years groups. Crude and adjusted rates in all women aged 35 to 64 years displayed an increase in the last 5-year period. CONCLUSIONS: These results show that in Barcelona the decrease in smoking prevalence among males is now leading to an initial decrease in lung cancer mortality. The turning point seems to be in the period 1989-1993. On the contrary, there is a clear increase among young women, although the rates are still much lower.

Adult↗
PubMed2001

[Tobacco in Barcelona's metropolitan transportation: observation study].

OBJECTIVE: To describe the extent of no-smoking notices, consumption and sales of tobacco in Barcelona's underground transport installations. DESIGN: Descriptive, observation study. SETTING: Community. METHODS: A sample of 54 stations was selected at random. The presence of users smoking, staff smoking, notices about tobacco consumption and tobacco sales were evaluated. INTERACTIONS: Platforms, entrance hall and corridors and/or stairs were observed for at least 5 minutes at each station. MEASUREMENTS AND MAIN RESULTS: Users smoking were recorded in 87% of the observations, and cigarette stubs in 97.5% of observations, whereas company staff were only seen smoking in 5.6%. In 72.2% of the entrances there were tobacco sales-points. The users observed smoking were divided equally between the sexes, although the men were mainly middle-aged adults (64.3%) and the women were mainly young (60.6%). In 64.2% of the observations, some sort of notice was seen. CONCLUSIONS: Both notices and compliance by staff are high, although users habitually consume tobacco. Tobacco sales-points at stations are very common. The findings justify the adoption of specific measures designed to improve compliance with the regulations.

Adult↗
PubMed2001

Smoking initiation and cessation by gender and educational level in Catalonia, Spain.

BACKGROUND: The role of gender and socioeconomic status in smoking has been characterized in the United States and Northern European countries. However, there is scarce information of the dynamic of the tobacco epidemic in Southern European countries. The aim of this study was to analyze smoking initiation and cessation according to level of education and gender in Catalonia, Spain. METHODS: Data from the Catalan Health Survey (1994), a cross-sectional study based in a representative sample of the noninstitutionalized population of Catalonia, was used. The relative risks and 95% confidence interval of smoking initiation were computed by means of Cox's regression. The odds ratios and 95% confidence intervals of quitting smoking were derived from logistic regression models. Direct responses from 4,370 men and 5,213 women ages 25 years or over were included for analysis. RESULTS: Ever smoking was inversely related to level of education in men. Males with the highest educational level tended to have a lower probability of being a smoker at a given age than those with less than primary school (relative risk = 0.6; 95% confidence interval: 0.5-0.7). This pattern appeared with small variation across age groups. In women, a reverse trend was present: the higher the level of education the higher the relative risk of starting smoking (relative risk = 4.6; 95% confidence interval: 3.1-6.7). Quitting smoking was more likely among men and women with higher education as compared to men and women with less than primary school (men: odds ratio = 1.5; 95% confidence interval 1.1-2.1; women: odds ratio = 4.6; 95% confidence interval: 2.1-10.4). CONCLUSIONS: The differential effect of education according to gender may reflect different phases of the smoking epidemic. In Catalonia, the transition of smoking from upper and lower socioeconomic groups occurred recently among men, and women have currently begun to experience this transition.

Adolescent↗
PubMed2000

[Validity of the declared tobacco consumption in pregnancy].

OBJECTIVES: To analyse the relationship between the stated consumption of tobacco by pregnant women who say they smoked before pregnancy and the levels of cotinine in their urine at the start and end of pregnancy. DESIGN: Observational, longitudinal study. PARTICIPANTS: During 1997. STUDY GROUP: 147 pregnant women at their first pre-natal visit to outclinics of the Hospital del Mar. CONTROL GROUP: 50 non-smoker pregnant women monitored during their pregnancy. MEASUREMENTS AND MAIN RESULTS: The numbers of cigarettes per day that they said they smoked on their first monitoring visit to our centre and at the last attendance before giving birth were recorded. Cotinine levels in the urine samples taken on these visits were measured. Mean cotinine in pregnant women who said they had given up smoking was higher than in non-smokers. There was a statistically significant linear relationship between the number of cigarettes stated and cotinine levels at the first and last pregnancy monitoring visits, as well as between the variation in the number of cigarettes and cotinine levels at these two visits. The negative predictive value of what they said about their tobacco habit was 82.9%. CONCLUSIONS: There was a certain under-declaration by pregnant smokers, although their statements of consumption and cotinine levels correlated closely. The under-declaration did not increase despite reiterated advice to stop smoking, which means that, despite its limitations, it could be a useful indicator for evaluating the effect of interventions aimed at stopping women smoking during pregnancy.

Biomarkers↗
PubMed2000

[Determinant factors of smoking cessation during pregnancy].

BACKGROUND: To investigate sociodemographic factors and smoking habit characteristics associated with spontaneous smoking cessation during pregnancy. DESIGN SUBJECTS AND METHODS: Cross-sectional study including 726 pregnant smoking women who attended the antenatal clinic of the Vall d'Hebron University Hospital in Barcelona between July and December 1997 and who agreed to participate were studied. Information was obtained by a structured questionnaire which included items on age, educational level, marital status, previous and current smoking habit, partner smoking habit and partner's attitude towards the smoking habit of the pregnant woman. RESULTS: At the first antenatal visit, 19.7% of women had given up smoking spontaneously. Light smokers (between 1 and 9 daily cigarettes; OR = 4.74) or moderate smokers (between 10 and 19 daily cigarettes; OR = 2.20) were more likely to stop smoking compared to heavy smokers (more than 20 daily cigarettes). If the partner did not smoke, smoking cessation was more likely among pregnant women (OR = 1.78). At the first antenatal visit, among those women who carried on smoking during pregnancy, there was a significative reduction in cigarette consumption of about half the usual daily number of cigarettes smoked. CONCLUSIONS: One out of five pregnant women give up smoking spontaneously during pregnancy from the moment they know they were pregnant until the first antenatal visit. Women who are less likely to stop smoking during pregnancy are those who smoke a larger number of cigarettes. Family environment is an important influential factor in the smoking habit of the pregnant woman.

