Publications
221 results found
Laverty AA, Been JV, Millett C, et al., 2017, A smoke-free world to protect child health., BMJ, Vol: 359, Pages: j4892-j4892
Vardavas C, Filippidis F, Laverty A, et al., 2017, Smoking Cessation in Europe: Trends in methods used in the European Union between 2012 and 2014, European-Respiratory-Society (ERS) International Congress, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
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Filippidis FT, Vardavas CI, 2017, Trends in exposure to secondhand smoke in the European Union, 2009-2014, European-Respiratory-Society (ERS) International Congress, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
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Filippidis FT, Somai M, 2017, A bibliometric overview of e-cigarette publications from 2007 to 2016, European-Respiratory-Society (ERS) International Congress, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
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Vardavas CI, Girvalaki C, Filippidis FT, et al., 2017, Characteristics and outcomes of e-cigarette exposure incidents reported to 10 European Poison Centers: a retrospective data analysis, Tobacco Induced Diseases, Vol: 15, ISSN: 1617-9625
Background: The use of e-cigarettes has increased during the past few years. Exposure to e-cigarette liquids, whetherintentional or accidental, may lead to adverse events our aim was to assess factors associated with e-cigarette exposuresacross European Union Member States (EU MS).Methods: A retrospective analysis of exposures associated with e-cigarettes reported to national poison centers wasperformed covering incidents from 2012 to March 2015 from 10 EU MS. De-identified and anonymous raw data wasacquired.Results: In total, 277 incidents were reported. Unintentional exposure was the most frequently cited type of exposure(71.3%), while e-cigarette refill vials were responsible for the majority of the reported incidents (87.3%). Two-thirds of allexposures (67.5%) occurred as ingestion of e-liquids, which was more frequent among children (≤ 5 years, 6–18 years)compared to adults (87.0% vs. 59.3% vs. 57.6%, p < 0.001 respectively), exposure via the respiratory (5.4% vs. 22.2% vs. 22.2%, p < 0.001) were more frequent among paediatric patients while ocular routes (2.2% vs. 3.7% vs. 11.4%, p = 0.021)were more frequent among adults. Logistic regression analyses indicated that paediatric incidents (≤ 5 years) were morelikely to be through ingestion (adjusted Odds Ratio [aOR] = 4.36, 95% Confidence Interval [C.I.]: 1.87–10.18), but less likelyto have a reported clinical effect (aOR = 0.41, 95% C.I.: 0.21–0.82).Conclusions: Our study highlighted parameters related to e-cigarette exposure incidents in 10 EU MS, the results ofwhich indicate that consideration should be given to the design features which may mitigate risks, thereby protectingusers, non-users and especially children.
Laverty AA, Filippidis FT, Fernandez E, et al., 2017, E-cigarette use and support for banning e-cigarette use in public places in the European Union., Prev Med, Vol: 105, Pages: 10-14
We investigated the factors associated with support for banning e-cigarette use in public places in the European Union (EU) and how this varies by socio-demographic determinants, use of tobacco, ever use of e-cigarettes and their perceived harm. Data are from the representative Special Eurobarometer for Tobacco survey performed in 2014 (n=27,801) in 28 EU member states. Analyses were conducted separately by tobacco use status (never, current, and former smokers) and e-cigarette experimentation status. 70.9% of never smokers, 63.1% of former smokers and 45.7% of current smokers in the EU supported a ban on the use of e-cigarettes in public places. In all groups, support for banning e-cigarettes in public places was lower among those who had experimented with e-cigarettes (adjusted odds ratios (aOR) 0.43 vs. 0.50 vs. 0.61, among never, current and former smokers respectively) and higher among those who perceived e-cigarettes as harmful (aORs 2.49 vs 2.35 vs. 2.40, among never, current and former smokers respectively). 40.5% of those who had experimented with e-cigarettes supported a ban on use in public places, although levels of support were lower among those who started using e-cigarettes in order to circumvent existing smoking bans (aOR 0.54, 95% Confidence Interval 0.45-0.64). Bans of e-cigarette use in public places in Europe have high levels of public support even among former and current tobacco smokers, although this does vary across population groups. As legislators consider approaches to e-cigarette use, public opinion is likely to become more important to the passing and enforcement of any legislation.
