Evolución de la prevalencia del tabaquismo en la Comunidad de Madrid, España: dos décadas de vigilancia epidemiológica, dos décadas de disminución progresiva (1995-2013) / Evolution of smoking prevalence in the Community of Madrid, Spain: two decades of epidemiological surveillance, two decades of progressive decrease (1995-2013)

Introducción. La vigilancia epidemiológica del tabaquismo constituye una medida esencial para combatir esta epidemia. La Consejería de Sanidad de la Comunidad de Madrid dispone de un Sistema para la Vigilancia Integral del Tabaquismo (VITa), integrado por diversos sistemas de información que se han ido desarrollando en el Servicio de Epidemiología desde 1995. Este trabajo analiza la evolución de la prevalencia de consumo de tabaco en la población adulta de la Comunidad de Madrid a lo largo del período 1995-2013. Material y métodos. Los datos proceden del Sistema de Vigilancia de Factores de Riesgo asociados a las Enfermedades No Transmisibles en la población adulta (SIVFRENT-A), uno de los sistemas que integran el sistema VITa, que mide de forma continua en la población de 18-64 años de la Comunidad de Madrid la prevalencia, distribución y características de los principales factores relacionados con el comportamiento o estilos de vida, entre ellos, el tabaco. Se ha calculado la prevalencia de consumo de tabaco anual en el período 1995-2013 y las razones de prevalencia de cada uno de los años respecto al primero, 1995. Resultados. Entre 1995 y 2013 la prevalencia de consumo de tabaco disminuyó en el conjunto de la población de 18-64 años de la Comunidad de Madrid del 42,4% (IC95%: 40,2-44,6%) en 1995 al 27,4% (IC95%: 25,4-29,5%) en 2013. En los hombres, la tendencia fue descendente, con una reducción del 45,8% (IC95%: 42,6-48,9%) en 1995 al 29,3% (IC95%: 26,4-32,3%) en 2013. En las mujeres, la tendencia fue descendente en las de 18-29 años, con una reducción del 52,2% (IC95%: 46,6-57,8%) en 1995 al 22,9% (IC95%: 17,4-29,1%) en 2013, y en las de 30-44 años, con una reducción del 48,5% (IC95%: 43,1-54,0%) en 1995 al 23,7% (IC95%: 19,5-28,3%) en 2013. En las mujeres de 45-64 años la tendencia fue ascendente, con un aumento del 19,1% (IC95%: 15,2-23,5%) en 1995 al 28,9% (IC95%: 24,5-33,7%) en 2013. Conclusiones. Entre 1995 y 2013 la prevalencia de consumo de tabaco disminuyó en el conjunto de la población de 18-64 años de la Comunidad de Madrid un 35,4% (36,0% en hombres y 34,5% en mujeres). La tendencia fue descendente durante todo el período en todos los grupos de edad y sexo, excepto en las mujeres de 45-64 años, en quienes la tendencia fue ascendente. El importante descenso no puede hacer perder de vista que el consumo de tabaco es aún elevado, con un fumador por cada 3,5-4 personas, también en los más jóvenes. Se necesitan intervenciones serias, contundentes y sostenidas para prevenir el inicio y ayudar al abandono del consumo. La epidemia de tabaquismo es un problema enteramente provocado por el ser humano y completa e inexcusablemente erradicable (AU)

