Publications
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Mechili EA, Girvalaki C, Saliaj A, et al., 2019, WHO FCTC Article 14 enforcement in Albania: An urgent issue to tackle, Tobacco Prevention and Cessation, Vol: 5, ISSN: 2459-3087
Tobacco use is a major preventable risk factor for non-communicable diseases such as cardiovascular disease, cancer etc. Smoking prevalence in Albania is high. The country ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in 2006 and has passed different bills and adopted strict tobacco control laws during the years. Despite this, there is a huge gap in primary healthcare (PHC) personnel education in this field. Additionally, tobacco treatment support facilities, such as free of charge telephone quit lines, tobacco treatment clinics in hospitals or in the community, are lacking or not well established. Training of healthcare professionals in evidence-based practices as well as the development of national guidelines on tobacco treatment, capacity building for tobacco treatment delivery, pharmacotherapy availability, public opinion awareness and promotion of smoking cessation practices are some of the measures Albanian policy makers should undertake.
Fu M, Castellano Y, Tigova O, et al., 2019, Prevalence and correlates of different smoking bans in homes and cars among smokers in six countries of the EUREST-PLUS ITC Europe Surveys, Tobacco Induced Diseases, Vol: 16, ISSN: 1617-9625
Introduction:Second-hand smoke exposure has decreased in a number of countries due to widespread smoke-free legislation in public places, but exposure is still present in private settings like homes and cars. Our objective was to describe to what extent smokers implement smoking rules in these settings in six European Union (EU) Member States (MS).Methods:A cross-sectional survey was conducted with a nationally representative sample of adult smokers from Germany, Greece, Hungary, Poland, Romania and Spain (ITC six European countries survey, part of the EUREST-PLUS Project). We analysed data from 6011 smokers regarding smoking rules in their homes and in cars with children (no rules, partial ban, total ban). We described the prevalence of smoking rules by EU MS and several sociodemographic and smoking characteristics using prevalence ratios (PR) and 95% confidence intervals (CI) derived from Poisson regression models.Results:In homes, 26.5% had a total smoking ban (from 13.1% in Spain to 35.5% in Hungary), 44.7% had a partial ban (from 41.3% in Spain to 49.9% in Greece), and 28.8% had no-smoking rules (from 20.2% in Romania to 45.6% in Spain). Prevalence of no-smoking rules in cars with children was 16.2% (from 11.2% in Germany to 20.4% in Spain). The correlates of not restricting smoking in homes and cars included: low education (PR=1.51; 95%CI: 1.20-1.90 and PR=1.55; 95%CI: 1.09-2.20), smoking >30 cigarettes daily (PR=1.53; 95%CI: 1.10-2.14 and PR=2.66; 95%CI: 1.40-5.05) and no attempts to quit ever (PR=1.18; 95%CI: 1.06-1.31 and PR=1.28; 95%CI: 1.06-1.54).Conclusions:Among smokers in six EU MS, no-smoking rules were more prevalent in homes than in cars with children. Whilst awareness about the health effects of exposure to tobacco smoke on children seemed to be high, more research is needed to better understand the factors that promote private smoke-free environments.
Feliu A, Filippidis FT, Joossens L, et al., 2019, Impact of tobacco control policies on smoking prevalence and quit ratios in 27 European Union countries from 2006 to 2014, Tobacco Control, Vol: 28, Pages: 101-109, ISSN: 0964-4563
BACKGROUND: Tobacco use is still highly prevalent in Europe, despite the tobacco control efforts made by the governments. The development of tobacco control policies varies substantially across countries. The Tobacco Control Scale (TCS) was introduced to quantify the implementation of tobacco control policies across European countries OBJECTIVE: To assess the midterm association of tobacco control policies on smoking prevalence and quit ratios among 27 European Union (EU) Member States (EU27). METHODS: Ecological study. We used the TCS in EU27 in 2007 and the prevalence of tobacco and quit ratios data from the Eurobarometer survey (2006 (n=27 585) and 2014 (n=26 793)). We analysed the relationship between the TCS scores and smoking prevalence and quit ratios and their relative changes (between 2006 and 2014) by means of scatter plots and multiple linear regression models. RESULTS: In EU27, countries with higher scores in the TCS, which indicates higher tobacco control efforts, have lower prevalence of smokers, higher quit ratios and higher relative decreases in their prevalence rates of smokers over the last decade. The correlation between TCS scores and smoking prevalence (rsp=-0.444; P=0.02) and between the relative changes in smoking prevalence (rsp=-0.415; P=0.03) was negative. A positive correlation was observed between TCS scores and quit ratios (rsp=0.373; P=0.06). The percentage of smoking prevalence explained by all TCS components was 28.9%. CONCLUSION: EU27 should continue implementing comprehensive tobacco control policies as they are key for reducing the prevalence of smoking and an increase tobacco cessation rates in their population.
