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INTRODUCTION Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases. METHODS This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses. RESULTS Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts. CONCLUSIONS Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit.

INTRODUCTION Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases. METHODS This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses. RESULTS Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts. CONCLUSIONS Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit., Supplement 2.

INTRODUCTION Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases. METHODS This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses. RESULTS Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts. CONCLUSIONS Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit., Supplement 2.

INTRODUCTION Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases. METHODS This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses. RESULTS Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts. CONCLUSIONS Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit., Supplement 2.

INTRODUCTION Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases. METHODS This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses. RESULTS Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts. CONCLUSIONS Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit.

INTRODUCTION Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases. METHODS This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses. RESULTS Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts. CONCLUSIONS Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit.

INTRODUCTION Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases. METHODS This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses. RESULTS Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts. CONCLUSIONS Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit.

INTRODUCTION Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases. METHODS This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses. RESULTS Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts. CONCLUSIONS Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit.

INTRODUCTION Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases. METHODS This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses. RESULTS Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts. CONCLUSIONS Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit., Supplement 2.

INTRODUCTION Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases. METHODS This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses. RESULTS Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts. CONCLUSIONS Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit., Supplement 2.

Objectives: To assess the prevalence of children’s exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. Methods: In 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N = 3187, mean age 9.5 ± 0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. Results: Of the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Children’s exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p<.001). Therefore, children with smoking parents were 5.44 times more likely to be exposed. Conclusions: Children’s exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard, Objetivos: Describir la prevalencia de la exposición de niños y niñas al humo ambiental del tabaco en el coche familiar; comparar la exposición de niños y niñas con padres fumadores y no fumadores. Métodos: En 2011, se aplicó un cuestionario auto-administrado a una muestra de niños y niñas portugueses de 4º curso (N = 3187, edad promedio 9,5 ± 0,7, 51,1% varones). Se calcularon ratios de prevalencia y pruebas de chi-cuadrado. Resultados: El 52,0% informaron tener al menos un padre/madre fumador. En la muestra total, la exposición fue del 28,9% (CI95%: 27,3-30,5). Esta exposición fue del 46,9% (CI95%:44,4-49,4) entre los niños y niñas con padres fumadores y del 8,6% (CI95%:7,1-10,1) entre los con padres no fumadores (p < 0,001), por lo tanto, fue más de cinco veces mayor entre los niños y niñas con padres fumadores. Conclusiones: La exposición es alta, especialmente si uno o ambos padres fuman. Esto indica la necesidad de medidas de control efectivo del consumo de tabaco para prevenir este severo riesgo para la salud

Second-hand tobacco smoke (SHS) is a major indoor pollutant that causes serious health problems for all exposed, especially children. Children are often exposed to SHS at home, due to parental or other households’ or guests’ smoking. This study describes Portuguese children's exposure to SHS at home (total and by Portuguese main regions). In 2010/2011, a questionnaire was applied to a sample of Portuguese children in the 4th grade (N = 3187, mean age 9.05 ± 0.7 years, 51.1% male). Descriptive analysis, chi-square tests and crude odds ratios were performed. Of the participants, 62.9% of those with smoking parents and 19.2% of those with non-smoking parents were exposed to SHS at their home. Parental smoking varied significantly among regions and was significantly associated with children's exposure to SHS at home. Children's exposure to SHS at home was high, especially if their parents smoke. Children living in Lisbon Region presented the highest SHS exposure rate. The association of SHS exposure with geographic regions suggests the influence of social and contextual factors on smoking behaviour and on tobacco control effectiveness. Our findings highlight the need to effectively prevent children's SHS exposure at their home and to develop tailored tobacco control measures by region