Palladino R, Hone T, Filippidis FT, 2017, Changes in support for bans of illicit drugs, tobacco, and alcohol among adolescents and young adults in Europe, 2008–2014, International Journal of Public Health, Vol: 63, Pages: 23-31, ISSN: 0303-8408
Objectives This study assessed the support for bans fortobacco, alcohol, and illicit drugs in adolescents and youngadults across the European Union (EU).Methods Data were analysed for the years 2008, 2011, and2014 for 27 EU member states. 37,253 individuals aged15–24 years were interviewed ascertaining their supportfor banning tobacco, alcohol, cannabis, cocaine, heroin,and ecstasy. Changes over time were assessed using multilevellogistic regression.Results Support for banning heroin, ecstasy, and cocainewas constantly greater than 90%, although support fell overtime. Support for cannabis ban declined (from 67.6% in2008 to 53.7% in 2014) as well as support for alcohol ban(from 8.9% in 2008 to 6.9% in 2014) and tobacco ban(from 17.9% in 2008 to 16.5% in 2014).Conclusions Support for banning substances among EUadolescents and young adults varied, with high support forheroin, cocaine, and ecstasy, but less support for banningcannabis, tobacco, and alcohol. There was reduction insupport of banning all substances between 2008 and 2014,but this varied substantially between European countries.
Korompoki E, Filippidis FT, Nielsen PB, et al., 2017, Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation, NEUROLOGY, Vol: 89, Pages: 687-696, ISSN: 0028-3878
Objective: To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up.Methods: A comprehensive literature search including MEDLINE, EMBASE, Cochrane library, clinical trials registry was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We considered studies capturing outcome events (ICH recurrence and IS) for ≥3 months and treatment exposure to vitamin K antagonists (VKAs), antiplatelet agents (APAs), or no antithrombotic medication (no-ATM). Corresponding authors provided aggregate data for IS and ICH recurrence rate between 6 weeks after the event and 1 year of follow-up for each treatment exposure. Meta-analyses of pooled rate ratios (RRs) were conducted with the inverse variance method.Results: Seventeen articles met inclusion criteria. Seven observational studies enrolling 2,452 patients were included in the meta-analysis. Pooled RR estimates for IS were lower for VKAs compared to APAs (RR = 0.45, 95% confidence interval [CI] 0.27–0.74, p = 0.002) and no-ATM (RR = 0.47, 95% CI 0.29–0.77, p = 0.002). Pooled RR estimates for ICH recurrence were not significantly increased across treatment groups (VKA vs APA: RR = 1.34, 95% CI 0.79–2.30, p = 0.28; VKA vs no-ATM: RR = 0.93, 95% CI 0.45–1.90, p = 0.84).Conclusions: In observational studies, anticoagulation with VKA is associated with a lower rate of IS than APA or no-ATM without increasing ICH recurrence significantly. A randomized controlled trial is needed to determine the net clinical benefit of anticoagulation in ICH survivors with AF.
