Geo-Epidemiology of Tobacco Smoking in Europe and the impact of Twelve Tobacco Control Measures
Science Journal of Public Health
Volume 3, Issue 3-1, May 2015, Pages: 24-29
Received: Mar. 28, 2015;
Accepted: Mar. 30, 2015;
Published: Apr. 11, 2015
Views 4484 Downloads 136
Pistolla Georgia, Faculty of Medicine, University of Crete, Iraklion, Greece
Sifaki-Pistolla Dimitra, Faculty of Medicine, University of Crete, Iraklion, Greece
Background: Tobacco use is one of the major causes of premature death worldwide. The purpose of the present study is to examine which of the known evidence-based control measures actually work, and indentify their preventive or risky effects, in order to determine the various risk areas for any daily tobacco use in Europe. This is a cross-sectional geo-epidemiological study using secondary database data from the World Health Organization. Methods: Data from 2009 were used for all European countries. Daily smoking of any tobacco product (DSTP) and 12 other factors referring to tobacco control, comprise the main under study parameters. The final sample consisted of subjects from 45 European countries. First, the data management was fulfilled. Then, spatial statistics were performed in Arcmap 10 (GIS). Moran’s I and OLS spatial regression model were applied for the detection of spatial correlations and the high risk areas. Results: High spatial heterogeneity was demonstrated through the DSTP distribution. Greece and Austria have the highest rates (38-49%), Bulgaria, Albania, Bosnia Herzegovina, and Russia follow with 30-37%. Three out of the twelve factors examined were found to be random. The rest of them were used in the regression model, highlighting the high risk areas. Greece presented the highest risk (Exp B= 2.9; 95% CI= 2.183-3.326), Bulgaria, Turkey, Serbia and other countries followed (Exp B= 2.7; 95% CI= 1.937-3.013), whereas Finland, Norway and UK proved to be of no present risk (Exp B= 0.76; 95% CI= 0.258-0.936). Conclusions: Geo-epidemiology of tobacco usage monitors the phenomenon’s dynamics, effectively. It offers an insight in applying measures, co-examining for the first time, the effects of twelve measures of tobacco control as possible preventive or risk factors.
Geo-Epidemiology of Tobacco Smoking in Europe and the impact of Twelve Tobacco Control Measures, Science Journal of Public Health. Special Issue: Spatial Analysis and Mathematics in Health Research, During Times of Global Socio-Economic Instability.
Vol. 3, No. 3-1,
2015, pp. 24-29.
Jha P, Chaloupka FJ. Tobacco control in developing countries. Oxford, UK: Oxford University press 2000.
WHO Report on the Global Tobacco Epidemic. The MPOWER package. Geneva: World Health Organization 2008.
Peto R, Lopez AD, Boreham J, Thun M, Health C. Mortality from smoking in developed countries 1950-2000; indirect estimation from National Vital Statistics. Am J of Epidem 1996; 149: 529-530.
Mackay J, Eriksen M. The Tobacco Atlas. Geneva: World Health Organization 2002.
Li X, Li Q, Dong L, Sun B, Chen J, Jiang Y, et al.. Risk factors associated with smoking behaviour in recreational venues: findings from the International Tobacco Control (ITC) China Survey. Tobacco Control 2010; 19: 130-139.
WHO, Tobacco Free Initiative: Ten facts about tobacco and second-hand smoke. Available at: http://www.who.int/feaures/factfiles/tobacco/tobacco_facts/en/index.html , Accessed in: 01/05/2012.
Huisman M, Kunst AE, Mackenbach J P. Inequalities in the prevalence of smoking in the European Union: comparing education and income. Prev Med 2005; 40:756-764.
Health Law 76017. Legislation Newspaper of the Government of the Hellenic Democracy, 2nd edition, page 1001, August 1, 2002.
Levy D, Gallus S, Blackman K, Carreras G, Vecchia C, Gorini G. Italy SimSmoke: the effect of tobacco control policies on smoking prevalence and smoking attributable deaths in Italy. BMC Public Health 2012; 12:709.
Thomas RF, Mostashari F, Kerker BD, Miller N, Hajat A, Frankel M. Adult Tobacco Use Levels After Intensive Tobacco Control Measures: New York City, 2002–2003. American Journal of Public Health 2005; 95:1016-1023.
Shibuya K, Ciecierski C, Guindon E, Bettcher DW, Evans DB, Murray CJL. WHO Framework Convention on Tobacco Control: development of an evidence based global public health treaty. BMJ 2003; 327:154.
Niederdeppe J, Farrelly MC, Wenter D. Media advocacy, tobacco control policy change and teen smoking in Florida. Tob Control 2007;16:1 47-52.
Hamilton WL, Turner-Bowker DM, Celebucki CC, Connolly GN. Recall of anti-tobacco ads impact of warnings advertising: Cigarette advertising in magazines: the tobacco industry response to the Master Settlement Agreement and to public pressure. Tob Control 2002; 11:54-58.
Ross H, Stoklosa M, Krasovsky K. Economic and public health impact of 2007–2010 tobacco tax increases in Ukraine. Tob Control 2010; doi:10.1136/tc.2010.040071.
WHO database, World Health Organization, Available at: http://www.who.int/gho/en/ , Accessed in: 28/01/2012.
Anselin L. Local indicators of spatial association – LISA. Geographical analysis 1995; 27: 93-115.
Moran PAP. Notes on Continuous Stochastic Phenomena. Biometrika 1950; 37: 17–23.
Basu S, Reinsel GC. Regression models with spatially correlated errors. Journal of the American Statistical Association 1994; 89: 88-99.
Mitchell A. The ESRI Guide to GIS Analysis, Vol 2. ESRI Press. 2005.
Sethi JM, Rochester CL. Smoking and chronic obstructive pulmonary disease. Clinics in Chest Medicine 2000; 21: 67-86.
The Health Benefits of Smoking Cessation. A Report of the Surgeon General, DHHS Publication, no. (CDC) 90-8416, US Department of Health and Human Services, Public Health Service, Centers for Disease Control, Centers for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Rockville, Md, USA, 1990.
Karp I , O’Loughlin J, Hanley J, Tyndal RF, Paradis G. Risk factors for tobacco dependence in adolescent smokers. Tob Control 2006;15:199-204.
Rodriguez D, Carlos HA, Adachi-Mejia AM, Berke EM, Sargent JD. Predictors of tobacco outlet density nationwide: a geographic analysis. Tob Control 2010; 19: 256-258.
Vardavas CI, Connolly GN, Kafatos AG. Geographical information systems as a tool for monitoring tobacco industry advertising. Tob Control 2006;15:199-204.
Siahpush M, Jones PR, Singh GK, Timsina LR, Martin J. The association of tobacco marketing with median income and racial/ethnic characteristics of neighbourhoods in Omaha, Nebraska. Tob Control 2010;19:256-258.