126 results on '"Antigona Trofor"'
Search Results
2. Adapting to change: How the SARS-CoV-2 outbreak changed the medical practice of a regional respiratory unit
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Andrei T. Cernomaz, Radu Crisan-Dabija, and Antigona Trofor
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covid-19 ,pandemic ,implementation science ,medical practice ,education ,Medicine - Published
- 2022
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3. The Lipid Profile and Biochemical Parameters of COPD Patients in Relation to Smoking Status
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Cristina Vicol, Ioana Buculei, Oana Elena Melinte, Mona Elisabeta Dobrin, Emanuel Ioan Stavarache, Cristina-Maria Gavrilescu, Paraschiva Postolache, Daniela Matei, and Antigona Trofor
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tobacco consumption ,smoking status ,COPD ,lipid profile ,biochemical parameters ,uric acid ,Biology (General) ,QH301-705.5 - Abstract
Tobacco consumption is the most incriminated and studied risk factor for Chronic obstructive pulmonary disease (COPD), but other factors such as air pollution, are also linked to this disease. One of the known aspects of this chronic lung disease is that its occurrence is mainly due to the chronic inflammation of the airways. Lipid metabolism seems to be affected by smoking, with studies showing a correlation between this habit and high levels of triglycerides and low levels of high-density lipoprotein cholesterol (HDL-CHOL). Uric acid concentration is thought to reflect the antioxidative capacity of the body because it is the most abundant aqueous antioxidant. The aim of this study was to investigate the lipid profile and biochemical parameters of COPD patients in relation to smoking status. The present study was conducted between 2020 and 2021 in the Clinical Hospital of Pneumology in Iasi, Romania. Patients diagnosed with COPD (n = 52) were included and divided in three groups depending on their smoking status: non-smokers, smokers and ex-smokers. The obtained results show low correlations between COPD stages and serum uric acid concentrations (r = 0.4; p ˂ 0.05), smoking status (smoker/non-smoker/ex-smoker) and total serum cholesterol values (r = 0.45; p ˂ 0.05), but also between serum urea concentrations and the number of packs-years for the smoker/ex-smoker groups (r = 0.45, p ˂ 0.05). Smoking was associated with changes in the lipid profile of smokers and ex-smokers, along with increased low-density lipoprotein cholesterol (LDL-CHOL) and low serum uric acid values.
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- 2022
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4. Opinions and practices regarding electronic cigarette use among Romanian high school students
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Lucia Maria Lotrean, Bianca Varga, Monica Popa, Cornel Radu Loghin, Milena Adina Man, and Antigona Trofor
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e-cigarettes ,Adolescents ,Romania ,Public aspects of medicine ,RA1-1270 - Abstract
Objective: The study assessed awareness, opinions, practices regarding electronic cigarettes (e-cigarettes) and factors associated with their use among Romanian high school students. Methods: A cross-sectional study was conducted in 2013 in two major Romanian cities, distributing anonymous questionnaires to 342 high school students aged 16–18. Results: 52.3% of the smokers, 29.2% of the ex-smokers and 7% of the never-smokers had tried e-cigarettes at least once in their life; 7.8% of the smokers and 4.6% of the ex-smokers had used e-cigarettes in the last month. Among smokers, e-cigarette use was associated with lower participation in school health education regarding e-cigarettes and with having parents using e-cigarettes.. Among ex-smokers and never-smokers, e-cigarette use was associated with intention to use e-cigarettes in the next year and with having friends who use e-cigarettes. Conclusion: Health education programmes and regulatory interventions addressing e-cigarettes are needed in Romania. More research is necessary on how to develop effective public health messages.
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- 2016
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5. Quitting behaviors and cessation assistance used among smokers with anxiety or depression: Findings among six countries of the EUREST-PLUS ITC Europe Surveys
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Ioanna Petroulia, Christina N. Kyriakos, Sophia Papadakis, Chara Tzavara, Filippos T. Filippidis, Charis Girvalaki, Theodosia Peleki, Paraskevi Katsaounou, Ann McNeill, Ute Mons, Esteve Fernández, Tibor Demjén, Antigona Trofor, Aleksandra Herbec, Witold Zatoński, Yannis Tountas, Geoffrey T. Fong, Constantine I. Vardavas, and on behalf of the EUREST-PLUS Consortium
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quit smoking ,smoking cessation ,anxiety ,depression ,Diseases of the respiratory system ,RC705-779 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Introduction The current study explores quitting behaviours and use of cessation assistance among adult tobacco users with probable anxiety or depression (PAD) and in six European (EU) Member States (MS). Material and Methods The EUREST-PLUS ITC Wave 1 Europe Survey was conducted with a nationally representative cross-sectional sample of 6,011 adult cigarette smokers from six European Union (EU) Member States (MS) (Germany, Greece, Hungary, Poland, Romania, Spain) in 2016. Results Our study found that one in five smokers sampled from six EU MS had a diagnosis, treatment or positive screen for anxiety or depression, with rates of PAD varying between EU MS. Results of the multivariable logistic regression analysis showed that respondents with PAD were more likely to have made a quit attempt in the last 12 months (AOR 1.75; 95%CI 1.45-2.11), compared to respondents without PAD. Among those respondents with PAD who used support the most frequently reported quit method was prescription-based quit smoking pharmacotherapy (15.4%) followed by e-cigarettes (13.7%) and NRT (11.3%). Person-to-person behavioral support (i.e. local quit services, face-to-face advice from a doctor or other health care professional, telephone or quitline services) was reported significantly more frequently among respondents with PAD compared to those without PAD. Conclusions Given both pharmacological and non-pharmacological quit smoking aids have been shown to be safe, acceptable and effective for people with and without mental illness it is important that their use be promoted among smokers with anxiety and depression alongside behavioral counseling. Our findings support the need for interventions targeting health care professionals in providing smoking cessation assistance among this population of smokers. Acknowledgements EUREST-PLUS is a Horizon2020 project conducted by researchers throughout Europe from both the six participating countries as well as other institution partners within Europe and abroad. Partnering organizations include the European Network on Smoking Prevention (Belgium), Kings College London (United Kingdom), German Cancer Research Centre (Germany), University of Maastricht (The Netherlands), University of Athens (Greece), Aer Pur Romania (Romania), European Respiratory Society (Switzerland), the University of Waterloo (Canada), the Catalan Institute of Oncology (Catalonia, Spain), Smoking or Health Hungarian Foundation (Hungary), Health Promotion Foundation (Poland), University of Crete (Greece), and Kantar Public Brussels (Belgium). Funding The EUREST-PLUS Project takes place with the financial support of the European Commission, Horizon 2020 HCO-6-2015 program (EUREST-PLUS: 681109; C. Vardavas) and the University of Waterloo (GT. Fong). Additional support was provided to the University of Waterloo by the Canadian Institutes of Health Research (FDN-148477). GT. Fong was supported by a Senior Investigator Grant from the Ontario Institute for Cancer Research. E. Fernández is partly supported by Ministry of Universities and Research, Government of Catalonia (2017SGR139) and by the Instituto Carlos III and co-funded by the European Regional Development Fund (FEDER) (INT16/00211 and INT17/00103), Government of Spain.
