Effects of comprehensive smoke-free legislation in Europe / Efectos de la legislación antitabaco en Europa

This paper reviews data regarding the effects of the legislation banning smoking in enclosed public places, including workplaces, restaurants and bars which entered into force in several countries of Europe starting with the year 2004. The source of data is represented by articles and short information published in peer reviewed journals or in electronic format between the years 2005 and 2008. Highlights include a consideration of the effects of these laws on the attitudes of the population regarding their implementation, exposure to passive smoking in public places as well as the scientific evidence on the public health and economic impact of these laws. The results of smoking ban in public places observed in several parts of Europe support initiatives in many countries toward implementing smoke-free legislation, particularly those who have ratified the Framework Convention on Tobacco Control, which calls for legislation to reduce tobacco smoke pollution.

Se revisaron datos sobre el impacto de las leyes que prohíben fumar en espacios públicos cerrados, incluyendo centros de trabajo, restaurantes y bares, las cuales entraron en vigor en varios países de Europa en 2004. La fuente de datos incluye artículos indexados y notas breves publicadas en revistas científicas o en formato electrónico entre 2005 y 2008. Los hallazgos incluyen una descripción del impacto de estas leyes sobre las actitudes de la población con respecto a su implementación, la exposición al humo de tabaco ambiental en espacios públicos cerrados, así como la evidencia científica sobre el impacto de estas leyes en la salud pública y en la economía. Los resultados de la prohibición de fumar en lugares públicos que se observaron en varios países de Europa confirman la importancia de promulgar iniciativas legislativas para crear ambientes libres de humo de tabaco en varios países del mundo, en particular en aquellos que han ratificado en Convenio Marco para el Control del Tabaco, que promueve una legislación para reducir la contaminación del aire con humo de tabaco.

A study on smoking habits among slum dwellers and the impact on health and economics.

To assess the impact on health from smoking with economic implications with major emphasis given to see whether passive smoking is an established outcome and if it is, how much additional burden of the disease is put on the smokers' families and consequently how much extra economic cost is put on such families, a study was conducted in a slum area of Howrah Municipal Corporation (HMC) on approximately 3000 families, which were randomly selected. Data was collected in relation to the socio-economic status, family members, housing with water and environmental sanitation, smoking habit, energy used for cooking, health awareness, follow-up of episodes of diseases of all ages, their remedial action taken and estimation of economic burden of the disease due to smoking (active and passive). There was a statistically significant difference in disease pattern between smokers' family and non-smokers' family especially with relation to chronic obstructive pulmonary disease, coronary heart disease, acute respiratory infections, common cold, hypertension and peptic ulcer (p<0.05). Also it was observed that with increasing years (1st, 2nd, 3rd years), the number of cases in each disease group gradually increased. This can be attributed to the effect of passive smoking especially when environmental conditions and socio-economic variants are same in both groups. Cost analysis of the illness episodes in the smokers' and non-smokers' families showed that there was a 3-fold difference in average annual expenditure between the families of the non-smokers and that of smokers and a 8-fold difference in work days lost. There was a 4-fold difference in annual expenditure on these diseases by the families. It is observed that when the total cost of smoking was included in the total expenditure, there was a 12-fold increase in annual expenditure between smokers' and non-smokers' families. The study conclusively proves that there are ill effects on health both from active and passive smoking. It is also demonstrated here that apart from economic implications due to direct smoking, the economic loss has been added to smokers' families due to passive smoking.

Tabaquismo y enfermedad pulmonar obstructiva crónica: determinación de fracciones atribuibles / Smoking and chronic obstructive pulmonary disease: attributable risk determination

Background: Smoking is the main risk factor for Chronic Obstructive Pulmonary Disease (COPD), an important cause of morbidity and mortality. Aim: To estimate smoking attributable risk and population attributable risk in COPD patients attended in Public Health Services of Santiago. Materials and methods: A case control study matched by sex and age was carried out. Crude and adjusted attributable risks as well as population attributable risk were estimated, controlled by potential confounders and by interaction variables. Results: Mean ages for cases and controls were 68 and 67 years respectively. When compared to the control group, COPD patients had a higher smoking prevalence (at least 100 cigarettes in their life span: 89.7 percent vs 60.3 percent; p <0.01). Among COPD patients, heavy smokers proportion was 4 times higher than in controls, they smoked for more years (43 vs 31; p <0.01) and more cigarettes per day (18 vs 5; p <0.01). Adjusted attributable risk was 87 percent (95 percent Confidence Interval (CI): 63.7-94.8). If a patient smoked at least 100 cigarettes in his/her life span and this risk was 92.7 percent (CI: 82.4-96.9) for heavy smokers. Projecting this index to Santiago inhabitants, about 87,000 individuals older than 40 years would be suffering COPD due to smoking. Conclusions: This article confirms the strong association between smoking and COPD. Attributable risks are high and significant, even when they are adjusted by confounding variables. Women had a higher risk than men, at lower levels of tobacco consumption.

Usos alternativos del dinero dedicado a fumar y valoración del riesgo por exposición al humo de tabaco ambiental / Alternative uses of the money spent in smoking and assessment of the risk for exposure to the environmental cigarette smoke

En la lucha antitabáquica, lo referente al costo que el tabaquismo representa para el fumador, su familia, las instituciones de salud y la sociedad no ha sido incluido con frecuencia. Los objetivos de esta investigación fueron identificar en qué emplearían los fumadores y los no fumadores el dinero que los primeros dedican a su adicción, así como describir en ambos grupos la valoración del daño producido por el humo de tabaco ambiental. Se emplearon 3 cohortes que incluyeron 1 104 personas, pareadas por sexo y edad (± 5 años). Entre los resultados más significativos se observó que la alimentación fue la alternativa de uso del dinero más recurrida por ambos grupos. Aunque 9 de cada 10 encuestados valoraron como dañina la exposición al humo de tabaco ambiental, la mayor proporción de ellos fueron no fumadores. Puede concluirse que los fumadores asumen sus adicciones conscientes de que renuncian a otras actividades de la vida cotidiana, así como que en el desarrollo de las estrategias actuales en el país contra el tabaquismo es aún insuficiente el énfasis sobre la dimensión social que tiene la conducta de fumar