[Tobacco in Barcelona's metropolitan transportation: observation study]. / El tabaco en el transporte metropolitano de Barcelona: un estudio observacional.

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.

El tabaco en el transporte metropolitano deBarcelona: un estudio observacional / Tobacco in barcelona´s underground transport: an observation study

Objetivo. Describir el grado de señalización, consumo y venta de tabaco en las instalaciones del transporte metropolitano de Barcelona.Diseño. Estudio observacional, descriptivo.Emplazamiento. Comunitario.Métodos. Se seleccionó al azar una muestra de 54 estaciones, en las que se valoró la presencia de usuarios fumando, de personal fumando, de señalización sobre el consumo de tabaco y de venta de tabaco. Interacciones. En cada estación se realizaron observaciones de al menos 5 minutos en andenes, vestíbulo de acceso y pasillos y/o escaleras.Mediciones y resultados principales. Se registraron usuarios fumando en un 87 por ciento de las observaciones y colillas en el 97,5 por ciento de los casos, mientras que únicamente se observó personal de la compañía fumando en un 5,6 por ciento. En el 72,2 por ciento de las entradas se detectaron puntos de venta de tabaco. Los usuarios que fueron observados fumando se distribuyeron por igual en ambos sexos, si bien los varones en su mayoría eran adultos de edad media (64,3 por ciento) y las mujeres eran mayoritariamente jóvenes (60,6 por ciento). Se registró algún tipo de señalización en el 64,2 por ciento de las observaciones.Conclusiones. El grado de señalización y cumplimiento por parte del personal es elevado, aunque el consumo de tabaco por los usuarios es habitual. La venta de tabaco en las estaciones es muy frecuente. Los resultados justifican la adopción de intervenciones específicas dirigidas a mejorar el cumplimiento de las normativas. (AU)

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.

[Trends in smoking among school children: Barcelona, 1987-1996]. / Tendencias en el tabaquismo de los escolares: Barcelona, 1987-1996.

OBJECTIVE: Despite the growth of aids and of other causes of premature death, smoking is the main single cause of avoidable mortality in Spain. Given the addictive nature of tobacco and the difficulties experienced by many smokers to quit, the primary prevention of smoking is crucial. In recent years several initiatives have been developed to this end. The objective of this paper is to monitor smoking among schoolchildren by repeated surveys over a decade, to ascertain the impact of current interventions and to reorient them according to evidence. DESIGN: Cross sectional surveys over a decade, from 1987 to 1996, while several smoking prevention efforts were developed. Survey instruments were similar self administered and anonymous questionnaires. SITE: Schools in Barcelona (Catalonia, Spain). PARTICIPANTS: Around 1000 participants in each survey were selected through representative samples of 8th grade students (predominantly 13-14 years old), stratified by school type and size in each round. MAIN RESULTS: Ever smoking declined, specially for boys (global decline 12.4%, p = 0.05). There is a clear and steady decline, statistically significant, in the proportion smoking in the month prior to the survey (global decline 50.5%, p < 0.0001). The proportion of regular smokers declines from 1987 to 1994, and then is stabilized (global decline 23%, p < 0.05). The proportion of daily smokers fluctuates, but globally it is the lowest of the decade in 1996. No changes are visible in the proportion who declare buying tobacco for personal use. DISCUSSION: From 1987 to 1996 several smoking indicators show a decline among 8th grade schoolchildren in Barcelona, Spain. The pattern suggests a decline in global smoking experimentation and in the intensity of experimentation, with a small reduction in the prevalence of regular use, while the small proportion of daily smokers at this young age does not change.

[Evaluation of a community intervention program ("Quit and Win") for smoking cessation]. / Evaluación de una intervención comunitaria (programa "Quit and Win") para dejar de fumar.

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.

[The knowledge and application of regulations on smoking in secondary teaching centers]. / Conocimiento y aplicación de las normativas sobre tabaquismo en centros de enseñanza secundaria.

