The Finnish National Programme for Chronic Bronchitis and Chronic Obstructive Pulmonary Disease (COPD) 1998-2007 was set up to reduce the prevalence of COPD, improve COPD diagnosis and care, reduce the number of moderate to severe cases of the disease, and reduce hospitalisations and treatment costs due to COPD. Over 900 events for 25,000 participating healthcare workers were arranged. The major strengths of this programme included multidisciplinary strategies and web-based guidelines in nearly all primary health care centres around the country.
Data from national registries, epidemiological studies and questionnaires were used to measure whether the goals had been reached.
The prevalence of COPD remained unchanged. Smoking decreased in males from 30% to 26% (p
Comment In: Prim Care Respir J. 2011 Jun;20(2):109-1021603847
BACKGROUND: To date only a few studies have evaluated the long-term influence of smoking and smoking cessation on periodontal health. The present study, therefore, was undertaken with the aim to prospectively investigate the influence of smoking exposure over time on the periodontal health condition in a targeted population before and after a follow-up interval of 10 years. METHODS: The primary study base consisted of a population of occupational musicians that was investigated the first time in 1982 and scheduled for reinvestigation in 1992 and 2002. The 1992 investigation included 101 individuals from the baseline study constituting a prospective cohort including 16 smokers, who had continued to smoke throughout the entire length of the 10-year period; 28 former smokers who had ceased smoking an average of approximately 9 years before the commencement of the baseline study; 40 non-smokers, who denied ever having smoked tobacco; and 17 individuals whose smoking pattern changed or for whom incomplete data were available. The clinical and radiographic variables used for the assessment of the periodontal health condition of the individual were frequency of periodontally diseased sites (probing depth > or =4 mm), gingival bleeding (%), and periodontal bone height (%). The oral hygiene standard was evaluated by means of a standard plaque index. RESULTS: The changes over the 10 years with respect to frequency of diseased sites indicated an increased frequency in continuous smokers versus decreased frequencies in former smokers and non-smokers. Controlling for age and frequency of diseased sites at baseline, the 10-year change was significantly associated with smoking (P
The consumption of tobacco products has evolved to include more complex combinations of different products. We investigated the tobacco habits of a representative population of young Finnish male conscripts in order to evaluate the prevalence of dual use of cigarettes and snus as well as the transition from one tobacco product to another. In addition, we evaluated the correlation between the level of education and the use of cigarettes and snus.
A questionnaire-based survey was carried out in three out of 17 garrisons among conscripts during their first week of service in 2014. A total of 1971 male conscripts were selected by simple random sampling of the 9013 males in the selected garrisons. Of them 1916 participated and filled in the questionnaire. The response rate was 97.2%. The questionnaire consisted of 25 questions including age, gender, basic education, use of tobacco products as well as questions assessing nicotine dependency.
The amount of dual users of cigarettes and snus was 21%. There was a higher probability of dual use of cigarettes and snus among smokers compared to snus users (p
To review cigarette smoking among patients referred to the Northeastern Ontario Regional Cancer Centre (NEORCC).
Database analysis of the smoking history information for patients referred to the NEORCC from 1991-1999 was performed.
Data was available for 15,850 patients and 72.7% reported being either current or previous smokers. Approximately 24.5% of patients were still smoking and 7.8% had quit within the last year. Smoking rates and total consumption were highest among those patients with cancers arising in the lung, bladder, esophagus and head & neck regions. The percentage of patients reporting a history of smoking remained consistently high over the time period studied.
Cigarette smoking rates are high among NEORCC patients and strategies to improve the situation are required.
This study assessed whether US and Canadian smoking reduction objectives for the year 2000 are attainable. The United States seeks to cut smoking in its population to 15%; the Canadian goal is 24%.
Smoking data were obtained for the United States (1974-1994) and Canada (1970-1995) for the overall populations and several age-sex subpopulations. Analyses estimated trends, future prevalences, and the likelihood of goal attainment. Structural time-series models were used because of their ability to fit a variety of trends.
The findings indicate that smoking has been declining steadily since the 1970s, by approximately 0.7 percentage points a year, in both countries. Extrapolating these trends to the year 2000, the US prevalence will be 21% and the Canadian prevalence 24%.
If the current trends continue, the Canadian goal seems attainable, but the US goal does not. The US goal is reachable only for 65-to 80-year-olds, who already have low smoking prevalences. It appears that both countries must increase their commitment to population-based tobacco control.
Cites: JAMA. 1989 Jan 6;261(1):49-552908994
Cites: JAMA. 1989 Jan 6;261(1):61-52908996
Cites: Can J Public Health. 1992 Nov-Dec;83(6):404-61286438
Cites: Prev Med. 1990 Sep;19(5):552-612235922
Cites: Med Clin North Am. 1992 Mar;76(2):289-3031548962
The purpose of this study was to examine the relationship between municipal no-smoking bylaw strength and the odds of being a former smoker.
Data from Statistics Canada's Canadian Community Health Survey (Cycle 1.1, 2001) and a validated bylaw scoring scheme (2001) were linked and analyzed to determine whether the odds of being a former smoker were related to the strength of no-smoking bylaws in municipalities that had been matched for potentially confounding factors. The sample consisted of ever smokers (current and former smokers) from Ontario municipalities that did not have a no-smoking bylaw, or had a fully implemented no-smoking bylaw before September 2000. Data were analyzed using a Mantel-Haenszel Chi-square test and a logistic regression.