Filippidis FT, Laverty AA, Fernandez E, et al., 2017, Correlates of self-reported exposure to advertising of tobacco products and electronic cigarettes across 28 European Union member states., Tobacco Control, Vol: 26, Pages: e130-e133, ISSN: 0964-4563
BACKGROUND: Despite advertising bans in most European Union (EU) member states, outlets for promotion of tobacco products and especially e-cigarettes still exist. This study aimed to assess the correlates of self-reported exposure to tobacco products and e-cigarettee advertising in the EU. METHODS: We analysed data from wave 82.4 of the Eurobarometer survey (November-December 2014), collected through interviews in 28 EU member states (n=27 801 aged ≥15 years) and data on bans of tobacco advertising extracted from the Tobacco Control Scale (TCS, 2013). We used multilevel logistic regression to assess sociodemographic correlates of self-reported exposure to any tobacco and e-cigarette advertisements. RESULTS: 40% and 41.5% of the respondents reported having seen any e-cigarette and tobacco product advertisement respectively within the past year. Current smokers, males, younger respondents, those with financial difficulties, people who had tried e-cigarettes and daily internet users were more likely to report having seen an e-cigarette and a tobacco product advertisement. Respondents in countries with more comprehensive advertising bans were less likely to self-report exposure to any tobacco advertisements (OR 0.87; 95% CI 0.79 to 0.96 for one-unit increase in TCS advertising score), but not e-cigarette advertisements (OR 1.08; 95% CI 0.95 to 1.22). CONCLUSION: Ten years after ratification of the Framework Convention for Tobacco Control, self-reported exposure to tobacco and e-cigarette advertising in the EU is higher in e-cigarette and tobacco users, as well as those with internet access. The implementation of the Tobacco Products Directive may result in significant changes in e-cigarette advertising, therefore improved monitoring of advertising exposure is required in the coming years.
Alshaikh M, Rawaf S, Filippidis F, et al., 2017, The Ticking Time Bomb in lifestyle-related diseases among women in the Gulf Cooperation Council Countries; Review of systematic reviews, BMC Public Health, Vol: 17, ISSN: 1471-2458
BackgroundThis study aims to review all published systematic reviews on the prevalence of modifiable cardiovascular disease risk factors among women from the Gulf Cooperation Council countries (GCC). This is the first review of other systematic reviews that concentrates on lifestyle related diseases among women in GCC countries only.MethodLiterature searches were carried out in three electronic databases for all published systematic reviews on the prevalence of cardiovascular disease risk factors in the GCC countries between January 2000 and February 2016.ResultsEleven systematic reviews were identified and selected for our review. Common reported risk factors for cardiovascular disease were obesity, physical inactivity, diabetes, metabolic syndrome and hypertension. In GCC countries, obesity among the female population ranges from 29 to 45.7%, which is one of the highest rates globally, and it is linked with physical inactivity, ranging from 45 to 98.7%. The prevalence of diabetes is listed as one of the top ten factors globally, and was reported with an average of 21%. Hypertension ranged from 20.9 to 53%.ConclusionsThe high prevalence of lifestyle-related diseases among women population in GCC is a ticking time bomb and is reaching alarming levels, and require a fundamental social and political changes. These findings highlight the need for comprehensive work among the GCC to strengthen the regulatory framework to decrease and control the prevalence of these factors.
Filippidis FT, Gerovasili V, Millett C, et al., 2017, Medium-term impact of the economic crisis on mortality, health-related behaviours and access to healthcare in Greece, Scientific Reports, Vol: 7, ISSN: 2045-2322
Previous studies on the health consequences of the crisis in Greece investigated short-term impacts on selected outcomes. This study examined the impact of the crisis on a key set of health indicators with longer follow up than previous studies. We conducted interrupted time series (ITS) analysis to compare trends in standardised mortality by cause before and during the crisis. We examined changes in fruit and vegetable consumption, smoking, physical activity, obesity, out-of-pocket payments and unmet needs for healthcare using national household data from the “Hellas Health” surveys. Standardised mortality rates for suicides (p < 0.001) and infant mortality (p = 0.003) increased during the crisis compared to pre-existing trends, while mortality from respiratory diseases (p = 0.053) and transport accidents (p = 0.067) decreased. The prevalence of smoking (42.6% to 36.5%; RR = 0.86) and sedentary lifestyle (43.4% to 29.0%; RR = 0.69) declined. The prevalence of unmet need for healthcare significantly increased from 10.0% to 21.9% (RR = 2.10) and the proportion of people paying out-of-pocket for healthcare from 34.4% to 58.7% (RR = 1.69) between 2010 and 2015. The impact of the economic crisis in Greece on health was more nuanced than previous reports suggest. Effective strategies to mitigate the adverse health impacts of economic crises need to be better understood and implemented.