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- 2018
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6. Evaluating the European Union (EU) Tobacco Products Directive: Findings from the EUREST-PLUS ITC cohort study among six EU Member States (MS)
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Constantine I. Vardavas, Nicolas Bécuwe, Tibor Demjén, Esteve Fernández, Ann McNeill, Ute Mons, Yannis Tountas, Antigona Trofor, Aristidis Tsatsakis, Gernot Rohde, Marc Willemsen, Krzysztof Przewoźniak, Witold A. Zatoński, Geoffrey T. Fong, and on behalf of the EUREST-PLUS Consortium
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tobacco products directive ,Diseases of the respiratory system ,RC705-779 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Efforts to mitigate the devastation of tobacco-attributable morbidity and mortality in the European Union (EU) consist of its newly adopted Tobacco Products Directive (TPD) along with the first-ever health treaty, the WHO Framework Convention on Tobacco Control (FCTC). The aim of this Horizon 2020 project entitled European Regulatory Science on Tobacco: Policy Implementation to Reduce Lung Disease (EUREST-PLUS) is to monitor and evaluate the impact of the implementation of the TPD across the EU, within the context of WHO FCTC ratification. The EUREST-PLUS ITC cohort study of adult smokers in six EU MS (Germany, Greece, Hungary, Poland, Romania, Spain), uses a pre- vs. post-TPD implementation study design, evaluating the impact of several tobacco control policy provisions, including but not limited to health warning labels, smoke free areas and electronic cigarettes. The study is designed to generate strong inferences about the effectiveness of tobacco control policies, as well as to elucidate the mechanisms and factors by which policy implementation translates to population impact. Findings from EUREST-PLUS have potential global implications for implementation of innovative tobacco control policies and its impact on the prevention of lung diseases. Acknowledgements EUREST-PLUS is a Horizon2020 project conducted by researchers throughout Europe from both the six participating countries as well as other institution partners within Europe and abroad. Partnering organizations include the European Network on Smoking Prevention (Belgium), Kings College London (United Kingdom), German Cancer Research Centre (Germany), University of Maastricht (The Netherlands), University of Athens (Greece), Aer Pur Romania (Romania), European Respiratory Society (Switzerland), the University of Waterloo (Canada), the Catalan Institute of Oncology (Catalonia, Spain), Smoking or Health Hungarian Foundation (Hungary), Health Promotion Foundation (Poland), University of Crete (Greece), and Kantar Public Brussels (Belgium). Funding The EUREST-PLUS Project takes place with the financial support of the European Commission, Horizon 2020 HCO-6-2015 program (EUREST-PLUS: 681109; C. Vardavas) and the University of Waterloo (GT. Fong). Additional support was provided to the University of Waterloo by the Canadian Institutes of Health Research (FDN-148477). GT. Fong was supported by a Senior Investigator Grant from the Ontario Institute for Cancer Research. E. Fernández is partly supported by Ministry of Universities and Research, Government of Catalonia (2017SGR139) and by the Instituto Carlos III and co-funded by the European Regional Development Fund (FEDER) (INT16/00211 and INT17/00103), Government of Spain.
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- 2018
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7. 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
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Christina N. Kyriakos, Filippos T. Filippidis, Sara Hitchman, Charis Girvalaki, Chara Tzavara, Tibor Demjén, Esteve Fernández, Ute Mons, Antigona Trofor, Yannis Tountas, Mateusz Zatoński, Witold A. Zatoński, Geoffrey T. Fong, Constantine I. Vardavas, and on behalf of the EUREST-PLUS consortium
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e-cigarette ,e-cigarette use ,Diseases of the respiratory system ,RC705-779 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Introduction Article 20 of the European Union (EU) Tobacco Products Directive (TPD) sets forth provisions on electronic cigarette (e-cigarette) product regulation, such as child-proof packaging and protection against e-liquid refilling without leakage. The aim of the current study was to examine frequencies and correlates of experiencing undesirable events during e-cigarette use related to e-cigarette product design parameters prior to the implementation of the EU TPD. Material and Methods The EUREST-PLUS ITC Europe Wave 1 survey was conducted with adult cigarette smokers from June to September 2016 across Germany, Greece, Hungary, Poland, Romania, Spain. Results Among our sample of adult cigarette smokers, one in five reported having ever used e-cigarettes. Prevalence of current e-cigarette use (daily or weekly) was very low (1.5%). Major undesirable events, such as battery exploding or catching fire (1.9%) or overheating (11%) were uncommon. Among those reporting at least monthly use and whose usual/current brand has a tank that you fill with liquids, 18.8% experienced spilling during refill and 18.5% experienced e-liquid leaking during use. Nearly one-quarter reported that the e-liquid cap was easy for a child to open. Conclusions In light of the EU TPD establishing standards around e-cigarette design parameters to mitigate undesirable events and risks during e-cigarette use, these findings further support the need for its implementation, as well as for monitoring undesirable events experienced during e-cigarette use once Article 20 is fully implemented. Acknowledgements EUREST-PLUS is a Horizon2020 project conducted by researchers throughout Europe from both the six participating countries as well as other institution partners within Europe and abroad. Partnering organizations include the European Network on Smoking Prevention (Belgium), Kings College London (United Kingdom), German Cancer Research Centre (Germany), University of Maastricht (The Netherlands), University of Athens (Greece), Aer Pur Romania (Romania), European Respiratory Society (Switzerland), the University of Waterloo (Canada), the Catalan Institute of Oncology (Catalonia, Spain), Smoking or Health Hungarian Foundation (Hungary), Health Promotion Foundation (Poland), University of Crete (Greece), and Kantar Public Brussels (Belgium). Funding The EUREST-PLUS Project takes place with the financial support of the European Commission, Horizon 2020 HCO-6-2015 program (EUREST-PLUS: 681109; C. Vardavas) and the University of Waterloo (GT. Fong). Additional support was provided to the University of Waterloo by the Canadian Institutes of Health Research (FDN-148477). GT. Fong was supported by a Senior Investigator Grant from the Ontario Institute for Cancer Research. E. Fernández is partly supported by Ministry of Universities and Research, Government of Catalonia (2017SGR139) and by the Instituto Carlos III and co-funded by the European Regional Development Fund (FEDER) (INT16/00211 and INT17/00103), Government of Spain.