Kahnert S, Demjen T, Tountas Y, et al., 2019, Extent and correlates of self-reported exposure to tobacco advertising, promotion and sponsorship in smokers: Findings from the EUREST-PLUS ITC Europe Surveys, Tobacco Induced Diseases, Vol: 16, ISSN: 1617-9625
Introduction:Tobacco advertising, promotion and sponsorship (TAPS) are known to promote tobacco consumption and to discourage smoking cessation. Consequently, comprehensive TAPS bans are effective measures to reduce smoking. The objective of this study was to investigate to what extent smokers are exposed to TAPS in general, and in various media and localities, in different European countries.Methods:A cross-sectional analysis of national representative samples of adult smokers in 2016 from Germany, Greece, Hungary, Poland, Romania, and Spain (EUREST-PLUS Project, n=6011), as well as England (n=3503) and the Netherlands (n=1213) (ITC Europe Surveys) was conducted. Prevalence of self-reported TAPS exposure is reported by country, and socioeconomic correlates were investigated using logistic regression models.Results:Self-reported exposure to TAPS varied widely among the countries, from 15.4 % in Hungary to 69.2 % in the Netherlands. In most countries, tobacco advertising was most commonly seen at the point of sale, and rarely noticed in mass media. The multivariate analysis revealed some variation in exposure to TAPS by sociodemographic factors. Age showed the greatest consistency across countries with younger smokers (18–24 years) being more likely to notice TAPS than older smokers.Conclusions:TAPS exposure tended to be higher in countries with less restrictive regulation but was also reported in countries with more comprehensive bans, although at lower levels. The findings indicate the need for a comprehensive ban on TAPS to avoid a shift of marketing efforts to less regulated channels, and for stronger enforcement of existing bans.
Hummel K, Nagelhout GE, Fong GT, et al., 2018, Quitting activity and use of cessation assistance reported by smokers in eight European countries: Findings from the EUREST-PLUS ITC Europe Surveys, TOBACCO INDUCED DISEASES, Vol: 16, ISSN: 1617-9625
Nogueira SO, McNeill A, Fu M, et al., 2018, Impact of anti-smoking advertising on health-risk knowledge and quit attempts across 6 European countries from the EUREST-PLUS ITC Europe Survey, Tobacco Induced Diseases, Vol: 16, ISSN: 1617-9625
Introduction:Exposure to anti-smoking advertising and its effects differ across countries. This study examines the reported exposure to anti-smoking advertising among smokers and its relation to knowledge of smoking harms and quit attempts in six European countries.Methods:Data come from Wave 1 of the International Tobacco Control (ITC) 6 European Country (6E) Survey (Germany, Greece, Hungary, Poland, Romania, Spain) carried out among smokers between June and September 2016 (n=6011). Key measures included whether participants had noticed anti-smoking advertising in the last six months in 6 different channels, their knowledge of 13 adverse smoking/second-hand smoking health effects and if they had made at least one quit attempt in the last 12 months. Multivariate logistic regression models were used in the analysis.Results:Across the six countries, only 35.2% of smokers reported being exposed to any anti-smoking advertising. Television was the most common channel identified (25.7%), followed by newspapers and magazines (13.8%), while social media were the least reported (9.5%). Participants 18–24 years old were significantly more likely to have noticed advertisements on the Internet than participants >55 years old (24.3% vs 4.9%; OR=5.15). Participants exposed to anti-smoking advertising in all six channels were twice more likely to have a higher knowledge of smoking risks than those not exposed (2.4% vs 97.6%, respectively; OR=2.49). The likelihood of making a quit attempt was increased by 10% for each additional channel through which smokers were exposed to anti-smoking advertising.Conclusions:Knowledge of health risks of smoking tended to be higher in countries that aired a campaign in recent years. Exposure to anti-smoking advertising, in the six channels combined, was related to higher smoking knowledge of risks and to more quit attempts. Future anti-smoking mass media campaigns should consider advertising in all dissemination channels to increase the a