Vardavas C, Agaku I, Filippidis F, et al., 2017, The Secondhand Smoke Exposure Scale (SHSES): A hair nicotine validated tool for assessing exposure to secondhand smoke among elderly adults in primary care, Tobacco Prevention and Cessation, Vol: 3, ISSN: 2459-3087
Introduction:Accurate estimation of exposure to Secondhand Smoke (SHS) is important in both research and clinical practice. We aimed to develop, an easy to implement, biomarker validated scale to provide an estimation of adult exposure to SHS for use within primary health care or epidemiological research.Methods:A pool of 26 baseline questions evaluating exposure to SHS was administered to 178 non-smoking adults (mean age 68.1 years), recruited from both urban and rural primary health care practices in Crete, Greece in November 2011, while concurrent hair samples were collected and nicotine concentrations were measured. To generate scores for each question item, we fitted a backward linear regression using the main predictors of SHS exposure selected from the initial pool of questions, weighted against each individuals biomarker evaluated exposure.Results:Among the pool of participants and weighted according to hair nicotine levels, in descending order, the most important sources of SHS exposure were the home (5 points, β=0.37), the family car (3 points, β=0.20), public places (2 points, β=0.15) and the workplace (1 point, β=0.013), the relative weighting of which led to the development of an 11-point scale to assess exposure to SHS. For every unit increase in the score, there was an associated increase in mean hair nicotine concentrations by 1.35 ng/mg (95%CI: 1.25-1.45, p<0.0001)Conclusions:The SHS exposure score (SHSES) may be a useful tool in an estimating the level of the exposure to SHS among elderly adults and investigating the relationship between SHS exposure and potential health outcomes.
Rajani NB, Vlachantoni IT, Vardavas CI, et al., 2017, The association between occupational secondhand smoke exposure and life satisfaction among adults in the European Union, Tobacco Induced Diseases, Vol: 15, ISSN: 1617-9625
BackgroundDespite existing legislation, a large proportion of the European Union (EU) population is exposed to occupational secondhand smoke (SHS). The aim of this study was to explore associations between occupational exposure to SHS and self-reported life satisfaction.MethodsWe analysed data collected through the Eurobarometer survey (wave 82.4) from n = 11,788 individuals working in indoor spaces. The sample was representative of the population of the 28 EU member states. We fitted a multilevel logistic regression model adjusting for smoking, age, gender, occupation, area of residence, education, difficulty paying bills, marital status and social class.Results27.5% of those working indoors reported at least some occupational exposure to SHS. People exposed to occupational SHS were less likely to report that they were satisfied with the life they lead (adjusted Odds Ratio = 0.72, 95% Confidence Interval: 0.60-0.87). The effect of occupational exposure on life satisfaction did not differ by smoking status, with all interaction terms between smoking status and occupational exposure to SHS not statistically significant.ConclusionExposure to SHS at the workplace does not only have negative consequences on physical health, but it can also impact life satisfaction of smokers and non-smokers. Our findings highlight the need for stricter enforcement of smokefree environments at the workplace in the EU.