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- 2018
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8. Association between alpha 1 -antitrypsin (α 1 -AT) levels, lipid profile and ventilatory pulmonary function in predicting the cardiovascular risk in simptomatic smokers
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Ligia Puiu, Ovidiu Fira-Mladinescu, Dana Alexandrescu, Ancuta Petrovan, and Antigona Trofor
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WCTOH ,Diseases of the respiratory system ,RC705-779 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background Cigarette smoke oxidants can cause oxidative inactivation of methionine residues of α 1 -AT, leading to lipid binding, with dyslipidemia, inflammation and endothelial dysfunction, the early stage of atherosclerosis. The aim of the study was to assess the relationship between serum α 1 -AT levels, pulmonary function and lipids in predicting the risk of cardiovascular disease among symptomatic smokers adult subjects in an Out-patient Pulmonology Health Unit. Methods 100 respiratory symptomatic adults mean aged 53.34±9.69 year-old, were grouped in smokers (current and former heavy smokers) (n=64) and nonsmokers (n=36). Demographic, anthropometric, pack-years smoking, serum α 1 -AT, plasma lipid profile {(total cholesterol-TC, low density lipoprotein cholesterol-LDLc, high density lipoprotein cholesterol-HDLc, triglycerides-TG, nonhigh density lipoprotein cholesterol-nonHDLc, very low density lipoprotein cholesterol-VLDL), by which were calculated lipid indices}, were performed. All subjects underwent spirometry according to the international recommendations. Lung function was expressed as forced vital capacity (FVC% predicted), forced expiratory volume in one second (FEV1% predicted), Forced Expiratory volume in 1 second/Forced Vital Capacity ratio (FEV1/FVC% predicted). Cardiovascular disease risk was evaluated through Framingham Risk Score (FRS). Statistical analysis included Spearman correlations tests and one-way ANOVA test. Results α 1 -AT (p=0.008), FEV1 (p=0.008), FVC (p=0.03) was significantly lower, while LDLc/HDLc ratio (p=0.01), Atherogenic Index of Plasma (AIP) (p=0.04), FRS (p=0.003) increased in smokers versus nonsmokers. In smokers, statistically significant correlations were found between α 1 -AT and FVC (r=-0.26;p=0.03); FEV1/FVC ratio (r=0.30;p=0.01); TC (r=0.35;p=0.003); LDLc (r=0.27; p=0.02); nonHDLc (r=0.26;p=0.03). Conclusions α 1 -AT interacts with lipid oxidation pathways, decreasing in smokers. A better understanding of the relationships between smoking, oxidative modifications of α 1 -AT, lung function and, lipid profile can better predict the risk of heart disease. Smoking is a modifiable health risk factor and tobacco cessation may prevent the occurence of cardiovascular diseases.
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- 2018
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9. Prevalence and knowledge on e-cigarette among teenagers in Romania 2016
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Ioana Munteanu, Florin Mihaltan, Antigona Trofor, Doina Todea, Monica Marc, Corina Marginean, Mihaela Trenchea, and Oana Arghir
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WCTOH ,Diseases of the respiratory system ,RC705-779 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background The prevalence of smoking for adolescents in Romania is growing, especially due to girls. According to the study GATS 2011 most of daily smokers started smoking at age 17-19 years (43.1%); 17% started smoking even before 15 years, mostly in rural areas Identifying factors that favor its use will allow better management of the phenomenon. Worrying is the fact that they use the device for inhalation of other psychoactive substances . The number of users among young people the electronic cigarette tends to be a in an ascendant trend among teenagers and especially girls. Methods The main objectives were to establish the prevalence of using, condition of using and knowledge about e-cigarette among them A number of 2000 original questionnaires was directly distribute to teenagers for high schools from 6 important towns from Romania. Results A number of 776 (457 girls and 319 boys ) adolescents from different parts of the country where involved. The main objectives were to establish the prevalence of using, condition of using and knowledge about e-cigarette among them. 324 (42%) had used the device 177 girls and 147 boys. Majority of users were smokers but a number of 61 (21%) were nonsmokers and they used it. Although the majority said they use it occasionally they are able to present the advantages and disadvantages of the device . The one who never used it related no advantages and the users mentioned : less toxicity, money save, you can smoke it everywhere . Regarding disadvantages the option were more variety like: battery power, price, utility and so on. Conclusions In conclusion, in the absence of specific legislative measures for Romania we can expect an increasing number of users among young people the electronic cigarette tends to be a in an ascendant trend among teenagers and especially girls.
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- 2018
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10. Integration of a personalized approach for tobacco use and dependence in a dentistry setting-preliminary results
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Antigona Trofor, Ionela Alina Grosu, Cristina Vicol, and Larisa Moldovan
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WCTOH ,Diseases of the respiratory system ,RC705-779 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background Tobacco smoking is a major risk factor for many oral cavity disorders, amongst which periodontal disease and oral cancer - the most frequent conditions in current dentistry practice. Oral pathology clinics lack their own smoking cessation services, and a personalized approach of tobacco consumers addressing dentistry settings would improve their oral health. Aim: To design a personalized smoke-free approach in a dentistry department and to preliminary evaluate the effectiveness of smoking cessation counseling in a pilot group of smokers with oral cancer. Methods Screening for oral health and smoking status of 270 patients admitted in an oral pathology university department for periodontal disease and oral malignancies. All patients answered a personalized oral health and tobacco use questionnaire. 59 smokers with oral cancers underwent a specially designed 3 sessions smoking cessation counseling program (personalized enrollment questionnaire, brief advice and counseling) with initial and in 8 weeks follow-up clinical evaluation of both smoking and oral status Results Periodontal disease was more frequent in smokers (60%) with poor oral hygiene and diet. Majority of smokers with oral cancers were men, age average 57.2 (SD: 4.6) and 49.2 smoked > 20 cigs/day. Most frequently, oral malignancy affected the lips and the jowl. All 59 smokers with oral cancers answered the personalized questionnaire and attended the brief advice session, whilst 46 (78%) agreed to try to quit smoking, with a 52.5% abstinence rate at 8 weeks follow up and a significant oral status improvement identified in all quitters. Conclusions There is a great need to design a personalized smoke-free approach for dental patients, by routinely adding screening and treatment of tobacco use to overall oral health evaluation. Smoking cessation proved beneficial in the oral cancers pilot group.
