Tobacco consumption in Europe can be estimated from several sources, including sales statistics and population surveys. The first source provides a reasonable estimate of total tobacco consumption, whereas the second gives estimates of the prevalence of smokers by sex and age. In 1950, daily cigarette consumption by adults in European countries varied between 1.7 in Portugal and 6.9 in Ireland, the corresponding US consumption being 8.9. In 1989, the variation was much smaller, ie, between 3.5 in the Netherlands and 10.1 in Greece. In the countries where consumption was high in 1950, maximum consumption was achieved around 1975, followed by stabilization or reduction. In other countries, where consumption was low in 1950, it is still increasing. In a 1987 European survey, the proportion of current smokers varied between 33% in Portugal and 46% in Denmark. Much of this difference comes from the low prevalence of smoking habits in the adult female population of southern Europe.
Data on the prevalence of smoking among doctors in Europe could be retrieved from 22 countries. Only in the UK, Finland, Norway, Sweden and the Netherlands surveys have been carried out systematically over many years. Marked decreases in the percentage of smokers among doctors have been noted, particularly in the UK and the Scandinavian countries. Only about 13 to 15% of physicians at present smoke in these countries, down from 60 to 70% in the 1950s. The highest percentages of smokers among doctors--about 40%--are found in Italy, Greece and Spain.
A decline in the incidence of notified hepatitis B cases has been observed in major parts of Europe since the mid-1980s. Sweden may be taken as an example of a low prevalence area in the north where notifications of acute hepatitis B declined from 6 cases/100,000 inhabitants in 1985 to only 3/100,000 annually in 1988-91. Choosing W. Germany as an example from central Europe, the notification rate of acute hepatitis B declined from 11 cases/100,000 inhabitants in 1984 to 6-8/100,000 in 1988-91. In Italy, a dramatic decline in hepatitis B infections has occurred since 1985, according to the national hepatitis surveillance system (SEIEVA), from 12 cases/100,000 inhabitants in 1985 to 5/100,000 in 1988-91. A similar trend has also been observed in the USA which seems to be unrelated to vaccination, since only limited vaccination programs have been initiated in high-risk groups. Also in Europe, changed sexual and needle-usage practices in risk groups such as drug addicts and male homosexuals have probably contributed to the observed decline. In southern Europe, rapidly improving socio-economic conditions and improved medical precautions against hepatitis B have probably also been important factors.
The article presents data on the mortality trends in Russia during the last decade in comparison with other countries in Europe. It is shown that in spite the decline in death rates, Russia remains among the countries with the highest mortality rates from CVD. The specifics of mortality that distinguish Russia from other countries are described: a large variability between regions in mortality levels, differences between sexes, dependence on geographical location and socio-economic development of the regions, and late referral to a doctor in life-threatening conditions. The article emphasizes the role of risk factors and accessibility and quality of medical care to the population, as the two main components of the mechanism for changing mortality from CVD.
Pneumococcal disease (Pnc) is responsible for invasive pneumococcal disease (IPD)--mainly meningitis and septicaemia--and is an infection of public health importance in Europe. Following the licensure of an effective conjugate vaccine (PCV) in Europe, several European countries, including France, Germany, the Netherlands, Norway, Spain and the United Kingdom, are introducing universal Pnc childhood immunisation programmes. As part of a European Union (EU) funded project on pneumococcal disease (Pnc-EURO), a questionnaire was distributed in late 2003 to each of the current 25 European Union member states as well as Norway and Switzerland to get a clearer picture of national surveillance for invasive pneumococcal disease (IPD) in Europe. All respondents were contacted in 2006 and asked to provide an update to the questionnaire. Twenty two of the 27 countries targeted completed and returned the questionnaire. Four of the 22 responding countries have no reporting requirement for IPD. Eighteen countries reported a total of 27 national surveillance systems. Case definitions employed in these systems differed. Fourteen of the 18 countries reported collection of IPD strains to a single reference lab for serotyping and in 12 countries to a single laboratory for susceptibility testing. Thirteen countries undertook laboratory quality assurance. Information on age and sex were widely collected, but only 11/27 systems collected information on pneumococcal polysaccharide vaccine status, while 5/27 systems collected information on pneumococcal conjugate vaccine status. The incidence of IPD reported in each of the 18 countries ranged from 0.4 to 20/100,000 in the general population, with a total of 23,470 IPD cases reported over a 12 month period. Surveillance for IPD in Europe is very heterogeneous. Several countries lack surveillance systems. Large differences in reported disease incidence may reflect both true differences, and also variations in patient and healthcare factors, including surveillance. If IPD surveillance in Europe can be strengthened, countries will be able to make informed decisions regarding the introduction of new pneumococcal vaccines and also to monitor and compare the impact and effectiveness of new programmes.
BACKGROUND: Mental health problems have become more common among young people over the last twenty years, especially in certain countries. The reasons for this have remained unclear. The hypothesis tested in this study is that national trends in young people's mental health are associated with national trends in young people's labour market. METHODS: National secular changes in the proportion of young people with mental health problems and national secular labour market changes were studied from 1983 to 2005 in Austria, Belgium, Denmark, Finland, Hungary, Norway, Spain, Sweden, Switzerland and the United Kingdom. RESULTS: The correlation between the national secular changes in the proportion of young people not in the labour force and the national secular changes in proportion of young people with mental health symptoms was 0.77 for boys and 0.92 for girls. CONCLUSION: Labour market trends may have contributed to the deteriorating trend in mental health among young people. A true relationship, should other studies confirm it, would be an important aspect to take into account when forming labour market policies or policies concerning the delivery of higher education.