Tobacco sales to underage buyers in France: findings from a mystery shopping study.

OBJECTIVES: In 2017, one in four French 17-year-olds was a daily smoker, even though France prohibited the sale of tobacco to under-18 minors in 2009. This research aims to evaluate the retail violation rate for sale to minors (RVRms) and the associated factors. STUDY DESIGN: The study design used is observational mystery shopping study. METHODS: We conducted a mystery shopping study enlisting 12-year-old and 17-year-old youths in a representative sample of 527 tobacco outlets during three weeks in spring 2019. Multinomial Logit and Probit regressions were estimated on the data collected. RESULTS: The law is not respected. Two of three sellers (65.2%) were willing to make an illegal sale to a 17-year-old minor, and almost one in 12 (8.1%) were willing to sell to a 12-year-old child attempting to buy tobacco. Illegal sales were more likely to be made by male sellers, retailing in big cities, when there were no in-shop queues, and to 17-year-old females. The absence of the mandatory enforcement poster flagging up the ban on the sale of tobacco to minors appears to be a strong factor associated with RVRm. CONCLUSIONS: These findings show that progress needs to be made to better enforce tobacco control legislation to help decrease underage smoking in France. Rate of compliance with the law could be improved by stronger enforcement measures and tougher sanctions, but also by training and the provision of age-verification tools for sellers, as demonstrated by experiments in other countries.

[Do smokers and potential smokers have to be offended in order to be dissuaded from smoking? The effectiveness of anti-smoking pictograms]. / Faut-il choquer les fumeurs et les fumeurs potentiels pour dissuader les comportements tabagiques ? Efficacité des pictogrammes contre le tabagisme.

BACKGROUND: As recommended by WHO in the fight against smoking, the French authorities have decided to implement the display of 14 "shock pictures" on cigarette packages in 2011. This study examines the effectiveness of this policy. METHODS: The present study is based on a self-reported questionnaire administered to a sample of 418 first-year medical students from a private faculty in January 2010. We consider a set of 12 European visual warnings that address different smoking problems. Econometric modeling is used to study the determinants of answers. RESULTS: Our results were twofold. Firstly, the most effective symbols concern the smoker himself/herself, they are explicit and related to an advanced stage of disease. Secondly, the warnings seem to be more effective to confirm the non-smokers in their choice than to deter smokers to smoke. CONCLUSION: This tobacco control policy seems to be effective. Therefore, visual warnings have to be carefully chosen before implementation.

Riesgo de complicaciones perinatales en embarazadas con periodontitis moderada y severa, en la ciudad de Córdoba. Argentina / Risk for adverse pregnancy outcome in a population with moderate and severe periodontal disease in Córdoba. Argentina

Objetivo: Evaluar en nuestro medio a las Periodontitis Moderadas a Severas (PM/S) en embarazadas como factores de riesgo de prematuridad (PP), ruptura prematura de membranas (RPM) y bajo peso al nacer (BPN). Método: Este estudio de cohorte, observacional y prospectivo involucró a 66 embarazadas en las semanas 24 a 30 de gestación, sin patologías sistémicas diagnosticadas, asistidas en dos hospitales universitarios de Maternidad y Neonatología de la ciudad de Córdoba, Argentina. Las pacientes fueron incorporadas al Grupo 1 ó de Cohorte expuesta al riesgo (CE) y Grupo 2 ó Cohorte no expuesta al riesgo (CNE) según presentaran o no PM/S en no menos de 4 sitios ubicados en diferentes cuadrantes de la boca. Fueron considerados los siguientes indicadores clínicos: índice de Placa Bacteriana (Pb); índice Gingival (IG); Profundidad de Sondaje (PS) y Nivel de Inserción Clínica (NIC) e"3 mm. Posteriormente, fueron recolectados los datos perinatales a partir de las historias clínicas de acuerdo con el sistema informático perinatal SIP (CLAP-OPS/OMS) y sometidos a los análisis estadísticos correspondientes. Resultados: Veintiún pacientes (n=21) conformaron el Grupo 1 ó CE; veintitrés mujeres (n=23) el Grupo 2 ó CNE y 22 embarazadas debieron ser excluidas por razones médicas. El 13.6 por ciento del total de pacientes, presentó su parto antes de las 37 semanas de gestación (PP). El Odds Ratio hallado para prematuridad fue de 6.06 (IC 95 por ciento; 5.86 - 7.76); para RPM, 2.8 (IC 95 por ciento; 1.81 - 4.39) y con respecto al BPN no se hallaron diferencias en la población estudiada. Conclusión: En la población analizada, las Periodontitis maternas moderadas a severas constituyen un verdadero factor de riesgo para PP y para RPM; por el contrario las mismas parecerían no tener influencia sobre los nacimientos de bajo peso.

Objectives: To evaluate moderate to severe Periodontitis (M/SP) in pregnant women as a risk factor for preterm birth (PTB), premature rupture of membranes (PROM) and low birth weight (LBW). Method: This observational and prospective cohort study involved 66 pregnant women between weeks 24 and 30 of gestation, without diagnosed systemic pathologies, attending at the Maternal and Neonatology University Hospital, Cordoba, Argentina. The patients were integrated into Group 1 or Cohort exposed to risk (CER) and Group 2 or Cohort not exposed to risk (CNER) according to whether they showed or not moderate to severe PD in no less than 4 points situated in different quadrants of the mouth. The following clinical indicators were considered: Dental Plaque Index (DP); Gingival index (GI); Periodontal Depth (PD) and Clinical Attachment Level (CALe"3 mm). Later, the perinatal data was collected from the medical records, according to the Perinatal informatic system, Latin American Center of Perinatology and Human Development-Panamerican Health Organization/WHO) and submitted to under proper statistical analyses. Results: Group 1 or CER comprised twenty-one patients (n=21); Group 2 or CNER comprised twenty-three women. 22 pregnant women had to be excluded due to medical reasons. 13.6 percent of the patients gave birth before the 37th week of gestation (PTB). The Odds Ratio for prematurity was 6.06 (CI 95 percent; 5.86 - 7.76); 2.8 for PROM (CI 95 percent; 1.81 - 4.39) and no differences were found concerning LBW among the population studied. Conclusion: In the population of patients studied, moderate to severe PD in pregnant women constitute a real risk factor for premature birth as well as for premature rupture of membranes; on the other hand, these diseases would not seem to affect low birth weight.

Origin differences in self-reported health among older migrants living in France.

OBJECTIVES: Little is known about the health status of older migrants living in Europe. Using detailed data collected in 2003, this study investigated differences in health status by country of origin within the older immigrant population living in France using a self-rated health measure. STUDY DESIGN: The database used in this research was the Passage à la Retraite des Immigrés survey, conducted from November 2002 to February 2003 on a sample of 6211 migrants aged 45-70 years and living in France at the time of the survey. METHODS: A difficulty with a self-rated outcome is that it may not be comparable between different origin groups, particularly because of cultural and linguistic differences. Therefore, generalized ordered Probit models were estimated, and an indicator of health, net of cross-cultural effects was constructed for each respondent. RESULTS: This study found that male immigrants from southern Africa and Asia, and female immigrants from northern Europe, southern Africa and Asia are more likely to be in good health, while the health status is lower among immigrants from Eastern Europe living in France. CONCLUSION: The diversity in health status within the immigrant population is large in France. These results are helpful in order to target the more disadvantaged origin groups and to adjust the provision of health care.