Introduction. Tobacco epidemiologic surveillance is essential to fight against this epidemic. The Regional Ministry of Health of Madrid has a comprehensive system, the Tobacco Epidemic Comprehensive Surveillance System (Sistema para la Vigilancia Integral del Tabaquismo, VITa), which has been developed by the Department of Epidemiology since 1995. This study analyzes the prevalence of tobacco consumption from 1995 to 2013. Material and methods. Data from the Non-Communicable Diseases Associated Risk Factors Surveillance System in the adult population (Sistema de Vigilancia de Factores de Riesgo asociados a las Enfermedades No Transmisibles en la población adulta, SIVFRENT-A) have been analyzed. SIVFRENT-A is one of the systems that comprises the VITa system. This system measures on an annual basis the prevalence, distribution and characteristics of the main health behaviour risk factors, one of which is tobacco consumption. Annual prevalence of smokers was estimated for the period 1995-2013. Prevalence ratios were estimated for every year in respect of the first one, 1995. Results. Between 1995 and 2013, the prevalence of tobacco consumption in the population of the Community of Madrid aged 18-64 years decreased from 42.4% (95%CI: 40.2%-44.6%) in 1995 to 27.4% (95%CI: 25.4%-29.5%) in 2013. Men showed a downward trend, with a decrease from 45.8% (95%CI: 42.6%-48.9%) in 1995 to 29.3% (95%CI: 26.4%-32.3%) in 2013. Women showed a downward trend in those aged 18-29 years and 30-44 years, with declines from 52.2% (95%CI: 46.6%-57.8%) in 1995 to 22.9% (95%CI: 17.4%- 29.1%) in 2013 and from 48.5% (95%CI: 43.1%- 54.0%) in 1995 to 23.7% (95%CI: 19.5%-28.3%) in 2013, respectively. Women aged 45-64 years showed an upward trend, increasing from 19.1% (95%CI: 15.2%- 23.5%) in 1995 to 28.9% (95%CI: 24.5%-33.7%) in 2013. Conclusions. Between 1995 and 2013, the prevalence of tobacco consumption declined by 35.4% (36.0% for men and 34.5% for women). A downward trend was observed for the whole period in all the analyzed groups, except women aged 45-64 years, who showed an upward trend. Despite the important global reduction, current prevalence is still high and must not be overlooked (there is one smoker out of every 3.5-4 individuals in this population, even the youngest). Strong, dedicated and sustained interventions are needed to prevent people from starting to smoke and to promote smoking cessation. Tobacco epidemic is an entirely human-made epidemic and it is completely and undeniably eradicable (AU)

Sigamos trabajando duro para que los niños crezcan sin tabaco / We are continuing to work hard for children to grow up without smoking

No disponible

Informe: Vigilancia del consumo de tabaco y de la exposición ambiental al humo de tabaco en la Comunidad de Madrid en 2012. Resultados del sistema de Vigilancia Integral del Tabaquismo (VITa) / Report: Control of tobacco consumption and environmental exposure to tobacco smoke in the Community of Madrid in 2012. Results of the Global Tobacco Surveillance System

La Consejería de Sanidad de la Comunidad de Madrid dispone de un Sistema para la Vigilancia Integral del Tabaquismo (VITa) integrado por diversos sistemas de información que se han ido desarrollando en el Servicio de Epidemiología desde 1995. Su objetivo es proporcionar la información necesaria para combatir una epidemia que causa anualmente más de 5.000 muertes en la región de Madrid y más de 53.000 en España. En este informe se describe la situación de la epidemia hasta 2012, último año disponible. Entre 1995 y 2012 la prevalencia de consumo de tabaco en adultos disminuyó globalmente un 33,7%. En la población juvenil, la prevalencia de fumadores diarios disminuyó globalmente un 63,5% entre 1996/1997 y 2011/2012. Por otro lado, la prevalencia de exposición pasiva al humo de tabaco en espacios públicos descendió drásticamente hasta niveles inferiores al 5% en todos los espacios que han sido regulados de manera taxativa por las normativas sanitarias de prevención y control del tabaquismo (en concreto, las leyes de medidas sanitarias frente al tabaquismo en España 28/2005 y 42/2012), entre ellos, los bares, pubs, restaurantes y otros lugares de ocio (AU)

The Regional Ministry of Health of Madrid has a comprehensive system for the surveillance of the tobacco epidemic (Tobacco Epidemic Comprehensive Surveillance System). This system is comprised of several information systems that have been developed by the Department of Epidemiology since 1995. The aim of this system is to provide the information needed to fight an epidemic that causes more than 5,000 deaths in the Community of Madrid every year and more than 53.000 per year in Spain. This report describes the epidemic until 2012, the most recent year available. Between 1995 and 2012 the prevalence of tobacco consumption within the adult population decreased 33.7%. Among adolescents, the prevalence of daily smokers decreased 63.5% from 1996/1997 to 2011/2012. Additionally, the prevalence of involuntary exposure to tobacco smoke dropped dramatically to less than 5% in all public places that have been firmly regulated by the Spanish comprehensive public health smoke-free laws (National Law 28/2005 and National Law 42/2012), among which are bars, pubs, restaurants and other leisure facilities (AU)

[Mortality from cancer in children and adolescents in Madrid, 1977-2001]. / Mortalidad por cáncer en niños y adolescentes de la Comunidad de Madrid, 1977-2001.