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- 2018
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11. 'Lung age' - a motivational smoking cessation tool in smokers with chronic obstructive pulmonary disease
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Antigona Trofor, Ramona Miron, Ioana Buculei, Ligia Puiu, and Milena Adina Man
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WCTOH ,Diseases of the respiratory system ,RC705-779 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background Smoking cessation is the most efficient treatment for chronic obstructive pulmonary disease (COPD). The educational and motivational role of the “lung age” concept, used together with lung function testing and biochemical validation of tobacco exposure, deserves thorough attention for driving intention to quit. Aim : To demonstrate the motivational role of “lung age” measurement towards stopping smoking in COPD patients. To assess effects of continuing versus stopping smoking on “lung age” , on exhaled carbon monoxide (CO) and on lung function, and to determine correlations between these parameters, in such patients. Methods 100 COPD patients naive to any smoking cessation intervention, were invited to attend a “lung age” measurement study. Only 61 patients (30 smokers and 31 ex-smokers) agreed a full evaluation for demographics, smoking characteristics (packs-years -PY, nicotine dependence score), COPD status: lung function (FVC,FEV1,FEV1/FVC ratio), mMRC dyspnea, COPD assessment test (CAT), exhaled CO and “lung age”, in a prospective study, with statistic SPSS Inc pack analysis. Results All participants acknowledged the motivational value of “lung age” for stopping smoking. Mean “lung age” was 118.3 years in smokers (mean 41.63 PY) and 119.58 years in ex- smokers (mean 36.32 PY). Lung age was statistically significant correlated with FVC % (p=0.03), with FEV1% (p< 0.001) and respectively with mMRC dyspnea (p< 0,026). CAT scores ranged from 20.9 (smokers) to 22.7 (ex-smokers). Significant statistic differences were found in exhaled CO concentrations of smokers (9.73 ppm) compared to ex-smokers (0.58 ppm) (p≤ 0.001). Exhaled CO was statistically correlated with FEV1/FVC ratio (p= 0.05). Conclusions “Lung age” measurement, used together with lung function and exhaled CO testing, adds value to proving impact of tobacco exposure on COPD patients and helps increasing motivation to quit smoking in this difficult to treat category of patients.
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- 2018
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12. ADDICTION TO NICOTINE IN MODERATE SMOKERS – CLINICAL PROFILE AND SMOKING CESSATION OUTCOMES
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Irinel Oana Pascal, Letitia Trofor, Roxana Chirita, Ramona Miron, and Antigona Trofor
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moderate smokers ,nicotine dependence ,Dentistry ,RK1-715 - Abstract
Aim of the study was to determine smoking cessation outcomes in a group of moderate smokers, based on clinical and smoking profile and on level of nicotine dependence. Material and methods Moderate smokers included in a tobacco dependence 3 months treatment program were evaluated for age, gender, smoking profile, nicotine dependence score and co-morbidities, to determine smoking cessation rates at both 3 and 6 months follow up. Results We found 124 moderate smokers, age average 31. 2 yrs., in majority women (60%) and 12% had also psychiatric co-morbidities. Nicotine dependence was predominantly moderate and severe: only 31.2% subjects had a Fagerstrom score < 3. Abstinence rate at 3 and 6 months follow-up was 30 %, respectively 12.5%. Conclusions Moderate smoking has become more frequent nowadays, due to tobacco control successful legislation, worldwide. Smoking abstinence rate in moderate smokers was satisfactory, considering the complex clinical profile and the high level of nicotine dependence we have found.
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- 2015
13. BIOMARKERS OF TOBACCO EXPOSURE- RELEVANT DIAGNOSTIC IMPLICATIONS IN DAILY PRACTICE
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Ramona Miron, Letitia Trofor, Daniela Bucur, Milena Man, Roberta Cernat, and Antigona Trofor
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biomarkers ,carbon monoxide ,cotinine ,nitric oxide ,tobacco exposure ,Dentistry ,RK1-715 - Abstract
Aim of the study was to present available data on biomarkers of tobacco exposure and to inform about their utility in daily practice, focusing on expertise in the field in the Clinic of Pulmonary Diseases of Iasi, Romania. Data overview Smoking status declared by patients must be objectively validated by biochemical tests to determine biomarkers of tobacco exposure. The main biomarkers utilized by practitionners are: carbon monoxide in expired air and plasma, saliva, urine, hair and intranasal cotinine. More recently, researchers have studied also the role of some new biomarkers: anatabine, anabasine, thyocianate, serum uric acid and nitric oxide in expired air. We present up to date data about advantages and disadvantages of each such biomarker and practical details on clinical use, as some of them are also markers of chronic airway inflammation. Conclusions Laboratory tests for tobacco biomarkers offer the opportunity to measure constituents of tobacco smoke and to show exposing to toxicants in tobacco, regardless smoking behavior. In daily clinical practice of the Clinic of Pulmonary Diseases of Iasi have been succesfully introduced carbon monoxide and nitric oxide in exhaled air, serum uric acid and urinary cotinine determinations.