Filippidis FT, Laverty AA, Mons U, et al., 2018, Changes in smoking cessation assistance in the European Union between 2012 and 2017: pharmacotherapy versus counselling versus e-cigarettes, Tobacco Control, Vol: 28, Pages: 95-100, ISSN: 0964-4563
BACKGROUND: The landscape of smoking cessation may have changed in Europe recently. OBJECTIVES: To identify changes in use of smoking cessation assistance in the European Union (EU) and factors associated with use of cessation assistance. METHODS: Data from the 2012 (n=9921) and 2017 (n=9489) waves of the Eurobarometer survey were used. Self-reported use of smoking cessation assistance was assessed among smokers who had ever tried to quit and former smokers. Changes in use of each type of assistance were assessed using logistic regression. RESULTS: Among current and former smokers, those who had ever attempted to quit without assistance increased from 70.3% (2012) to 74.8% (2017). Current smokers were more likely to have used any assistance compared with former smokers (P<0.001). Use of e-cigarettes for smoking cessation assistance increased (3.7% to 9.7%)%), while use of pharmacotherapy (14.6% to 11.1%)%) and smoking cessation services (7.5% to 5.0%)%) declined. Younger people were more likely to have reported e-cigarette use for smoking cessation but less likely to have used a cessation service. Individuals living in countries with comprehensive smoking cessation policies were more likely to have used any cessation assistance (adjusted OR (aOR)=1.78; 95% CI 1.15 to 2.76), pharmacotherapy (aOR=3.44; 95% CI 1.78 to 6.66) and smoking cessation services (aOR=2.27; 95% CI 1.27 to 4.06) compared with those living in countries with weak smoking cessation policies. CONCLUSIONS: These findings highlight the need for approaches that ensure that smokers get support to quit smoking across the EU. The question of whether the availability of e-cigarettes will displace other methods, and the impact of such a displacement, should be closely evaluated.
Zatonski M, Herbec A, Zatonski W, et al., 2018, Characterising smokers of menthol and flavoured cigarettes, their attitudes towards tobacco regulation, and the anticipated impact of the Tobacco Products Directive on their smoking and quitting behaviours: The EUREST-PLUS ITC Europe Surveys, Tobacco Induced Diseases, Vol: 16, ISSN: 1617-9625
Introduction:Little research exists on the sociodemographic characteristics of menthol and flavoured cigarette (MFC) smokers in Europe. This study assessed the proportion of MFC smokers in Europe, their sociodemographic characteristics, and their attitudes towards tobacco control measures.Methods:Cross-sectional data were collected in 2016 among 10760 adult current smokers from 8 European countries (ITC Europe Project and EUREST-PLUS). Smokers of menthol, other flavoured, unflavoured tobacco, or no usual brand were compared on sociodemographic characteristics, attitudes towards a range of tobacco control measures (e.g. ban on flavouring), and on intentions regarding their smoking behaviour following the ban on flavoured tobacco. Data were analysed in SPSS Complex Samples Package using univariate analyses.Results:Among the respondents, 7.4% smoked menthol cigarettes and 2.9% other flavoured tobacco, but large differences existed between countries (e.g. 0.4% smokers smoked menthol cigarettes in Spain vs 12.4% in England). Compared to other groups, menthol cigarette smokers were younger, more likely to be female, better educated, had higher household income, and smoked fewer cigarettes (all p<0.001). A quarter of menthol smokers supported a ban on additives, compared with almost half of all other smokers (p<0.001). In case of a ban on flavourings, around a fifth of all MFC smokers intended to switch to another brand, and a third to reduce the amount they smoked or to quit smoking, but there was no consistent pattern across MFC smokers among the countries.Conclusions:The ban on flavourings introduced by the EU Tobacco Products Directive (extended to 2020 for menthols) will affect one in ten smokers in the countries surveyed, which provides an opportunity for targeting these groups with cessation programmes. However, smokers of menthol and flavoured cigarettes in the different European countries are a heterogeneous group and may need different approaches.