Filippidis FT, Vardavas C, 2016, Exposure to e-cigarette advertising in the European Union, International Congress London 2016, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Geraghty O, Korompoki E, Filippidis FT, et al., 2016, Cardiac diagnostic work-up for atrial fibrillation after transient ischaemic attacks in England and Wales: results from a cross-sectional survey, BMJ Open, Vol: 6, ISSN: 2044-6055
Objectives Transient ischaemic attacks (TIAs) are an important precursor of stroke. Atrial fibrillation (AF) is among the most dangerous aetiologies shared between TIAs and strokes. Detection of AF after TIAs is essential for the initiation of oral anticoagulants. We aimed to identify variations in the use of cardiac investigations used to detect AF and cardiac pathology in patients with TIA in the UK.Setting All TIA clinical leads in England and Wales received an invitation by email to participate in an online survey in February 2015. The questionnaire consisted of 36 multiple choice questions covering the domains: (1) general information about stroke units, (2) ECG diagnostics and cardiologic work-up and (3) management of AF.Results 146 survey invitations were sent. The response rate was 40% (n=59). Diagnosis of AF largely depends on medical history and 12-channel ECG which is performed in the vast majority of patients with TIA (>75%) in 94.1% of the TIA services. Many patients with TIA either do not receive 24-hour Holter recording (requested regularly in 42% of the services) or only after considerable delay (>2 weeks). Prolonged event recording is only rarely performed (16%). Only about half of patients with TIA undergo echocardiography. Cranial imaging in patients with TIA is mainly performed as CT (62%). The majority of TIA clinics rapidly initiate anticoagulation in TIA patients with AF (81.6%) preferably using new oral anticoagulants (75.5%).Conclusions Significant variation in the cardiac diagnostic work-up following TIA exists regarding the use of particular detection techniques and the duration of cardiac ECG monitoring. Only limited resources are allocated to cardiac evaluation. In addition to research establishing the optimal ECG technique for patients with TIA, healthcare delivery programmes are needed to ensure proper management to prevent strokes.
Palladino R, Lee JT, Hone T, et al., 2016, The great recession and increased cost sharing In European health system, Publisher: Oxford University Press (OUP), ISSN: 1101-1262
Filippidis F, Gerovasili V, Man W, et al., 2016, Trends in mortality from respiratory system diseases in Greece during the financial crisis, European Respiratory Journal, Vol: 48, Pages: 1487-1489, ISSN: 1399-3003
Filippidis FT, Laverty AA, Vardavas CI, 2016, Experimentation with e-cigarettes as a smoking cessation aid: a cross-sectional study in 28 European Union member states, BMJ Open, Vol: 6, ISSN: 2044-6055
Objectives: To describe patterns of experimentation with electronic cigarettes as a smoking cessation aid, their self-reported impact on smoking cessation and to identify factors associated with self-reported successful quit attempts within the European Union (EU). Design: A cross-sectional study. Setting: 28 European Union member states. Methods: We analysed data from wave 82.4 of the Special Eurobarometer survey, collected in December 2014 from all 28 EU member states. The total sample size was n=27 801 individuals aged .15 years; however, our analyses were conducted in different subgroups with sample sizes ranging from n=470 to n=9363. Data on e-cigarette experimentation and its self-reported impact on smoking cessation were collected. Logistic regression models were used to assess factors associated with experimentation of e-cigarettes as cessation aids and with successful quitting. Logistic regression was also used to assess changes in the use of e-cigarettes as cessation aids between 2012 (using data from wave 77.1 of the Eurobarometer) and 2014 in each member state. Results: E-cigarettes were often experimented with as a cessation aid, especially among younger smokers (OR=5.29) and those who reported financial difficulties (OR=1.33). In total, 10.6% of those who had ever attempted to quit smoking and 27.4% of those who did so using a cessation aid had experimented with e-cigarettes as a cessation aid. Among those who had used e-cigarettes as a cessation aid, those with higher education were more likely to have been successful in quitting (OR=2.23). There was great variation in trends of use of e-cigarette as a cessation aid between member states. Conclusions: Experimentation with e-cigarettes as a potential cessation aid at a population level has increased throughout the EU in recent years, and certain population groups are more likely to experiment with them as cessation aids. Research on the potential population impact of these trends is imperatively needed
Hone T, Palladino R, Filippidis FT, 2016, Association of searching for health-related information online with self-rated health in the European Union., Eur J Public Health, Vol: 26, Pages: 748-753
BACKGROUND: The Internet is widely accessed for health information, but poor quality information may lead to health-worsening behaviours (e.g. non-compliance). Little is known about the health of individuals who use the Internet for health information. METHODS: Using the Flash Eurobarometer survey 404, European Union (EU) citizens aged ≥15 (n = 26 566) were asked about Internet utilisation for health information ('general' or 'disease-specific'), the sources used, self-rated health, and socioeconomic variables. Multivariable logistic regression was employed to assess the likelihood of bad self-rated health and accessing different health information sources (social networks, official website, online newspaper, dedicated websites, search engines). RESULTS: Those searching for general information were less likely to report bad health [odds ratios (OR) = 0.80; 95% confidence intervals (CI): 0.70-0.92], whilst those searching for disease-specific information were more likely (OR = 1.22; 95% CI: 1.07-1.38). Higher education and frequent doctor visits were associated with use of official websites and dedicated apps for health. Variation between EU member states in the proportion of people who had searched for general or disease-specific information online was high. CONCLUSIONS: Searching for general health information may be more conducive to better health, as it is easier to understand, and those accessing it may already be or looking to lead healthier lives. Disease-specific information may be harder to understand and assimilate into appropriate care worsening self-rated health. It may also be accessed if health services fail to meet individuals' needs, and health status is currently poor. Ensuring individuals' access to quality health services and health information will be key to addressing inequalities in health.