- Published
- 2014
14. SMOKING CESSATION – A 'MUST HAVE' OF GOOD ORAL HEALTH STATUS
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Antigona Trofor and Ramona Miron
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dentists ,nicotine dependence ,oral health. ,smoking ,smoking cessation ,Dentistry ,RK1-715 - Abstract
Chronic tobacco consumption is a disease per se and it is defined as nicotine dependence. Furthermore, smoking is known to induce many diseases such as cancers, cardiovascular disorders, chronic obstructive lung diseases, etc., to seriously affect pregnancy and delivery in smokers as well as infant and foetus, to be an unaesthetic condition and to generally damage anyone actively or passively exposed to this major risk factor. From dental medicine practitioner’s point of view, we can say for sure smoking has a negative impact on oral health and on evolution towards healing of oral pathology in smokers. By such perspectives, we propose an analysis of best pattern to make dentists willing to involve in smoking cessation interventions. Therefore, best examples to enable dentists to preserve smoke-free patients and to avoid negative consequences of tobacco on oral health status are looked for. Despite scientific evidence of incriminatory effects of tobacco on human health, tobacco products continue to be legally sold everywhere in the world. Dentists have the opportunity to periodically assist smoking patients in their practice. So, if current or former smokers, such occasions should be frutified towards smoking abstinence or to create motivation to maintain smoke-free status in never smokers. Dentists should routinely evaluate smoking status of their patients, assess willingness to quit smoking and send motivated smokers to specialized smoking cessation centres which are now available in many cities in Romania. Swiss expertize on motivational interview to stop smoking is quoted, by giving example a team of Swiss dentists that have successfully implemented in their country a model of dentists units team trained to specifically assist smokers to quit in dentistry
- Published
- 2014
15. INTRODUCING A NEW CONCEPT IN DENTISTS’CURRICULA: MANAGEMENT OF NICOTINE DEPENDENCE IN SMOKERS WITH ORAL DISEASES
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Antigona TROFOR, Valentina ESANU, Ramona MIRON, and Letitia TROFOR
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oral diseases ,smoking ,therapy of nicotine dependence ,Dentistry ,RK1-715 - Abstract
Most people are now aware that smoking is bad for health. It can cause many different medical problems and, in some cases, fatal diseases. However, many people don’t realize the damage that smoking does to their mouth, gums and teeth. Smoking can lead to tooth staining, gum disease, tooth loss bad breath, enable efficiency of periodontal treatment or dental implants and induces oral cancer.As for any other disease, diagnosis of tobacco use must be followed by treatment, which is entitled advice/counselling to quit smoking and has two major components: pharmacological methods and cognitive-behavioural approach, optionally adding psychotherapy, hypnosis, self-helping written materials, support qui lines. Quitting smoking is a difficult process, as nicotine dependence is difficult to treat. Only 3-5% of smokers achieve tobacco use abstinence based on own will; majority of the cases need expert medical advice, therapy and counselling For this purpose, this paper is giving some basic landmarks to help improving quality of medical services delivered by dentists to this category of patients.
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- 2013
16. Contribution of Bronchoscopic Examination in Diagnosis of Congenital Tracheo-Broncho-Pulmonary Malformations
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Antigona Trofor, Ramona Miron, Letitia Trofor, and Mihaela Ciobanu
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bronchi and lung ,bronchoscopy ,malformations of the trachea ,pulmonary practice ,Dentistry ,RK1-715 - Abstract
Diagnosis of congenital malformations of the trachea, bronchi and lung is often a stumbling block, even for experienced clinicians, given the rarity of some anomalies, many clinical masks and the complexity of investigational methods required to confirm such conditions. In current practice of an adult respiratory medicine service, in the congenital lung pathology, most often, physicians can meet cases of: pulmonary hypoplasia, intralobar pulmonary sequestration, tracheal strictures, abnormal division of the airways, air cysts, and rarely congenital lobar emphysema and pulmonary agenesis. Many of these malformations are discovered in newborn or infant, because of pulmonary and cardiovascular complications and frequent combination with other congenital anomalies. So, these anomalies should be included in differential diagnosis of lung or mediastinal disease, especially in young adult. No doubt, bronchoscopy is one of the basic tracks in the diagnosis of these malformations. Some are correctable if promptly recognized, others are incompatible with life, while probably the majority are symptomless, appearing as incidental findings at routine medical, surgical or post-mortem examination. Non-recognition of this lung disease group in current medical practice can lead to serious diagnostic errors. Basic concepts are presented in diagnosis of major malformations of trachea, bronchi and lung encountered in current medical practice and some examples of bronchoscopic aspects as experienced in several respiratory medicine services are given.
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- 2010
17. Understanding perceived addiction to and addictiveness of electronic cigarettes among electronic cigarette users: a cross-sectional analysis of the International Tobacco Control Smoking and Vaping (ITC 4CV) England Survey
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Valerie Lohner, Ann McNeill, Sven Schneider, Sabine Vollstädt‐Klein, Marike Andreas, Daria Szafran, Nadja Grundinger, Tibor Demjén, Esteve Fernandez, Krzysztof Przewozniak, Yannis Tountas, Antigona Trofor, Witold Zatonski, Marc C. Willemsen, Constantine Vardavas, Geoffrey T. Fong, Ute Mons, Health promotion, and RS: CAPHRI - R6 - Promoting Health & Personalised Care
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reinforcement ,Psychiatry and Mental health ,E-cigarettes ,relative addictiveness ,electronic cigarettes ,DEPENDENCE ,POPULATION ASSESSMENT ,perceived addiction ,1ST CIGARETTE ,Medicine (miscellaneous) ,vaping ,HEALTH ,TIME - Abstract
Background and AimsThe addictive potential of electronic cigarettes (e-cigarettes) remains to be fully understood. We identified patterns and correlates of perceived addiction to e-cigarettes and perceived addictiveness of e-cigarettes relative to tobacco cigarettes (relative addictiveness) in dual users as well as exclusive e-cigarette users. Design, Setting and ParticipantsObservational study using cross-sectional survey data from England (2016) from the International Tobacco Control Project (ITC) Four Country Smoking and Vaping (4CV) survey. The study comprised 832 current e-cigarette users who had been vaping for at least 4 months. MeasurementsPerceived addiction to e-cigarettes and relative addictiveness of e-cigarettes were examined. Socio-demographic factors were age, gender and education; markers of addiction included urge to vape, time to first vape after waking and nicotine strength used; vaping and smoking characteristics included frequency and duration of e-cigarette use, intention to quit, adjustable power or temperature, enjoyment, satisfaction relative to tobacco cigarettes and tobacco cigarette smoking status. FindingsA total of 17% of participants reported feeling very addicted to e-cigarettes, while 40% considered e-cigarettes equally/more addictive than tobacco cigarettes. Those who felt very addicted had higher odds of regarding e-cigarettes as more addictive than tobacco cigarettes (odds ratio 3.4, 95% confidence interval 2.3-5.1). All markers of addiction, daily use and enjoyment were associated with higher perceived addiction, whereas time to first vape after waking, daily vaping and perceiving vaping as less satisfying than smoking were associated with relative addictiveness. ConclusionsMarkers of addiction to e-cigarettes appear to correspond with perceived addiction to e-cigarettes, suggesting that self-reported perceived addiction might serve as an indicator of addiction. Prevalence both of markers of addiction and perceived addiction were comparatively low overall, suggesting a limited but relevant addictive potential of e-cigarettes. Additionally, positive and negative reinforcement, reflected here by enjoyment and relative satisfaction, might play a role in e-cigarette addiction.