Fong GT, Thompson ME, Boudreau C, et al., 2018, The Conceptual Model and Methods of Wave 1 (2016) of the EUREST-PLUS ITC 6 European Countries Survey, Tobacco Induced Diseases, Vol: 16, ISSN: 1617-9625
Population-level interventions represent the only real approach for combatting the tobacco epidemic. There is thus great importance in conducting rigorous evaluation studies of tobacco control policies and regulations such as those arising from the WHO Framework Convention on Tobacco Control (FCTC) and the European Union’s 2014 Tobacco Products Directive (TPD). The ITC 6 European Countries Survey, a component of the Horizon 2020 Project entitled European Regulatory Science on Tobacco: Policy Implementation to Reduce Lung Disease (EUREST-PLUS), was created to evaluate and impact of the TPD in six EU Member States: Germany, Greece, Hungary, Poland, Romania, and Spain. In each country, a cohort survey of a representative national sample of 1000 smokers was conducted. This paper describes the conceptual model, methodology, and initial survey statistics of Wave 1 of the ITC 6E Survey, which was conducted June–September 2016. The ITC 6E Survey’s conceptual model, methodology, and survey instrument, were based on the broader 29-country ITC Project cohort studies, which have been conducted since 2002. The commonality of methods and measures allow a strong potential for cross-country comparisons between the 6 EU countries of the ITC 6E Project and 3 other EU countries (England, France, The Netherlands) in the ITC Project, as well as the broader set of ITC countries outside the EU.
Laverty AA, Filippidis FT, Vardavas C, 2018, Patterns, trends and determinants of e-cigarette use in 28 European Union Member States 2014-2017, Preventive Medicine, Vol: 116, Pages: 13-18, ISSN: 0091-7435
There is a lack of nationally representative data on regular e-cigarette use, as well as on the transition from experimentation to regular use. This study examines changes in these in Europe between 2014 and 2017. Data come from the 2014 (n = 27,801) and 2017 (n = 27,901) adult Special Eurobarometer for Tobacco Survey, providing nationally representative surveys of 28 EU member states. We defined regular use of e-cigarettes as daily or weekly use from a question on frequency of e-cigarette use. Among ever users of e-cigarettes we assessed socio-demographic correlates of becoming a regular user. 1.5% of the EU population were regular e-cigarette users in 2014, which had risen to 1.8% in 2017. In 2017 63 million Europeans aged 15 or older had ever used e-cigarettes (95% CI, 59.9 million–66.2 million), and 7.6 million (95% CI, 6.5million–8.9 million) were regular e-cigarette users. Among those who had ever used e-cigarettes, participants aged 15–24 years were less likely to be regular user than those aged ≥55 years (16.9% vs. 38.1%), as were never smokers compared with current and former smokers (12.8% vs. 27.0% vs. 41.3%). The proportion of adults who were regular e-cigarette users in 2017 ranged from 4.7% in the UK to 0.2% in Bulgaria. There have been slight rises in the proportion of people regularly using e-cigarettes in the EU, and this varies considerably between member states, indicating the role of the regional environment in supporting or deterring e-cigarette use.
Filippidis FT, Mechili E-A, Girvalaki C, et al., 2018, Prevalence and correlates of cigarillo use in European Union member states, 28th International Congress of the European-Respiratory-Society (ERS), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Vardavas CI, Becuwe N, Demjen T, et al., 2018, Study Protocol of European Regulatory Science on Tobacco (EUREST-PLUS): Policy implementation to reduce lung disease, Tobacco Induced Diseases, Vol: 16, Pages: 1-8, ISSN: 1617-9625
Efforts to mitigate the devastation of tobacco-attributable morbidity andmortality in the European Union (EU) are founded on its newly adoptedTobacco Products Directive (TPD) along with the first-ever health treaty,the WHO Framework Convention on Tobacco Control (FCTC). The aimof this Horizon 2020 Project entitled European Regulatory Science onTobacco: Policy Implementation to Reduce Lung Disease (EURESTPLUS) is to monitor and evaluate the impact of the implementation ofthe TPD across the EU, within the context of WHO FCTC ratification.To address this aim, EUREST-PLUS consists of four objectives: 1) Tocreate a cohort study of 6000 adult smokers in six EU MS (Germany,Greece, Hungary, Poland, Romania, Spain) within a pre-TID vs postTPD implementation study design; 2) To conduct secondary datasetanalyses of the Special Eurobarometer on Tobacco Survey (SETS); 3) Todocument changes in e-cigarette product parameters (technical design,labelling/packaging and chemical composition) pre-TID vs post-TPD;and 4) To enhance innovative joint research collaborations on chronicnon-communicable diseases. Through this methodological approach,EUREST-PLUS is designed to generate strong inferences about theeffectiveness of tobacco control policies, as well as to elucidate themechanisms and factors by which policy implementation translates topopulation impact. Findings from EUREST-PLUS have potential globalimplications for the implementation of innovative tobacco control policiesand its impact on the prevention of lung diseases.