Adult↗
PubMed2000

Changes in the alcohol consumption pattern among schoolchildren in Barcelona.

Alcohol consumption is a major health problem in most developed countries. In Mediterranean countries, experimentation with alcoholic beverages typically occurs during the early adolescent years within the family context. In this study we analysed alcohol consumption and its determinants in a survey of a sample of schoolchildren in 1994. The results were compared to those obtained in a previous study in 1987. In 1994 a random, stratified sample of all 8th grade classrooms of a city, public, private or subsidised school was, obtained. Some 759 13 and 14 year old pupils responded to a self-administered questionnaire on health-related habits. Overall, there was a high awareness of alcohol in the environment, as 20.7% of the pupils reported their father was a regular or occasional drinker and 41.6% declared some of their friends were drinking. Compared with the results of the 1987 survey, there was a marked decline in the proportion of schoolchildren reporting alcohol consumption by their father or their siblings. Regarding the pupils' consumption, 66.7% of them had tried drinking alcohol in 1994, 54.7% declared they were allowed to drink in family celebrations, and 17.2% had experienced being drunk. Most of these indicators showed a significant decrease compared with the 1987 data, with the exception of drunken episodes where there appears to be no changes. The results suggest that there are some changes in the Spanish context, where regular drinking among adolescents may be declining.

Adolescent↗
PubMed2000

Social inequalities in health related behaviours in Barcelona.

OBJECTIVE: This study describes social class inequalities in health related behaviours (tobacco and alcohol consumption, physical activity) among a sample of general population over 14 years old in Barcelona. DESIGN: Cross sectional study (Barcelona Health Interview Survey). SETTING: Barcelona city (Spain). PARTICIPANTS: A representative stratified sample of the non-institutionalised population resident in Barcelona was obtained. This study refers to the 4171 respondents aged over 14. DATA: Social class was obtained from a Spanish adaptation of the British Registrar General classification. In addition, sociodemographic variables such as family structure and employment status were used. As health related behaviours tobacco consumption, alcohol consumption, usual physical activity and leisure time physical activity were analysed. Age adjusted percentages were compared by social class. Multivariate analysis was performed using logistic regression models. MAIN RESULTS: Women in the upper social classes were more likely to smoke, the adjusted odds ratio (OR) for social class V in reference to social class I was 0.36 (95% confidence intervals (95%CI): 0.19, 0.67), while the opposite occurred among men although it was not statistically significant in multivariate analysis. Smoking cessation was more likely among men in the higher classes (OR for class V 0.41, 95%CI: 0.18, 0.90). Excessive alcohol consumption among men showed no differences between classes, while among women it was greater in the upper classes. Engaging in usual physical activity classified as "light or none" in men decreased with lowering social class (OR class IVa: 0.55 and OR class IVb: 0.47). Women of social classes IV and V were less likely to have two or more health risk behaviours (OR for class V 0.33, 95% CI: 0.18, 0.62). CONCLUSION: Health damaging behaviours are differentially distributed among social classes in Barcelona. Health policies should take into account these inequalities.

Adolescent↗
PubMed1999

[Preventive behaviors for the sexual transmission of AIDS, other infections, and pregnancy in high-school students].

OBJECTIVES: To describe preventive behaviors and behavioral intentions related to AIDS sexual transmission, other sexually transmitted diseases and unwanted pregnancies among 10th grade Barcelona students. DESIGN: Cross-sectional study. Stratified random sample from Barcelona secondary schools in 1996. SETTING: Secondary schools. PARTICIPANTS: 981 students at 35 10th grade classrooms. MAIN RESULTS: 82% of the students are 15-16 years old. 58% are girls. 16% have had sexual intercourse (boys 18% and girls 14%); among those, 43% of males and 30% of females have had only once sexual intercourse. 78% use always or almost always a condom. 22% of boys and 44% of girls have refused at least an opportunity of unprotected intercourse. Boys feel more confident to buy, carry on and use a condom, however girls feel more confident in convincing their partner and refusing unprotected sex. Among those with sexual experience, partner opinion predicts condom use (boys OR = 30.8 and girls OR = 8.8), as well as partner use (boys OR = 14.2 and girls OR = 15.4). Intention to use condoms with a regular partner is related to the perception of youth normative behaviors (boys OR = 10.9 and girls OR = 4.4) and friends opinion (boys OR = 6.2 and girls OR = 5.4). Condom use with a non regular partner is related also to the perception that its use avoids infections and unwanted pregnancies (boys OR = 9.9 and girls OR = 8.0). Intention to refuse unprotected sex relates, in both genders, to youth normative behaviors and self-efficacy to refuse unprotected intercourse. CONCLUSIONS: 16% of the 10th grade students have had a sexual intercourse. Only half part of them use always condom, although it is the contraceptive method more frequently used. Condom use relates mainly to partners opinions and their current use. Intentions to use condoms are associated also to friends opinion and youth social norm perception. Intention to use a condom with non regular partners aims avoiding diseases and unwanted pregnancies.

Acquired Immunodeficiency Syndrome↗