Introduction: Children's exposure to Environmental Tobacco Smoke (ETS) is associated with serious problems to their health, such as increased risk of acute lower airway infections, greater likelihood of recurrent respiratory infections, increased risk of ear infections induction and exacerbation of asthma and pulmonary emphysema. Exposure to ETS is especially serious for children with asthma. This exposure occurs in most cases when parents and / or other cohabitant smoke at home and / or in the car. Objectives: 1) to determine the prevalence of children exposed to ETS, at home and in the car; 2) to determine the prevalence of asthmatic children exposed to ETS at home; 3) to characterize the smoking behavior of parents and / or other cohabitant at home and in the car; 4) to identify socio-demographic factors associated with tobacco use at home. Methods: An observational cross-sectional study was developed: administration of a self-report questionnaire to 513 students from the 4th grade (8-11 years old) in the municipality of Braga during the academic year of 2010/2011. Results: Exposure to ETS at home was found in 27.5% of children; exposure to ETS in the car was found in 25.1% of children who use the car. Among the smoking parents, 69.8% of mothers and 56.8% of fathers smoke at home. Smoking at home is more common among parents with low socioeconomic status (p < 0,01). Conclusion: Exposure of children to the ETS is high. Fathers and mothers usually smoke at home and often in the car. These data justify an effective preventive intervention, which should constitute a priority for health education in schools and for health professionals., Introdução: A exposição das crianças ao Fumo Ambiental do Tabaco (FAT) está associada a graves problemas para a sua saúde, tais como maior risco de infeções agudas das vias aéreas inferiores, maior probabilidade de infeções respiratórias de repetição, risco acrescido de infeções nos ouvidos, indução e exacerbação de asma e enfisema pulmonar. A exposição ao FAT é especialmente grave para as crianças asmáticas. Esta exposição ocorre, na maioria dos casos, quando os pais e/ou outro convivente fumam no domicílio e/ou no carro. Objetivos: 1) Determinar a prevalência de crianças expostas ao FAT, em casa e no carro; 2) Determinar a prevalência de crianças asmáticas expostas ao FAT, em casa; 3) Caracterizar o comportamento tabágico dos pais e/ou outros conviventes em casa e no carro; 4) Identificar fatores sociodemográficos associados ao consumo de tabaco em casa. Metodologia: Estudo observacional descritivo transversal: aplicação de um questionário de auto-preenchimento a 513 alunos do 4.º ano de escolaridade (8-11 anos de idade) do Concelho de Braga no ano letivo de 2010/2011. Resultados: Estão expostas ao FAT: 27,5% das crianças em casa e 25,1% das crianças que usam o carro. Fumam em casa: 69,8% das mães e 56,8% dos pais fumadores. Fumar em casa é mais frequente nos pais com menor nível socioeconómico (p < 0,01). Conclusão: A exposição das crianças ao FAT é elevada. Os pais/mães fumam frequentemente em casa e no carro, o que justifica uma intervenção preventiva eficaz, que deverá ser uma prioridade de educação para a saúde, na escola e por parte dos profissionais de saúde.

Introduction: Children's exposure to Environmental Tobacco Smoke (ETS) is associated with serious problems to their health, such as increased risk of acute lower airway infections, greater likelihood of recurrent respiratory infections, increased risk of ear infections induction and exacerbation of asthma and pulmonary emphysema. Exposure to ETS is especially serious for children with asthma. This exposure occurs in most cases when parents and / or other cohabitant smoke at home and / or in the car. Objectives: 1) to determine the prevalence of children exposed to ETS, at home and in the car; 2) to determine the prevalence of asthmatic children exposed to ETS at home; 3) to characterize the smoking behavior of parents and / or other cohabitant at home and in the car; 4) to identify socio-demographic factors associated with tobacco use at home. Methods: An observational cross-sectional study was developed: administration of a self-report questionnaire to 513 students from the 4th grade (8-11 years old) in the municipality of Braga during the academic year of 2010/2011. Results: Exposure to ETS at home was found in 27.5% of children; exposure to ETS in the car was found in 25.1% of children who use the car. Among the smoking parents, 69.8% of mothers and 56.8% of fathers smoke at home. Smoking at home is more common among parents with low socioeconomic status (p < 0,01). Conclusion: Exposure of children to the ETS is high. Fathers and mothers usually smoke at home and often in the car. These data justify an effective preventive intervention, which should constitute a priority for health education in schools and for health professionals., Introdução: A exposição das crianças ao Fumo Ambiental do Tabaco (FAT) está associada a graves problemas para a sua saúde, tais como maior risco de infeções agudas das vias aéreas inferiores, maior probabilidade de infeções respiratórias de repetição, risco acrescido de infeções nos ouvidos, indução e exacerbação de asma e enfisema pulmonar. A exposição ao FAT é especialmente grave para as crianças asmáticas. Esta exposição ocorre, na maioria dos casos, quando os pais e/ou outro convivente fumam no domicílio e/ou no carro. Objetivos: 1) Determinar a prevalência de crianças expostas ao FAT, em casa e no carro; 2) Determinar a prevalência de crianças asmáticas expostas ao FAT, em casa; 3) Caracterizar o comportamento tabágico dos pais e/ou outros conviventes em casa e no carro; 4) Identificar fatores sociodemográficos associados ao consumo de tabaco em casa. Metodologia: Estudo observacional descritivo transversal: aplicação de um questionário de auto-preenchimento a 513 alunos do 4.º ano de escolaridade (8-11 anos de idade) do Concelho de Braga no ano letivo de 2010/2011. Resultados: Estão expostas ao FAT: 27,5% das crianças em casa e 25,1% das crianças que usam o carro. Fumam em casa: 69,8% das mães e 56,8% dos pais fumadores. Fumar em casa é mais frequente nos pais com menor nível socioeconómico (p < 0,01). Conclusão: A exposição das crianças ao FAT é elevada. Os pais/mães fumam frequentemente em casa e no carro, o que justifica uma intervenção preventiva eficaz, que deverá ser uma prioridade de educação para a saúde, na escola e por parte dos profissionais de saúde.