Kyriakos CN, Filippidis FT, Hitchman S, et al., 2018, Characteristics and correlates of electronic cigarette product attributes and undesirable events during e-cigarette use in six countries of the EUREST-PLUS ITC Europe Surveys, Tobacco Induced Diseases, Vol: 16, Pages: 1-13, ISSN: 1617-9625
Introduction:This study assessed characteristics and correlates associated with e-cigarette product attributes and identified correlates of experiencing undesirable events during e-cigarette use among adult smokers across six European Union (EU) Members States (MS) prior to the implementation of the Tobacco Products Directive (TPD) in 2016.Methods:We conducted a cross-sectional survey with a nationally representative sample of adult cigarette smokers from six EU MS (Germany, Greece, Hungary, Poland, Romania, Spain) reporting e-cigarette use; randomly selected through a multistage cluster sampling design from June to September 2016. Stepwise logistic regressions were used to identify factors associated with use of flavors, noticing health warnings, mixing e-liquids, experiencing ‘dry puff’, e-liquid leaking during use and e-liquid spilling during refill.Results:Current daily or weekly prevalence of e-cigarette use among this sample of adult smokers was 7.5%. The most common attributes of e-cigarettes used included those that are flavored, contain nicotine, and are of tank style. Noticing health warnings on e-cigarette packaging and leaflets, respectively, was low (10.2% and 28%, respectively). Use of e-liquid refill nozzle caps, described as easy for a child to open, was associated with spilling during refill (OR=6.73; 95% CI: 2.02–22.37). Participants who adjusted occasionally or regularly the power (voltage) or temperature of their e-cigarette had greater odds of ever experiencing a ‘dry puff’ (OR=6.01; 95% CI: 2.68–13.46). Mixing different e-liquids was associated with leaking during use (OR=7.78; 95% CI: 2.45–24.73) and spilling during refill (OR=8.54; 95% CI: 2.29–31.88).Conclusions:Ongoing evaluation of factors associated with e-cigarette attributes and of the correlates of experiencing e-cigarette undesirable events during use, related to product design, is crucial to monitoring the impact of the implementing Act
Huepers A, Taddese H, Filippidis F, 2018, European Union citizens’ views on development assistance for developing countries, during the recent migrant crisis in Europe, Globalization and Health, Vol: 14, ISSN: 1744-8603
Background:Development assistance from governments of high income countries represents the vast majority of international funding for global health. Recent stagnation of this important source of funding may affect attainment of major global health goals. The financial crisis is widely accredited as denting governments’ outlay for development aid, as well as citizen’s support for aid. Europe has also recently experienced record levels of migration; the so called ‘European migration crisis’. This study aims to analyse trends in public attitudes towards development aid in European Union (EU) countries, in the context of the European migrant crisis.Methods:Eurobarometer survey data from 2011 (prior to the migrant crisis) and 2015 (at the peak of the crisis) was analysed for 27 EU countries. The outcome variables related to people’s levels of support to three statements around the importance of supporting people in developing countries, increasing countries’ commitments to aid and willingness to pay extra for products from developing countries. EU Member States were categorised as ‘arrival’ or ‘destination’ countries in view of migration routes and numbers of asylum applications per 100,000 population, respectively. Multiple linear regression analysis was performed, adjusting for countries’ economic status (gross domestic product per capita).Results:In general, support for development aid has increased from 2011 to 2015, but was largely unaffected by migration status when applying the regression model. In 2015, the belief that development assistance is ‘very important’ was significantly higher in countries where migrants first arrived compared to other EU Member States, with a trend towards this association also apparent in 2011.Conclusions:The positive trends in public support for development aid are encouraging in an age where economic hardships at home, as well as the tone of national politi
Filippidis F, Laverty A, 2018, “Euphoria” or “Only Teardrops”? Eurovision Song Contest performance, life satisfaction and suicide, BMC Public Health, Vol: 18, ISSN: 1471-2458
BackgroundThe popularity of the Eurovision Song Contest (ESC) in Europe has been high for decades. We aimed to assess whether a country’s performance in the ESC is associated with life satisfaction and suicide mortality in European countries.MethodsWe analysed nationally representative Eurobarometer survey data on life satisfaction from 33 European countries (N = 162,773) and country-level standardised suicide mortality data for years 2009 to 2015. The associations of winning the Contest, performing terribly, and higher final ranking with life satisfaction and suicide rates were all assessed.ResultsWinning the ESC was not statistically significantly associated with increased life satisfaction or suicide rates, although every ten-place increase in final ranking was associated with an increase in life satisfaction (adjusted odds ratios [aOR] 1.04; 95% confidence interval [CI]: 1.02 to 1.05) and a decrease in suicide mortality rates (β = − 0.30; 95% CI: -0.59 to − 0.01). Terrible performance was associated with greater life satisfaction compared to not competing at all (aOR 1.13; 95%CI: 1.07 to 1.20).ConclusionThe good news for participating countries is that just competing at the ESC is associated with higher life satisfaction among the population. As improved performance is linked to Ooh Aah Just a Little Bit of improved life satisfaction, further research into how such international competitions may impact public health is needed.