Filippidis FT, Gerovasili V, Laverty AA, 2016, Commentary on Farsalinos et al. (2016): Electronic cigarette use in the European Union: analysis of a representative sample of 27 460 Europeans from 28 countries., Addiction, Vol: 112, Pages: 544-545, ISSN: 1360-0443
Filippidis FT, Vardavas C, 2016, E-cigarette experimentation and support for tobacco control policies in the European Union, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Filippidis FT, Gerovasili V, Man WD-C, 2016, Trends in mortality from respiratory diseases in Greece during the financial crisis, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Filippidis FT, Mian SS, Millett C, 2016, Perceptions of quality and safety and experience of adverse events in 27 European Union healthcare systems, 2009-2013, International Journal for Quality in Health Care, Vol: 28, Pages: 721-727, ISSN: 1464-3677
OBJECTIVE: To assess trends in the perception of quality and safety between 2009 and 2013 in the European Union (EU). DESIGN: We analysed data from waves 72.2 and 80.2 of the Eurobarometer survey. Multilevel logistic regression models adjusted for sociodemographic factors and country-level health expenditure were fitted to assess changes between 2009 and 2013 in each of the assessed outcomes. SETTING: Twenty-seven EU member states. PARTICIPANTS: A total of n = 26 663 (2009) and n = 26 917 (2013) individuals aged ≥15 years. MAIN OUTCOME MEASURES: Outcomes included the perception of being harmed in hospital and non-hospital care; rating of the overall quality of the healthcare system; and personal or family experience of adverse events. RESULTS: Respondents in 2013 were more likely to think that it was likely to be harmed in hospital (Odds Ratio [OR] = 1.09; 95% Confidence Interval [CI]: 1.05-1.13; P < 0.001) and non-hospital care (OR = 1.11; 95% CI: 1.07-1.15; P < 0.001), compared to 2009. However, they were more likely to rate the quality of their country's healthcare system as good (OR = 1.26; 95% CI: 1.21-1.32; P < 0.001) and no significant change over time was identified in reported experience of adverse events (OR = 1.00; 95% CI: 0.95-1.05; P = 0.929). Lower health expenditure and decrease in health expenditure between the two waves were associated with worse outcomes in overall quality and perceptions of harm. There was significant variation between and within countries in all indicators. CONCLUSIONS: The public's perception of safety in European healthcare systems declined in recent years, which highlights that there are safety issues that could be addressed.