INTRODUCTION: In the last few decades mortality from cancer among children and adolescents has not decreased homogeneously in industrialized countries. The aim of this study was to determine the epidemiological pattern and temporal trend of mortality from cancer in individuals aged less than 20 years old living in the Autonomous Community of Madrid from 1977 to 2001. MATERIAL AND METHODS: Data on deaths from cancer among children and adolescents were obtained from Spain's National Institute of Statistics and from the Mortality Registry of Madrid. Populations were obtained from official publications of the Institute of Statistics of Madrid. Variables analyzed were sex, 5-year age groups, 5-year death periods and underlying cause of death. The epidemiological pattern was studied and a Poisson's regression model was used to analyze cancer mortality trends in children and adolescents from 1977 to 2001. RESULTS: Cancer mortality among children and adolescents decreased by 41 % from 1977 to 2001. The decrease in mortality differed according to sex (46 % in boys and 33 % in girls) and type of cancer (leukemias: 38 %, non-Hodgkin's lymphomas: 58 %, malignant brain tumors: 45 %, malignant bone tumors: 19 %, ill-defined malignant tumors: 78 %). Moreover, the annual decrease was much greater in the last 5 years (4. 7 %) than during the entire period (2. 2 %). CONCLUSIONS: Cancer mortality among children and adolescents decreased between 1977 and 2001 and our results are similar to those observed in other European and North American regions. To improve knowledge of the epidemiology of cancer among children and adolescents in the Autonomous Community of Madrid, future assessments including mortality, incidence, and survival indicators are required.

Mortalidad por cáncer en niños y adolescentes de la Comunidad de Madrid, 1977-2001 / Mortality from cancer in children and adolescents in Madrid, 1977-2001

Introducción: La mortalidad por cáncer en niños y adolescentes ha disminuido de modo desigual en los diferentes países desarrollados en las últimas décadas. El objetivo del estudio es conocer el patrón y la tendencia de la mortalidad por cáncer en menores de 20 años residentes en la Comunidad de Madrid entre 1977 y 2001. Material y métodos: Las defunciones fueron cedidas por el Instituto Nacional de Estadística y por el Registro de Mortalidad de la Comunidad de Madrid y las poblaciones se tomaron a partir de publicaciones oficiales del Instituto de Estadística de la Comunidad de Madrid. Las variables estudiadas fueron: sexo, grupo quinquenal de edad, período quinquenal de defunción y causa básica de defunción. Se describe el patrón epidemiológico y se analiza la evolución temporal de la mortalidad por cáncer infantil entre 1977 y 2001 mediante el ajuste de un modelo de Poisson log-lineal. Resultados: La mortalidad por cáncer infantil ha disminuido un 41 % a lo largo del período de estudio. El descenso ha sido desigual para los distintos sexos (varones: 46%; mujeres: 33%) y tipos tumorales (leucemias: 38 %; linfomas no hodgkinianos: 58 %; tumores malignos encefálicos: 45 %; tumores malignos osteoarticulares: 19 %; tumores malignos mal definidos: 78 %). El porcentaje de disminución anual de la mortalidad ha sido mucho mayor para el último quinquenio (4,7 %) que para el período completo (2,2 %). Conclusiones: La mortalidad infantil por cáncer ha descendido entre 1977 y 2001, acercando la situación de nuestra región a la de otras regiones europeas y norteamericanas. Serán necesarias futuras evaluaciones que integren indicadores de mortalidad, incidencia y supervivencia para un mejor conocimiento de la epidemiología del cáncer infantil en la Comunidad de Madrid

Introduction: In the last few decades mortality from cancer among children and adolescents has not decreased homogeneously in industrialized countries. The aim of this study was to determine the epidemiological pattern and temporal trend of mortality from cancer in individuals aged less than 20 years old living in the Autonomous Community of Madrid from 1977 to 2001. Material and methods: Data on deaths from cancer among children and adolescents were obtained from Spain’s National Institute of Statistics and from the Mortality Registry of Madrid. Populations were obtained from official publications of the Institute of Statistics of Madrid. Variables analyzed were sex, 5-year age groups, 5-year death periods and underlying cause of death. The epidemiological pattern was studied and a Poisson’s regression model was used to analyze cancer mortality trends in children and adolescents from 1977 to 2001. Results: Cancer mortality among children and adolescents decreased by 41% from 1977 to 2001. The decrease in mortality differed according to sex (46 % in boys and 33 % in girls) and type of cancer (leukemias: 38 %, non-Hodgkin’s lymphomas: 58 %, malignant brain tumors: 45 %, malignant bone tumors: 19 %, ill-defined malignant tumors: 78 %). Moreover, the annual decrease was much greater in the last 5 years (4. 7 %) than during the entire period (2. 2 %). Conclusions: Cancer mortality among children and adolescents decreased between 1977 and 2001 and our results are similar to those observed in other European and North American regions. To improve knowledge of the epidemiology of cancer among children and adolescents in the Autonomous Community of Madrid, future assessments including mortality, incidence, and survival indicators are required