Chin S, Laverty A, Filippidis F, 2018, Trends and correlates of unhealthy dieting behaviours among adolescents in the United States, 1999-2013, BMC Public Health, Vol: 18, ISSN: 1471-2458
The increase in adiposity problems among United States adolescents has been accompanied by persistently high prevalence of unhealthy dieting behaviours (UDBs) such as fasting, taking diet pills/powders/liquids, and vomiting/taking laxatives.This study aimed to examine the associationsofself-perceptions of weightstatus, weight change intentions (WCIs)and UDBswith sex, age and race, as well astrends of UDBs in American adolescents across the weight spectrum.
Laverty AA, Vamos EP, Filippidis F, 2018, Uptake of e cigarettes among a nationally representative cohort of UK children, TOBACCO PREVENTION & CESSATION, Vol: 4, ISSN: 2459-3087
Introduction:Using nationally representative data this study examined experimentation with and regular use of e-cigarettes among children not using tobacco at age 11 years, followed up to age 14 years.Material and Methods:Data come from 10 982 children in the UK Millennium Cohort Study. Logistic regression assessed experimentation with and current use of e-cigarettes by age 14 years. We considered associations of sociodemographics at age 11 years with subsequent e-cigarette use, including data on family income, peer and caregiver smoking. Subsequent models were adjusted for current tobacco use to assess both the strength of the assocations between e-cigarette use and tobacco, and whether sociodemographics were associated with e-cigarettes independently of tobacco.Results:Among 10 982 children who reported never smoking at age 11 years, 13.9% (1525) had ever tried an e-cigarette by age 14 years, and of these 18.2% (278) reported being current users. Children in lower income households were more likely to have tried an e-cigarette than those in higher income households (Adjusted Odds Ratio, AOR 1.89, p=0.002). Children who reported friend (AOR 2.28, p<0.001) or caregiver smoking (AOR 1.77, p<0.001) at age 11 years were more likely to have tried an e-cigarette by age 14 years. After adjusting for current tobacco use, there was some attenuation of these associations, although associations of friend and caregiver smoking with e-cigarette use remained statistically significant.Conclusions:Children from lower income families were more likely to experiment with e-cigarettes by age 14 years, although this was heavily mediated by concurrent tobacco use. Caregiver and friend smoking are linked to trying e-cigarettes, although these relationships are less clear for regular e-cigarette use.
Laverty AA, Thompson H, Cetateanu A, et al., 2018, Macro-environmental factors and physical activity in 28 European Union countries, European Journal of Public Health, Vol: 28, Pages: 300-302, ISSN: 1101-1262
Data from the representative 2013 Eurobarometer survey were combined with macro-environmental data to assess relationships with different domains of physical activity (PA) in 28 European Union countries. Higher mean annual temperatures were the only macro-environmental factor found to be associated with levels of physical activity; an increase in the mean annual temperature by 1°C was associated with−0.94 fewer minutes of vigorous-intensity activity per week (95% CI: −1.66 to −0.23). This highlights the importance of modifiable influences (e.g. opportunities for active travel) on PA and underscores the potential of public health interventions to raise levels of physical activity.
