Smoking habits in French farmers: a cross-sectional study.

BACKGROUND: Farmers are exposed to multiple air contaminants that may interact with tobacco smoking in the development of respiratory diseases. Farmers are currently considered to smoke less than non-farmers, but precise data in different categories of age and farming activities are lacking. METHODS: Smoking habits were studied in a cross-sectional study involving 4105 farmers and 996 non-farming controls aged 40-74 years in 9 French departments between October 2012 and May 2013. Three age groups were defined (40-54, 55-64 and 65-74years). Farmers were divided into four activity groups, namely cattle breeders, livestock farmers working in confined spaces, crop farmers and others. Smoking prevalence was compared between farmers and controls, and odds ratios (ORs) for smoking adjusted for age were calculated. RESULTS: The adjusted OR for ever-smoking was lower among farmers than among non-farmers in all age categories, but the ORs for current smoking were similar in farmers and controls. Smoking prevalence varied according to the type of farming activity, and was lower than in non-farming controls only among cattle breeders and confined livestock farmers. In farmers, the proportion of smokers was higher in the youngest age categories compared with the older age classes. CONCLUSIONS: Our results confirm that the prevalence of ever-smokers is lower in farmers than in non-farmers. Nevertheless, our data show that active smoking prevalence is similar in farmers and in non-farmers. This suggests that farmers, just like non-farmers, should be targeted by primary prevention campaigns against smoking.

Cystic fibrosis mortality trends in France.

BACKGROUND: In 1992 France set up a national cystic fibrosis observatory (Observatoire national de la mucoviscidose, ONM) to monitor the state of health of patients on an annual basis. Using the ONM data, this study estimates the main indicators for life expectancy and assesses the total number of cystic fibrosis patients. METHODS: The data for the years 1994 to 2003 are divided into 3-year periods. Life tables are drawn up for these periods, from which mean and median lengths of life are determined. Using the most recent life table, the number of births in 2003 and the incidence of the disease, the total population of patients can be estimated, assuming a stationary population. RESULTS: In 2001-2003, life expectancy at birth of patients registered with the ONM was 39.1 years and median length of life was 36.4 years. These results, substantially better than those of 1994-1996, are linked to improved conditions of patient inclusion in the ONM database, to improvements in their healthcare, but also to the limitations of the life tables. Based on the 2003 data, the total theoretical number of patients is 6490, and coverage by the ONM database is thus 63.2%. CONCLUSIONS: These provisional results demonstrate the need to convert the ONM observatory into a registry providing exhaustive coverage of all patients.