Morbilidad y mortalidad derivadas del consumo de tabaco. Especial referencia a España / Morbidity and mortality derived from tobacco usage. Special reference to Spain

No disponible

[Smoking-attributable deaths in Spain in 1998]. / Mortalidad atribuible al tabaquismo en España en 1998.

BACKGROUND: Between 1993 and 1997, smoking prevalence remained stable in Spain yet age-adjusted death rates by smoking-related diseases decreased. Our study aimed to estimate the burden of smoking-attributable mortality in Spain in 1998. POPULATION AND METHOD: Spain's smoking prevalence, mortality and relative risks for death from the Cancer Prevention Study II were used to estimate smoking-attributable mortality in the population aged 35 years and over. RESULTS: In 1998, 55,613 deaths were attributable to smoking. One out of 4 deaths in males and one out of 40 deaths in females were attributable to tobacco. Two thirds of the attributable mortality corresponded to deaths due to lung cancer, chronic obstructive pulmonary disease, ischemic heart disease and stroke. CONCLUSIONS: Smoking actually represents a remarkable burden of avoidable deaths in Spain. Smoking-attributable mortality appears to continue increasing in the last years.

Consumption of alcoholic beverages and subjective health in Spain.

STUDY OBJECTIVE: To examine the relation between alcohol and main alcoholic beverage consumption and subjective health in Spain. DESIGN: Logistic regression analysis using a cross sectional survey based on self reported data on alcohol and alcoholic beverage consumption, subjective health and the principal confounding factors (age, sex, civil status, educational level, job status, social support, region of residence, size of town or city, tobacco consumption, physical activity during leisure time and work hours, and chronic disease). SETTING: The 1993 Spanish National Health Survey. PARTICIPANTS: A 19 573 person sample, representative of the non-institutionalised Spanish population aged 16 years and over. MAIN RESULTS: Among Spaniards, 31.4% reported their health as suboptimal (fair, poor or very poor) and 56.9% consumed alcohol regularly, with the majority having a preference for wine. Light (1-2 drinks per day) or moderate consumption (3-4 drinks per day) was the most frequent pattern. After adjusting for confounding factors, a negative dose-response relation was observed between consumption of total alcohol, wine and beer, and prevalence of suboptimal health (linear trend: p<0.001 for total alcohol, p=0.023 for wine, and p=0.030 for beer). In contrast, for consumption of spirits the prevalence of ill health in moderate drinkers was lower than in non-drinkers, with no clear relation at higher consumption. While persons reporting a preference for wine had a lower frequency of suboptimal health than did abstainers, they showed no difference in frequency of subjective ill health with respect to persons with preference for other types of drink or no preference whatsoever. CONCLUSIONS: The higher the consumption of total alcohol, wine and beer, the lower the prevalence of suboptimal health. These results differ from those obtained in several Nordic countries, where a "J shaped" relation has been observed for total alcohol and wine, and suggest that the relation between alcohol consumption and subjective health may be different in Mediterranean countries.

[Smoking and subjective health in Spain]. / Consumo de tabaco y salud subjetiva en España.

BACKGROUND: To examine the relationship between smoking and subjective health in Spain. MATERIAL AND METHOD: Datacome from the 1993 National Health Survey. Analyses were performed with logistic regression, adjusting for the main confounding factors. RESULTS: Among those less than 25 years, there is a dose-response relationship (p = 0.0001)between cigarette consumption and suboptimal health (fair, pooror very poor health). CONCLUSIONS: Smoking controlactivities should inform on the worse subjective health of youngsmokers, for whom other effects of tobacco smoking are less relevant because they appear to happen in the distant future.