Filippidis F, Agaku I, Vardavas C, 2018, Transition from experimentation with tobacco and nicotine products to regular smoking in Europe, 17th World Conference on Tobacco or Health, Publisher: International Society for the Prevention of Tobacco Induced Diseases, Pages: 105-105, ISSN: 1617-9625
Yang Y, Jawad M, Filippidis F, 2018, Prevalence and correlates of waterpipe use among adolescents in 60 countries, 17th World Conference on Tobacco or Health, Publisher: International Society for the Prevention of Tobacco Induced Diseases, Pages: 309-309, ISSN: 1617-9625
Laverty AA, Filippidis FT, Fernandez E, et al., 2018, Associations of e-cigarette experimentation with support for tobacco control policies in the European Union, 2012-2014, Tobacco Induced Diseases, Vol: 16, ISSN: 1617-9625
Introduction:There are limited data on the potential effects of e-cigarette experimentation on support for tobacco control policies. To bridge this gap, we assessed associations between e-cigarette experimentation and support for tobacco control policies in the European Union 2012-2014. We also investigated variations across tobacco-use status, e-cigarette experimentation and sociodemographic characteristics.Methods:Datasets were used from the Special Eurobarometer for Tobacco surveys performed in 2012 (n=26 751) and 2014 (n=27 801). Tobacco control policies assessed were: banning advertising, policies to keep tobacco out of sight, banning online sales, banning flavors, standardized packaging, tax increases, and policies to reduce illicit trade in tobacco. We use multilevel logistic regression models to assess variations in socio-demographics and tobacco/e-cigarette use with support for these policies in 2014, and examined changes in support for these policies, between 2012 and 2014, separately by tobacco-use status (never, current, and former smokers).Results:Population support for tobacco control policies was high in 2014: policies to reduce illicit trade had the highest level of support at 70.1%, while tax increases were the least likely measure to be supported with 52.3% support. Among never and former smokers, experimentation with e-cigarettes was associated with reduced support for all tobacco control policies assessed. For example, never smokers who had experimented with e-cigarettes were less likely to support either tobacco advertising bans (adjusted odds ratio aOR=0.57, 95% confidence interval 0.46-0.71) or standardized packaging for tobacco (aOR=0.58, 95% CI: 0.47-0.71). Former smokers who had experimented with e-cigarettes were less likely to either support standardized packaging for tobacco (aOR=0.70, 95% CI: 0.60-0.82) or keeping tobacco out of sight (aOR=0.77, 95% CI: 0.65-0.90). Among current smokers, e-cigarette experimentation was not associated wi
Alsaud A, taddese, filippidis F, 2018, Trends and correlates of the public’s perception of the healthcare system in the European Union: a multi-level analysis of Eurobarometer survey data from 2009 to 2013, BMJ Open, Vol: 8, ISSN: 2044-6055
Objective The aim of the study is to assess trends in public perceptions of health systems in 27 European Union (EU) member states following the financial crisis (2009–2013), in order to discuss observed changes in the context of the financial crisis.Design Repeated cross-sectional studies.Setting 27 EU countries.Participants EU citizens aged 15 years and older.Methods The study mainly uses the Eurobarometer Social Climate Survey, conducted annually between 2009 and 2013, thereby analysing 116 706 observations. A multilevel logistic regression was carried out to analyse trends over time and the factors associated with citizens’ perceptions of their healthcare systems.Results Europeans generally exhibit positive perceptions of their national healthcare systems, 64.0% (95% CI 63.6% to 64.4%). However, we observed a significant drop in positive perceptions in the years following the crisis, especially within countries most affected by the crisis. Concerning fiscal characteristics, wealthier countries and those dedicating higher proportion of their national income to health were more likely to maintain positive perceptions. At the individual level, perceptions of healthcare systems were significantly associated with respondents’ self-perceptions of their social status, financial capacity and overall satisfaction in life.Conclusions Our finding confirms previous observations that citizens’ perceptions of their healthcare systems may reflect their overall prospects within the broader socioeconomic systems they live in; which have in turn been affected by the financial crisis and the policy measures instituted in response.