OBJECTIVES: Despite the growing body of legal and normative regulations regarding promotion, sales and consumption of cigarettes, a few studies have already pointed to a low enforcement and commitment of these restrictions. This study explores the degree of awareness and compliance of these norms in the secondary school. DESIGN: Cross-sectional, observational study. A telephone survey was carried out. PARTICIPANTS: A simple of school principals or deputy principal was surveyed. MEASUREMENTS: A questionnaire was designed to obtain respondents knowledge of the current policies regarding smoking, as well as on the existence of visible signals in the school wards. Besides, opinion on tolerance towards smoking behavior among the school teachers was ascertained. RESULTS: Virtually at the respondents (98.8%) declared to know the existence of the regulations, although only 74.4% declared to have specific regulations at the school level. Smoking by teachers was allowed in their own offices in 61.6% of the centers. In open grounds, only 4.7% of the centers authorized adults to smoke while 18.6% permitted to smoke to the students. Public centers were less restrictive than private centers. DISCUSSION: Principals of secondary schools are aware of the existing, policy, and in most cases largely restrict public consumption. However, there are still some important gaps regarding signals, consumption in outdoor public spaces and teachers consumption in their own offices. Specific interventions seem to be necessary to overcome this situation.

[Smoking and school children: context, opinions and behavior]. / El tabaco y los escolares: contexto, opiniones y comportamiento.

BACKGROUND: This paper studies smoking epidemiology in school-age students. MATERIAL AND METHODS: A cross-sectional survey of 8th grade students (13-14 years-old) in the schools of Barcelona (Catalonia, Spain) in 1987, 1992 and 1994. RESULTS: The perception of smoking in the students environment has decreased. The proportion of regular smokers decreases, from 12.6% in 1987 to 9.5% in 1994 (p < 0.05) (an annual decrease of 3.5%) although the proportion who experiment with tobacco remains table. CONCLUSIONS: There is a decrease in the prevalence of regular smoking in the school-age population (13-14 years-old) in Barcelona (Spain).

[Mid-term evaluation of a help program for smokers]. / Evaluación a medio plazo de un programa de ayuda a los fumadores.

BACKGROUND: Medical counsel to smokers is an intervention that has proved useful to motivate smokers to stop smoking. This study pretends evaluate the long-term impact (2 years and 9 months) of systematic and structured health counsel on the smoke habit from the primary health care. MATERIAL AND METHODS: In April 1990, in four primary care centers from Barcelona and Zaragoza, Spain, a program of systematic counselling to stop smoking with an offer of subsequent follow-up was initiated in all adult smokers (15-65 years of age). According to the answer, every patient was classified on one of seven established categories that allowed a individualized follow-up. Data from the total population included in the program from the beginning till January 1993, are analyzed. RESULTS: From 683 known smokers (59.2% males and 40.8% women), 20 were excluded for different reasons and 343 were included in the program (56.4% cover). Average age of included smokers was 35.1 years (SE = 0.6) and average number of visits of 5.3 (SE = 0.2) which was significantly higher than those not included in the program (33.4; SE = 0.6, and 2.7; SE = 0.1). An average follow-up of 14.3 months (SE = 0.5) and of 2.6 (SE = 0.1) interventions on each individual were done. The average daily number of cigarettes was 18.4 (SE = 0.6) in the initial period and 13.3 (SE = 0.6) on the last program evaluation. The final answers showed a 18.1% of quitters and a decrease of more than 50% on the initial consume on 32.6%. In 12% the answer was negative. CONCLUSIONS: Programs of systematic help for smokers show a higher level of favourable responses than does normal counselling.

[Prevalence and characteristics associated with tobacco use in a general population in Barcelona from 1983 to 1992]. / Prevalencia y características asociadas al consumo de tabaco en población general en Barcelona entre 1983 y 1992.

OBJECTIVES: To describe the evolution of smoking habits in the general population of Barcelona from 1983 to 1992 and motivation of smokers and the perceived social pressure to leave smoking in 1992. DESIGN: Cross-sectional descriptive study of trends. PLACE AND PARTICIPANTS: From 1983 to 1992 two health surveys were conducted with independent samples of the general population not living in an institution (n = 3,134 and n = 5,004, respectively) with an age > or = 15 years and resident in Barcelona. RESULTS: Prevalence of smoking for the study period among males had decreased significantly, from 54.6% to 46.2%, whereas in females a non-significant increase was observed, from 20.9% to 25.4%. The most marked decrease in smoking among males has occurred in the upper socioeconomic levels (I and II), whereas the increase among women has occurred in the lower socioeconomic levels (IV and V). In 1992 half of smokers of both sexes admitted the wish to leave smoking and a third part to have tried to do so sometime. Approximately 30% of smokers report to have been required to stop smoking indoor sometime. CONCLUSIONS: From 1983 and 1992 a decrease was observed in overall differences of smoking prevalence among both sexes, whereas differences associated with socioeconomic levels increased, with a higher consume in the mid-low levels. More than half of smokers wish to leave smoking, which indicates the need for spreading and reinforcing methods to leave smoking among predisposed smokers.