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- 2023
18. Smokers' support for the ban on sale of slim cigarettes in six European countries: findings from the EUREST-PLUS ITC Europe Surveys
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Enkeleint A. Mechili, Geoffrey T. Fong, Constantine I. Vardavas, Krzysztof Przewoźniak, Christina N Kyriakos, Anne Ck Quah, Esteve Fernández, Ute Mons, Paraskevi Katsaounou, Antigona Trofor, Tibor Demjén, Pete Driezen, Witold Zatonski, and Charis Girvalaki
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Cross-sectional study ,Cigarette use ,Odds ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Tobacco Products Directive ,media_common.cataloged_instance ,Medicine ,tobacco policy ,030212 general & internal medicine ,European Union ,European union ,slim cigarettes ,media_common ,Tobacco policy ,030505 public health ,Descriptive statistics ,business.industry ,Tobacco control ,General Medicine ,Articles ,3. Good health ,0305 other medical science ,business ,Research Article - Abstract
Background: Efforts to regulate tobacco products and reduce consumption in the European Union (EU) include the European Tobacco Products Directive (TPD), which went into force in May 2016. Despite the initial discussion to include a ban on sale of slim cigarettes, it was excluded in the final TPD. The main goal of this study was to examine support for a ban on slim cigarettes among smokers in six European Countries. Methods: Data from the 2018 (Wave 2) International Tobacco Control Policy Evaluation Project 6 European Country (ITC 6E) EUREST-PLUS project survey, a cross sectional study of adult smokers (n=5592) from Germany, Greece, Hungary, Poland, Romania, and Spain, was analysed. Descriptive statistics were used to estimate support for a ban on slim cigarettes by sociodemographic characteristics and smoking behaviors. Logistic regression analysis was used to examine factors associated with support for a ban on slim cigarettes and perceptions of harm. Results: Support for a ban on slims varied across countries, with highest support in Romania (33.8%), and lowest in Greece (18.0%). Female smokers (OR=0.77; 95%CI=0.66-0.90, daily smokers (OR=0.59; 95%CI=0.42-0.83), menthol smokers (OR=0.56; 95%CI=0.36-0.87), and smokers who did not have plans to quit within next six months (OR=0.45; 95%CI=0.36-0.57) had significantly lower odds of supporting a ban on slim cigarettes. Overall, 20% of smokers perceived slim cigarettes as less harmful than regular cigarettes. Conclusions: Support for a ban of slim cigarettes was relatively low among smokers, while misperceptions that slim cigarettes are less harmful is high, particularly among countries where slim cigarette use is more prevalent. Findings support a ban on slim cigarettes to reduce misperceptions around slim cigarettes being less harmful.
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- 2023
19. EUREST-RISE: European Regulatory Science on Tobacco – Research and Innovation Staff Exchange
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Cornel Radu-Loghin, Karina Mocanu, Hani Al Gouhmani, Constantine Vardavas, Ioanna Lagou, Zinovia Plyta, Aikaterini Papathanasaki, Stella Vogiatzidaki, Alexander Vardavas, Manolis Tzatzarakis, Aristidis Tsatsakis, Filippos Filippidis, Christina Kyriakos, Esteve Fernández, Olena Tigova, Christina Martínez, Anna Mar Lopez Luque, Marius Eremia, Lucia Maria Lotrean, Antigona Trofor, Thomas Wenzl, Bill Simpson, Pipa Powell, Polina Starchenko, Angeliki Bakou, Eleni Asimaki, and Victoria Vivilaki
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Health (social science) ,Epidemiology ,Public Health, Environmental and Occupational Health ,Health Professions (miscellaneous) - Published
- 2023
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20. Biochemical evaluation of oxidative stress induced by smoking in patients with COPD
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Mona Dobrin, Ioana Buculei, Daniela Popa, Oana Melinte, and Antigona Trofor
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Health (social science) ,Epidemiology ,Public Health, Environmental and Occupational Health ,Health Professions (miscellaneous) - Published
- 2022
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21. Assessment of air pollution exposure in relation with smoking status in COPD patients from Iasi, Romania
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Ioana Buculei, Mona Dobri, Daniela Popa, Raluca Arcana, and Antigona Trofor
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Health (social science) ,Epidemiology ,Public Health, Environmental and Occupational Health ,Health Professions (miscellaneous) - Published
- 2022
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22. Pharmacological strategies for smoking cessation in patients with chronic obstructive pulmonary disease: a pragmatic review
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Ioana Buculei, Sabina A Antoniu, Radu Crisan Dabija, Florin Mihaltan, and Antigona Trofor
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Nicotine ,medicine.medical_specialty ,medicine.medical_treatment ,Disease ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Pharmacotherapy ,Quinoxalines ,Humans ,Medicine ,Pharmacology (medical) ,Varenicline ,Intensive care medicine ,Bupropion ,Nicotine replacement ,Pharmacology ,COPD ,business.industry ,General Medicine ,Benzazepines ,medicine.disease ,Tobacco Use Cessation Devices ,Clinical trial ,chemistry ,030220 oncology & carcinogenesis ,Smoking cessation ,Smoking Cessation ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is progressive inflammatory disease of the lungs in which smoking plays a significant pathogenic role. Smoking cessation is the only therapeutic intervention which was demonstrated to interfere with disease progression. Smoking cessation intervention can benefit from pharmacological therapies such as nicotine replacement therapies, bupropion, or varenicline which can be given individually or in combination, their effectiveness being demonstrated in various clinical trials enrolling COPD patients.Areas covered: The authors provide a pragmatic discussion of the clinical data of the main studies evaluating therapies for smoking cessation within COPD starting with the seminal Lung Health Study and continuing with more recent ones.Expert opinion: Smoking cessation is one of the most difficult therapeutic interventions in COPD, despite having the highest impact on disease progression and despite the demonstrated benefit of the discussed pharmacological therapies. Potential approaches to maximize its chance of success might be represented by prolonging the time of administration, combinational options, or sequential pharmacotherapy.