Filippidis F, Laverty A, Hone T, et al., 2018, Associations of cigarette price differentials with infant mortality in 23 European countries, 17th World Conference on Tobacco or Health, Publisher: EUROPEAN PUBLISHING, Pages: 41-41, ISSN: 1617-9625
Petroulia I, Kyriakos CN, Papadakis S, et al., 2018, Quitting behaviors and cessation assistance used among smokers with anxiety or depression: Findings among six countries of the EUREST-PLUS ITC Europe Surveys, Publisher: EUROPEAN PUBLISHING, Pages: 24-25, ISSN: 1617-9625
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Kyriakos CN, Filippidis FT, Hitchman S, et al., 2018, Undesirable events during electronic cigarette use prior to the implementation of Article 20 of the European Union Tobacco Products Directive: Findings from the EUREST-PLUS ITC Europe Surveys, Publisher: EUROPEAN PUBLISHING, Pages: 24-24, ISSN: 1617-9625
Petroulia I, Vardavas C, Filippidis F, et al., 2018, The association between the awareness of the effects of smoking/secondhand smoke and the desire to quit, Publisher: EUROPEAN PUBLISHING, Pages: 274-274, ISSN: 1617-9625
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Feliu A, Joossens L, Filippidis FT, et al., 2018, Impact of tobacco control policies on smoking prevalence and quit ratios in 27 European Union countries from 2006-2014, Publisher: EUROPEAN PUBLISHING, Pages: 7-8, ISSN: 1617-9625
Filippidis FT, Girvalaki C, Mechili E-A, et al., 2017, Are political views related to smoking and support for tobacco control policies? A survey across 28 European countries., Tobacco Induced Diseases, Vol: 15, ISSN: 1617-9625
Background: General political views are rarely considered when discussing public support for tobacco control policies and tobacco use. The aim of this study was to explore potential associations between political views, smoking and support for tobacco control policies. Methods: We analysed responses from 22,313 individuals aged ≥15 years from 28 European Union (EU) member states, who self-reported their political views (far-left [1-2 on a scale 1-10]; centre-left (3-4); centre (5-6); centre-right (7-8); and far-right (9-10) in wave 82.4 of the Eurobarometer survey in 2014. We ran multi-level logistic regression models to explore associations between political views and smoking, as well as support for tobacco control policies, adjusting for socio-demographic factors. Results: Compared to those placing themselves at the political centre, people with far-left political views were more likely to be current smokers (Odds Ratio [OR] = 1.13; 95% Confidence Interval [CI]: 1.01-1.26), while those in the centre-right were the least likely to smoke (OR = 0.84; 95% CI: 0.76-0.93). Similar associations were found for having ever been a smoker. Respondents on the left side of the political spectrum were more likely to support tobacco control policies and those on the centre-right were less likely to support them, as compared to those at the political centre, after controlling for smoking status. Conclusions: General political views may be associated not only with support for tobacco control policies, but even with smoking behaviours, which should be taken into account when discussing these issues at a population level. Further research is needed to explore the implications of these findings.
Vardavas C, Filippidis FT, Ward B, et al., 2017, Plain packaging of tobacco products in the European Union: an EU success story?, European Respiratory Journal, Vol: 50, ISSN: 0903-1936
Filippidis FT, Laverty AA, Hone T, et al., 2017, Association of Cigarette Price Differentials With Infant Mortality in 23 European Union Countries., JAMA Pediatr, Vol: 171, Pages: 1100-1106
IMPORTANCE: Raising the price of cigarettes by increasing taxation has been associated with improved perinatal and child health outcomes. Transnational tobacco companies have sought to undermine tobacco tax policy by adopting pricing strategies that maintain the availability of budget cigarettes. OBJECTIVE: To assess associations between median cigarette prices, cigarette price differentials, and infant mortality across the European Union. DESIGN, SETTING, AND PARTICIPANTS: A longitudinal, ecological study was conducted from January 1, 2004, to December 31, 2014, of infant populations in 23 countries (comprising 276 subnational regions) within the European Union. INTERVENTIONS: Median cigarette prices and the differential between these and minimum cigarette prices were obtained from Euromonitor International. Pricing differentials were calculated as the proportions (%) obtained by dividing the difference between median and minimum cigarette price by median price. Prices were adjusted for inflation. MAIN OUTCOMES AND MEASURES: Annual infant mortality rates. Associations were assessed using linear fixed-effect panel regression models adjusted for smoke-free policies, gross domestic product, unemployment rate, education, maternal age, and underlining temporal trends. RESULTS: Among the 53 704 641 live births during the study period, an increase of €1 (US $1.18) per pack in the median cigarette price was associated with a decline of 0.23 deaths per 1000 live births in the same year (95% CI, -0.37 to -0.09) and a decline of 0.16 deaths per 1000 live births the following year (95% CI, -0.30 to -0.03). An increase of 10% in the price differential between median-priced and minimum-priced cigarettes was associated with an increase of 0.07 deaths per 1000 live births (95% CI, 0.01-0.13) the following year. Cigarette price increases across 23 European countries between 2004 and 2014 were associated with 9208 (95% CI, 8601-9814) fewer infant deaths; 3195 (95% CI, 3017-3372
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