Alshaikh M, Filippidis F, Rawaf S, et al., 2016, Women in Saudi Arabia and the Prevalence of Cardiovascular Risk Factors; A systematic review, Journal of Environmental and Public Health, Vol: 2016, ISSN: 1687-9813
Background. Cardiovascular disease (CVD) is one of the leading causes of death in Saudi Arabia. Saudi women in particular are more susceptible as there are sociocultural restrictions on female physical activities that may lead to high prevalence of CVD risks, especially obesity, and physical inactivity. This study aims to systematically review the published articles related to the prevalence of CVD risk among women in Saudi Arabia. The search strategy covers all published articles that assess the risk factor of CVD in Saudi Arabia from January 2000 to December 2015, using the following sources: Medline, Embase, and PsycINFO. A total of 61 studies were included. Results. Prevalence among Saudi women of smoking ranged from 1.1% to 9.1%, hypertension was 21.8%, diabetes ranged from 9.6% to 27.6%, overweight was 27%, and obesity was 40.23%, and physical inactivity ranged from 53.2% to 98.1%. Hypercholesterolemia prevalence on Saudi women on average was 24.5%, while metabolic syndrome ranged from 13.6% to 40.3%. Conclusion. The prevalence of CVD risk factors is high among women in Saudi Arabia especially in obesity and physical inactivity. Public health authorities must implement solutions from a gender specific aspect to reverse the trend and decrease the prevalence of CVDs among Saudi women.
Rajani NB, Giannakopoulos G, Filippidis FT, 2016, Job insecurity, financial difficulties and mental health in Europe, Occupational Medicine, Vol: 66, Pages: 681-683, ISSN: 1471-8405
Background The recession has increased job insecurity in the European Union (EU) which may result in higher levels of psychological distress, burnout and anxiety.Aims To investigate the association of job insecurity and financial difficulties with mental health in 27 member states of the EU and to explore the moderating effect of having financial difficulties on the relationship between job insecurity and mental health.Methods The sample consisted of employed people from 27 European countries where the Eurobarometer survey (73.2 wave, 2010) was administered by the European Commission. Mental well-being and psychological distress were measured using the Vitality and Mental Health Index (MHI-5) subscales from the Short-Form 36-item health survey (SF-36v2). Linear regression including an interaction term was used to test the underlying factors in this study.Results Among the 12594 respondents, experiencing job insecurity was associated with lower Vitality [β = −3.82, 95% confidence interval (CI) −5.29 to −2.36] and MHI-5 (β = −3.48, 95% CI −4.91 to −2.04). Similarly, having financial difficulties was significantly correlated with lower Vitality (β = −8.65, 95% CI −12.07 to −5.24) and MHI-5 (β = −11.51, 95% CI −15.08 to −7.94). However, having financial difficulties did not moderate the relationship between job insecurity and both mental health scales.Conclusions This study highlights the negative effect of job insecurity and financial difficulties on mental health in the EU. Support to employees facing job security issues should be a priority regardless of the financial circumstances.
Laverty AA, Vardavas C, Filippidis FT, 2016, Design and marketing features influencing choice of e-cigarettes and tobacco in the EU, European Journal of Public Health, Vol: 26, Pages: 838-841, ISSN: 1464-360X
Data were analysed from the 2014 Special Eurobarometer for Tobacco survey. We estimated self-rated importance of various factors in the choice of both tobacco and electronic cigarettes (e-cigarettes) among tobacco smokers who had ever used an e-cigarette. Among ever users of tobacco and e-cigarettes (N = 2430), taste (39.4%), price (39.2%) and amount of nicotine (27.3%) were the most commonly cited reasons for choosing their brand of e-cigarettes. Those aged 15–24 were more likely to cite external packaging [adjusted prevalence ratio (aPR = 2.06, 95% CI 1.00–4.23)] and design features (aPR = 1.99, 1.20–3.29) as important. As further legislation is debated and enacted enhanced regulation of price, design and marketing features of e-cigarettes may help to reduce the appeal of e-cigarettes.
Palladino R, Lee JT, Hone T, et al., 2016, The Great Recession And Increased Cost Sharing In European Health Systems., Health Aff (Millwood), Vol: 35, Pages: 1204-1213
European health systems are increasingly adopting cost-sharing models, potentially increasing out-of-pocket expenditures for patients who use health care services or buy medications. Government policies that increase patient cost sharing are responding to incremental growth in cost pressures from aging populations and the need to invest in new health technologies, as well as to general constraints on public expenditures resulting from the Great Recession (2007-09). We used data from the Survey of Health, Ageing and Retirement in Europe to examine changes from 2006-07 to 2013 in out-of-pocket expenditures among people ages fifty and older in eleven European countries. Our results identify increases both in the proportion of older European citizens who incurred out-of-pocket expenditures and in mean out-of-pocket expenditures over this period. We also identified a significant increase over time in the percentage of people who incurred catastrophic health expenditures (greater than 30 percent of the household income) in the Czech Republic, Italy, and Spain. Poorer populations were less likely than those in the highest income quintile to incur an out-of-pocket expenditure and reported lower mean out-of-pocket expenditures, which suggests that measures are in place to provide poorer groups with some financial protection. These findings indicate the substantial weakening of financial protection for people ages fifty and older in European health systems after the Great Recession.