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- 2020
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23. Analysis of air pollution exposure in the area of Iasi county – a warning signal for lung health and the risk of developing COPD
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Antigona Trofor, Ioana Buculei, Mona-Elisabeta Dobrin, Sabina A Antoniu, Oana Elena Rohozneanu, Anda Tesloianu, Cristina Vicol, and Radu-Adrian Crișan Dabija
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COPD ,business.industry ,Lung health ,Air pollution exposure ,Environmental health ,Medicine ,business ,medicine.disease ,Signal - Abstract
Air pollution is a major threat to public health, and the effects of pollution are perceived in all countries of the world, by all social categories, regardless of age. Chronic obstructive pulmonary disease (COPD) has a growing prevalence worldwide and an increasing number of risk factors that exacerbate symptoms and accelerate disease progression. Exposure to air pollution is one of the less studied and less investigated risk factors for COPD. Depending on the size and chemical nature of the pollutant, it can overcome the defence mechanism of the respiratory system and enter the lung tissues, thus causing some respiratory diseases. The World Health Organisation (WHO) reports that six major air pollutants have been identified, namely particulate matter (PM), ground-level ozone, carbon monoxide, sulphur dioxide, nitrogen dioxide and lead. The severe impact of PM exposure is demonstrated by the link between exposure to high concentrations of PM and certain severe diseases such as silicosis, lung cancer, cardiovascular disease and COPD. In Iași County, Romania, air quality measurements are performed by six automatic air quality monitoring stations, and the data obtained are used to create annual reports and these are also available online. Due to the high concentrations of air pollutants, the city of Iași is one of the three topmost polluted cities in Romania. A future assessment on the impact of air pollution on the health of the inhabitants of these cities and the implementation of new methods to improve air quality is needed.
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- 2020
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24. Influenza vaccine in COVID-19 patients: Who?, why?, when?
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Daniela Robu Popa, Antigona Trofor, Sabina A Antoniu, Anda Tesloianu, Ioana Buculei, Oana-Elena Rohozneanu, Raluca Ioana Dospinescu Arcana, and Radu Crișan-Dabija
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business.industry ,Transmission (medicine) ,Influenza vaccine ,viruses ,Mortality rate ,media_common.quotation_subject ,virus diseases ,Virology ,Virus ,Vaccination ,Immune system ,Hygiene ,Pandemic ,Medicine ,business ,media_common - Abstract
Considering the increased prevalence of influenza infections in the cold season and the pandemic evolution of severe acute respiratory syndrome-CoV-2 (SARS-CoV-2), the medical staffs are facing potential viral co-infection with SARS-CoV-2 and influenza virus. Both viruses belong to the category of ribonucleic acid (RNA) viruses, having common structural features, causing a similar immune response, with a related mode of transmission and with both respiratory and general symptoms. SARS-CoV-2 and influenza viruses cause contagious infections and the protective measures against them are the same: wearing masks in crowded spaces, proper hand hygiene and avoiding crowded places. Co-infections with influenza A and B viruses and SARS-CoV-2 virus involve additional precautions regarding the therapeutic and evolution approach. Studies show that patients who have been vaccinated against influenza have developed milder forms of confirmed SARS-CoV-2 infection. In elderly patients, increased influenza vaccination coverage has shown to be associated with a decrease in mortality rate and also reduced the heavy impact of double infection. The Influenza vaccine can trigger early immune mechanisms in order to facilitate early detection of SARS-CoV-2 as well as its clearance. Influenza vaccination should now be seen, more than ever, as a strategy to combat the growing SARS-CoV-2 pandemic, especially in vulnerable populations (elderly and people with associated comorbidities). © 2020 Raluca Ioana Dospinescu Arcana et al., published by Sciendo 2020.
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- 2020
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25. Gaps in COPD Guidelines of Low- and Middle-Income Countries
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Niels H. Chavannes, Antigona Trofor, Erick Wan-Chun Huang, Patricia Alupo, Aizhamal Tabyshova, Joan B. Soriano, Job F M van Boven, Oscar Flores-Flores, Tarana Ferdous, Gonzalo Gianella, John R. Hurst, William Checkley, Maarten J. Postma, David Meharg, Jennifer A. Alison, and Jaime Correia de Sousa
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Developing country ,Target audience ,Context (language use) ,Critical Care and Intensive Care Medicine ,COPD: Original Research ,03 medical and health sciences ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,GOLD, Global Initiative for Chronic Obstructive Lung Disease ,reference standards ,medicine ,Global health ,Humans ,030212 general & internal medicine ,IOM, Institute of Medicine ,GACD, Global Alliance for Chronic Diseases ,LMIC, low- and middle-income countries ,Research question ,pulmonary disease ,COPD ,PRISMA, preferred reporting items for a systematic review and meta-analysis ,chronic obstructive ,business.industry ,HIC, high-income countries ,Guideline ,developing countries ,medicine.disease ,GNI, gross national income ,3. Good health ,Gross national income ,030228 respiratory system ,consensus ,Family medicine ,Practice Guidelines as Topic ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Guidelines are critical for facilitating cost-effective COPD care. Development and implementation in low-and middle-income countries (LMICs) is challenging. To guide future strategy, an overview of current global COPD guidelines is required. Research Question We systematically reviewed national COPD guidelines, focusing on worldwide availability and identification of potential development, content, context, and quality gaps that may hamper effective implementation. Study Design and Methods Scoping review of national COPD management guidelines. We assessed: (1) global guideline coverage; (2) guideline information (authors, target audience, dissemination plans); (3) content (prevention, diagnosis, treatments); (4) ethical, legal, and socio-economic aspects; and (5) compliance with the eight Institute of Medicine (IOM) guideline standards. LMICs guidelines were compared with those from high-income countries (HICs). Results Of the 61 national COPD guidelines identified, 30 were from LMICs. Guidelines did not cover 1.93 billion (30.2%) people living in LMICs, whereas only 0.02 billion (1.9%) in HICs were without national guidelines. Compared with HICs, LMIC guidelines targeted fewer health-care professional groups and less often addressed case finding and co-morbidities. More than 90% of all guidelines included smoking cessation advice. Air pollution reduction strategies were less frequently mentioned in both LMICs (47%) and HICs (42%). LMIC guidelines fulfilled on average 3.37 (42%) of IOM standards, compared with 5.29 (66%) in HICs (P < .05). LMICs scored significantly lower compared with HICs regarding conflicts of interest management, updates, articulation of recommendations, and funding transparency (all, P < .05). Interpretation Several development, content, context, and quality gaps exist in COPD guidelines from LMICs that may hamper effective implementation. Overall, COPD guidelines in LMICs should be more widely available and should be transparently developed and updated. Guidelines may be further enhanced by better inclusion of local risk factors, case findings, and co-morbidity management, preferably tailored to available financial and staff resources.