[Adolescents faced with addictive substances: tobacco, alcohol and noninstitutionalized drugs]. / Los adolescentes ante las sustancias adictivas: tabaco, alcohol y drogas no institucionalizadas.

BACKGROUND: A large share of premature mortality is Spain in related with the abuse of addictive substances: tobacco, alcohol and non-institutionalized drugs. Adolescence is a key period for the adoption of their use. An accurate knowledge of the attitudes, beliefs, environmental perceptions and behaviours of teen-agers is necessary for the design and evaluation of preventive interventions. METHODS: Data were obtained from a survey conducted in 1992 on smoking, alcohol and non-institutionalized drugs in 8th grade students (13-14 years old) of a representative sample of the schools of the city of Barcelona (Catalonia, Spain). RESULTS: Up to 44.1% have ever smoked, 10.9% are regular smokers and 15.5% have bought tobacco at some point. There are no differences in smoking patterns by sex at this age. Even if 35.5% never drink alcohol, 1.7% drink it daily, 15.5% drink on week-ends and 62.9% at family celebrations, while 13.5% have bought alcohol at some point and 22.4% report having got drunk at least once. There are no differences by sex in alcohol use at this age. Concerning non-institutionalized drugs, 35.4% of the students think that many adults use them, and 22.4% say that some friends have tried them. CONCLUSIONS: The results show the increasing penetration of tobacco and alcohol in the personal environment of the students, and the process of initiation. Compared with previous studies in this population, we can estimate a modest and non-significant reduction of regular smoking, and a reduction in daily and regular alcohol use.

[Smoking in primary schools]. / El tabaco en las escuelas primarias.

OBJECTIVE: To analyze policies related to tobacco use in primary schools. DESIGN: Cross-sectional study. SITE. Primary schools in the city of Barcelona, Spain. PARTICIPANTS: Schools principals of a representative sample of the 493 primary schools in the city; 98 of the 100 selected schools participated. MEASUREMENTS AND MAIN RESULTS: Schools are aware of the existing regulations in Catalonia. Although there is no smoking in classrooms--which represents an improvement compared with previous years--, visible use of tobacco by adults is frequent. Usually there is no formal policy on smoking. No smoking signs are rare, and usually there is no designated person with responsibilities for the enforcement of smoking policies. Schools rarely address smoking outside school hours, and adults are often allowed to smoke in the court, the dining room or the aisles. There are no significant differences between public and private schools. CONCLUSIONS: Although an improvement can be seen compared to the previous situation, smoking is still visibly present in schools. There must be specific prevention projects if schools are to have a positive influence in the social perception of smoking by schoolchildren.

[Prevalence of dental caries among school children: a cross-sectional survey in the city of Barcelona]. / Prevalença de la càries dental entre els escolars: una enquesta transversal a la ciutat de Barcelona.

The results of a cross-sectional survey performed in the spring of 1990 in a sample of 533 twelve-year old schoolchildren in the city of Barcelona (Spain) are presented. The proportion of children with caries is 49.2%, with a DMFT index of 1.34 (1.09 for boys and 1.50 for girls). 63.4% of permanent decayed teeth were filled, and 2.2% were missing. There is a socioeconomic gradient in dental decay, with more caries among the lower socioeconomic strata, where missing teeth concentrate. The comparison of these results with those of other studies suggests a decline in caries incidence in school age in Spain, and greater use of dental care services.

[A community program to stimulate smoking cessation]. / Un programa comunitario de estímulo a la cesación tabáquica.

A community program to stimulate smoking cessation developed on the 1988 World No-smoking Day in the city of Barcelona (Spain) is presented. Participants in this program could make a written commitment to quit, and received support materials by mail. The results are evaluated in a sample of participants: 69% declare having quit on the specified date, and 29% do not smoke after one year.

[Program for helping the smoker in primary care. Preliminary evaluation]. / Programa de ayuda al fumador para la atención primaria. Evaluación preliminar.

The program of help to the smoker (PHS) consists of a systematic intervention upon the whole of the demanding population, identifying the smokers and acting on them with a short, concise advise in all visits. The results after 2 months of operation of the PHS in a primary care center are reported. Among 483 persons 104 smokers were detected (23.65%). 27% showed a favorable disposition towards quitting smoking within a short term; only 17% declared to be against quitting. The best response (36.8% of favorable responses) was obtained in the group smoking 20 cigarettes per day or more. The reported data suggest that the PHS could be useful both in heavy and in minimal or moderate smokers. We consider these data as a preliminary evaluation; assessment with data of long term cessation from smoking is required.