Filippidis FT, Laverty AA, Gerovasili V, et al., 2016, Two year trends and predictors of e-cigarette use in 27 European Union member states, Tobacco Control, Vol: 26, Pages: 98-104, ISSN: 0964-4563
Objective: This study assessed changes in levels of ever use, perceptions of harm from e-cigarettes and socio-demographic correlates of use among EU adults during 2012-2014, as well as determinants of current use in 2014. Methods: We analysed data from the 2012 (n=26,751) and 2014 (n=26,792) waves of the adult Special Eurobarometer for Tobacco survey. Point prevalence of current and ever use were calculated and logistic regression assessed correlates of current use and changes in ever use and perception of harm. Correlates examined included age, gender, tobacco smoking, education, area of residence, difficulties in paying bills and reasons for trying an e-cigarette. Results: The prevalence of ever use of e-cigarettes increased from 7.2% in 2012 to 11.6% in 2014 (Adjusted Odds Ratio [aOR]=1.91). EU-wide coefficient of variation in ever e-cigarette use was 42.1% in 2012 and 33.4% in 2014. The perception that e-cigarettes are harmful increased from 27.1% in 2012 to 51.6% in 2014 (aOR=2.99), but there were major differences in prevalence and trends between member states. Among those who reported that they had ever tried an e-cigarette in the 2014 survey, 15.3% defined themselves as current users. Those who tried an e-cigarette to quit smoking were more likely to be current users (aOR=2.82).Conclusion: Ever use of e-cigarettes increased during 2012-2014. People who started using e-cigarettes to quit smoking tobacco were more likely to be current users, but the trends vary by country. These findings underscore the need for more research into factors influencing e-cigarette use and its potential benefits and harms.
Stratakos G, Gerovasili V, Dimitropoulos C, et al., 2016, Survival and quality of life benefit after endoscopic management of malignant central airway obstruction, Journal of Cancer, Vol: 7, Pages: 794-802, ISSN: 1837-9664
BACKGROUND: Although interventional management of malignant central airway obstruction (mCAO) is well established, its impact on survival and quality of life (QoL) has not been extensively studied. AIM: We prospectively assessed survival, QoL and dyspnea (using validated EORTC questionnaire) in patients with mCAO 1 day before interventional bronchoscopy, 1 week after and every following month, in comparison to patients who declined this approach. Material/Patients/Methods: 36 patients underwent extensive interventional bronchoscopic management as indicated, whereas 12 declined. All patients received full chemotherapy and radiotherapy as indicated. Patients of the 2 groups were matched for age, comorbidities, type of malignancy and level of obstruction. Follow up time was 8.0±8.7 (range 1-38) months. RESULTS: Mean survival for intervention and control group was 10±9 and 4±3 months respectively (p=0.04). QoL improved significantly in intervention group patients up to the 6(th) month (p<0.05) not deteriorating for those surviving up to 12 months. Dyspnea decreased in patients of the intervention group 1 month post procedure remaining reduced for survivors over the 12th month. Patients of the control group had worse QoL and dyspnea in all time points. CONCLUSIONS: Interventional management of patients with mCAO, may achieve prolonged survival with sustained significant improvement of QoL and dyspnea.
Filippidis FT, Tzoulaki I, 2016, Greece giving up on tobacco control, Addiction, Vol: 111, Pages: 1306-1307, ISSN: 1360-0443
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