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Background: Despite several sources corroborating an expanding market and increased visibility and greater diversity in users' profiles, very little is known about the number of crack cocaine users in France., Method: The estimates rely on a single data source capture-recapture method. Annual data are extracted from treatment centres nationwide. To account for heterogeneity, we use an innovative zero-truncated geometric, regression-based estimator controlling for individual and centre characteristics. We use the well-known Zelterman estimator as a benchmark., Results: The number of crack cocaine users received in treatment centres increased dramatically, from 3388 in 2010 to 5143 in 2017 (+52%). The estimated number of crack cocaine users is believed to have tripled over the course of the same period (from 9775, 95% CI [8288-11530] to 28983 [24876-33766], respectively), with prevalences below 1‰, similar to other European countries. The coverage rate (observed number/estimated number of users) decreased in a similar fashion, indicating lower utilization. In particular, females and younger users are underestimated by data from treatment centres., Conclusion: The prevalence of crack cocaine use is fairly low but steadily increasing. The diversity in users' profiles is a challenge to prevention and public health policies that should expand their scope to a more inclusive perspective of what defines crack cocaine users. Our method overcomes several methodological issues (data sources, data linkage, heterogeneity) and can be easily applied to a wide range of settings., Competing Interests: Declaration of Competing Interest None., (Copyright © 2019. Published by Elsevier B.V.)

Background: Among older men, comparable cross-cultural investigations of sexual problems and associated distress that also include a multitude of relevant explanatory variables of these sexual problem and related distress are rare in the research literature., Aims: To investigate prevalence rates of sexual problems and associated distress among older men across 4 European countries (Norway, Denmark, Belgium, and Portugal) and assess for associated mental and physical health-related factors., Methods: Multinational cross-sectional questionnaire study using self-report measures., Outcomes: Prevalence rates of sexual problems and associated distress levels., Results: We found a high prevalence of sexual problems persisting for months or longer across countries, but noted that many affected men experienced minimal or no distress related to these problems. We also found marked cross-cultural differences in reported distress about sexual problems, with southern European men (ie Portugal) reporting significantly more distress related to the majority of sexual problems investigated compared with northern European men (ie Denmark and Norway). Finally, we identified several relational, physical, and mental health problems associated with the reported number of sexual problems and the distress related to these problems., Clinical Implications: We suggest that healthcare professionals also target distress when considering sexual problems among older men and contextualize these considerations within a multifactorial approach to general health in which (other) mental and physical health factors relevant to these patients' sexual health and function are also jointly considered., Strengths & Limitations: Strengths of this study include the large sample size, inclusion of participants from 4 European countries, assessment of distress associated with sexual problems, and similar research design and method of data collection across the 4 included countries. Limitations of the study include the cross-sectional design, which precludes causal conclusions; the low response rate in the Portuguese sample; the lack of homosexual participants; and the lack of comprehensive assessments of dyadic factors that may be of relevance to sexual problems and associated distress., Conclusion: This study identified a high prevalence of sexual problems persisting for 3 months or longer among older men across 4 European countries, but also found that many of the men with sexual problems experienced minimal or no distress related to these problems. G.M. Hald, C. Graham, A. Štulhofer, et al. Prevalence of Sexual Problems and Associated Distress in Aging Men Across 4 European Countries. J Sex Med 2019;16:1212-1225., (Copyright © 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

The aim of this article was to describe partnered and non-partnered sexual activity and sexual satisfaction in older men and women from Norway, Denmark, Belgium, and Portugal, and to explore sociodemographic correlates of sexual activity and satisfaction. Data were collected in 2016 using postal, anonymous questionnaires in probability samples of the population aged 60-75 years recruited by phone registers in Norway (676 men, 594 women), Denmark (530 men, 515 women), Belgium (318 men, 672 women), and Portugal (236 men, 273 women). In men, the percentage of sexually active participants in the past year ranged from 83% in Portugal to 91% in Norway. In women, the percentage of sexually active participants during the last year ranged from 61% in Belgium to 78% in Denmark. Regarding frequency of sexual intercourse activity during the past month, men in Norway, Denmark, and Belgium (23-24%) most often reported 2-3 times per month, whereas most men in Portugal (29%) reported 1-3 times per week. Masturbation was most commonly reported among Norwegian men (65%) and women (40%), and least commonly in Portugal. Concerning sexual satisfaction, across all countries, 40-60% of participants reported that they were sexually satisfied. Portuguese men and Danish women reported being most sexually satisfied. Having a partner was the most important positive predictor of sexual activity and sexual satisfaction in all subgroups except Portuguese men. In conclusion, partnered sexual activity was more frequent in the south of Europe, and solitary sexual activity more frequent in Northern Europe.

This study examined whether awareness of tobacco control policies was associated with social unacceptability of smoking and whether social unacceptability had an effect on smoking cessation in three European countries. Representative samples (n = 3865) of adult smokers in France, the Netherlands and Germany were used from two survey waves of the longitudinal International Tobacco Control Europe Surveys. Associations were examined of aspects of social unacceptability of smoking (i.e. feeling uncomfortable, important people disapproval and societal disapproval) with tobacco policy awareness (i.e. awareness of warning labels, anti-tobacco information and smoking restrictions at work) and smoking cessation. Only the positive association of awareness of anti-tobacco information with feeling uncomfortable about smoking was significant in each of the three countries. Important people disapproval predicted whether smokers attempted to quit, although this did not reach significance in the French and German samples in multivariate analyses. Our findings suggest that anti-tobacco information campaigns about the dangers of second-hand smoke in France and about smoking cessation in the Netherlands and Germany might have reduced the social acceptability of smoking in these countries. However, campaigns that influence the perceived disapproval of smoking by important people may be needed to ultimately increase attempts to quit smoking.

Background: Available data suggest a reduction in the number of overdoses due to psychoactive substances (tobacco and alcohol excluded) in France. Nevertheless, official levels remain considerably low compared to other European countries, and strong differences between the different sources providing information support the hypothesis of under-reporting., Methods: Two cross-tabulations of the main sources of information (police data and national mortality registry on one hand; police data and on another hand) allow the use of easy-to-compute, capture-recapture based indicators to estimate the invisible population (i.e. hidden overdoses)., Results: Results support a significant under-reporting of overdoses, reaching a minimum level of 30%., Conclusion: Unlike official claims, there has been a rise in overdoses in France during the last decade. Besides the applied corrections, levels of overdoses still remain low. Attention should be paid to death certification. Other issues of interest are the lack of a common definition and the need for greater institutional coordination.