The results from the Mantel-Haenszel (OR = 0.94, 95% CI 0.80-1.12) and logistic regression analyses (OR = 0.95, 95% CI 0.82-1.11) did not find support for the hypothesis that living in a municipality with a strong no-smoking bylaw would increase the odds of being a former smoker.
Findings were inconsistent with previous studies that have found no-smoking restrictions in homes, workplaces and public places increase the odds that smokers attempt and succeed in quitting smoking. However, results from this study must be interpreted with caution because of the cross-sectional design and limited control of potentially important covariates.
Reduced availability of tobacco outlets is hypothesized to reduce smoking, but longitudinal evidence on this issue is scarce.
To examine whether changes in distance from home to tobacco outlet are associated with changes in smoking behaviors.
The data from 2 prospective cohort studies included geocoded residential addresses, addresses of tobacco outlets, and responses to smoking surveys in 2008 and 2012 (the Finnish Public Sector [FPS] study, n?=?53?755) or 2003 and 2012 (the Health and Social Support [HeSSup] study, n?=?11?924). All participants were smokers or ex-smokers at baseline. We used logistic regression in between-individual analyses and conditional logistic regression in case-crossover design analyses to examine change in walking distance from home to the nearest tobacco outlet as a predictor of quitting smoking in smokers and smoking relapse in ex-smokers. Study-specific estimates were pooled using fixed-effect meta-analysis.
Walking distance from home to the nearest tobacco outlet.
Quitting smoking and smoking relapse as indicated by self-reported current and previous smoking at baseline and follow-up.
Overall, 20?729 men and women (age range 18-75 years) were recruited. Of the 6259 and 2090 baseline current smokers, 1744 (28%) and 818 (39%) quit, and of the 8959 and 3421 baseline ex-smokers, 617 (7%) and 205 (6%) relapsed in the FPS and HeSSup studies, respectively. Among the baseline smokers, a 500-m increase in distance from home to the nearest tobacco outlet was associated with a 16% increase in odds of quitting smoking in the between-individual analysis (pooled odds ratio, 1.16; 95% CI, 1.05-1.28) and 57% increase in within-individual analysis (pooled odds ratio, 1.57; 95% CI, 1.32-1.86), after adjusting for changes in self-reported marital and working status, substantial worsening of financial situation, illness in the family, and own health status. Increase in distance to the nearest tobacco outlet was not associated with smoking relapse among the ex-smokers.
These data suggest that increase in distance from home to the nearest tobacco outlet may increase quitting among smokers. No effect of change in distance on relapse in ex-smokers was observed.
Previous studies have found that smoking cessation is associated with a short-term increase in health-care use. This may be because 'sicker' smokers are more likely to stop smoking. The current study assessed the association between smoking cessation and health-care use, adjusting for pre-cessation physical and mental health conditions.
Data came from the ATTEMPT cohort, a multi-national prospective survey of smokers in the United States, Canada, United Kingdom, France and Spain, that lasted 18 months (with follow-ups every 3 months).
A total of 3645 smokers completed the baseline questionnaire. All participants smoked at least five cigarettes per day, intended to quit smoking within the next 3 months and were between 35 and 65 years of age.
Participants were asked questions about their socio-demographic and smoking characteristics, as well previous smoking-related morbidities. Participants were also asked to report their health-care use in the previous 3 months i.e. emergency room (ER) visits, hospitalization, whether hospitalization required surgery, and health-care appointments.
A total of 8252, 4779 and 1954 baseline episodes of smoking were available for 3, 6 and 12 months, respectively. Of these, 2.8% (n = 230), 0.9% (n = 40) and 0.7% (n = 14) were followed by 3, 6 and 12 months of abstinence. No significant differences were found among 3, 6 or 12 months of abstinence and ER visits, hospitalization and whether hospitalization required surgery or health-care visits. However, 6-month smoking cessation episodes were associated with higher odds of reporting an appointment with a dietician.
Smoking cessation does not appear to be associated with a substantial short-term increase or decrease in health-care use after adjusting for pre-cessation morbidities.
To investigate whether smoking by general practitioners (GPs) and gender influence smoking cessation advice.
A self-administered questionnaire, originally developed by the WHO and modified according to the Finnish health care system was sent by mail to physicians who were members of the Finnish Medical Association (FMA). Participants were restricted to those who were living in Finland and were younger than 65 years. Numbers of participants was 3,057 and the response rate 69%.
Smoking male GPs gave less smoking cessation advice only to patients with a stomach ulcer or patients using oral contraceptive pills compared with their non-smoking colleagues. Male GPs gave less smoking cessation advice to pregnant patients or patients using contraceptive pills than female GPs. Female smoking GPs less likely advised patients who were pregnant or who were using oral contraceptive pills to stop smoking than non-smoking female GPs (p
We sought to evaluate the relationship between the perception of being overweight and BMI (body mass index) when participants were adolescents and their cigarette smoking as young adults. In 1993, 1598 students in grade 6 from 107 schools in Scarborough (Ontario) completed the base line questionnaire. Of these, 1,543, 1,455 and 1,254 responded at follow-ups in grades 8 and 11, and as young adults (in 2002), respectively. Reported smoking behavior was used to categorize people as current and never smokers. Self-reported height and weight were used to calculate BMI. Girls who thought themselves overweight in grades 8 and 11 were more likely to be smoking as young adults (odds ratios of 1.778 and 1.627, respectively). Boys with higher self-reported BMIs in grades 8 and 11 were more likely to be smokers as young adults (odds ratios of 1.115 and 1.095, respectively). These findings provide evidence of the longitudinal effect of perception of being overweight as an adolescent on smoking as a young adult and suggest possible ways of averting smoking behavior.