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- 2020
26. Impact of the Tobacco Products Directive on self-reported exposure to e-cigarette advertising, promotion and sponsorship in smokers—findings from the EUREST-PLUS ITC Europe Surveys
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Sarah Kahnert, James Balmford, Geoffrey T. Fong, Pete Driezen, Witold Zatonski, Ute Mons, Tibor Demjén, Constantine I. Vardavas, Antigona Trofor, Krzysztof Przewoźniak, Christina N Kyriakos, Paraskevi Katsaounou, and Esteve Fernández
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Adult ,media_common.quotation_subject ,Electronic Nicotine Delivery Systems ,1117 Public Health and Health Services ,03 medical and health sciences ,0302 clinical medicine ,Promotion (rank) ,Advertising ,Germany ,Environmental health ,Humans ,Medicine ,media_common.cataloged_instance ,030212 general & internal medicine ,European union ,Generalized estimating equation ,media_common ,Hungary ,Smokers ,030505 public health ,Greece ,Romania ,business.industry ,Tobacco control ,Public Health, Environmental and Occupational Health ,EUREST-PLUS Consortium ,Tobacco Products ,Odds ratio ,Directive ,Europe ,Spain ,Supplement Papers ,Cigarette advertising ,Cohort ,Public Health ,Poland ,Self Report ,0305 other medical science ,business - Abstract
Background Advertising, promotion and sponsorship of electronic cigarettes (ECAPS) have increased in recent years. Since May 2016, the Tobacco Products Directive 2014/40/EU (TPD2) prohibits ECAPS in various advertising channels, including media that have cross-border effects. The objective of this study was to investigate changes in exposure to ECAPS in a cohort of smokers from six European Union member states after implementation of TPD2. Methods Self-reported exposure to ECAPS overall and in various media and localities was examined over two International Tobacco Control Policy Evaluation survey waves (2016 and 2018) in a cohort of 6011 adult smokers from Germany, Greece, Hungary, Poland, Romania and Spain (EUREST-PLUS Project) using longitudinal generalized estimating equations models. Results Self-reported ECAPS exposure at both timepoints varied between countries and across examined advertising channels. Overall, there was a significant increase in ECAPS exposure [adjusted odds ratio (aOR): 1.25, 95% CI: 1.09–1.44]. Between waves, no consistent patterns of change in ECAPS exposure across countries and different media were observed. Generally, ECAPS exposure tended to decline in some channels regulated by TPD2, particularly on television and radio, while exposure tended to increase in some unregulated channels, such as at points of sale. Conclusions The findings suggest that the TPD2 was generally effective in reducing ECAPS in regulated channels. Nonetheless, further research is warranted to evaluate its role in reducing ECAPS exposure, possibly by triangulation with additional sources of data.
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- 2020
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27. Cessation behaviours among smokers of menthol and flavoured cigarettes following the implementation of the EU Tobacco Products Directive: findings from the EUREST-PLUS ITC Europe Surveys
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Witold Zatonski, Christina N. Kyriakos, Pete Driezen, Anne C K Quah, Ann McNeill, Esteve Fernández, Aleksandra Herbec, Mateusz Zatoński, Ute Mons, Tibor Demjén, Krzysztof Przewoźniak, Kinga Janik-Koncewicz, Geoffrey T. Fong, Yannis Tountas, Antigona Trofor, Constantine I. Vardavas, Marc C. Willemsen, Health promotion, and RS: CAPHRI - R6 - Promoting Health & Personalised Care
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Longitudinal data ,medicine.medical_treatment ,030508 substance abuse ,Cigarette use ,1117 Public Health and Health Services ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Cigarette smoking ,framework ,Environmental health ,Tobacco ,Humans ,Medicine ,030212 general & internal medicine ,Smokers ,business.industry ,Significant difference ,Tobacco control ,Public Health, Environmental and Occupational Health ,Tobacco Smokers ,EUREST-PLUS Consortium ,Tobacco Products ,Europe ,Menthol ,chemistry ,Supplement Papers ,Smoking cessation ,Smoking Cessation ,Public Health ,0305 other medical science ,business - Abstract
The European Tobacco Products Directive (TPD) introduced a ban on characterizing flavours in cigarettes (2016), including menthol (2020). The longitudinal data analysis of the EUREST-PLUS International Tobacco Control (ITC) Project Europe Surveys (n = 16 534; Wave 1 in 2016 and Wave 2 in 2018) found significant but small declines in the weighted prevalence of menthol (by 0.94%; P = 0.041) and other flavoured cigarette use (by 1.32%; P
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- 2020
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28. Evaluating the impact of introducing standardized packaging with larger health-warning labels in England: findings from adult smokers within the EUREST-PLUS ITC Europe Surveys
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James Balmford, Mateusz Zatoński, Máirtín S. McDermott, Sarah Aleyan, Ann McNeill, Filippos T. Filippidis, Pete Driezen, Geoffrey T. Fong, Antigona Trofor, Constantine I. Vardavas, Krzysztof Przewoźniak, Christina N Kyriakos, Ute Mons, Tibor Demjén, Esteve Fernández, Paraskevi Katsaounou, Sarah Kahnert, and Sara C. Hitchman
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Adult ,Appeal ,030508 substance abuse ,Product Labeling ,1117 Public Health and Health Services ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Germany ,Surveys and Questionnaires ,Environmental health ,Product Packaging ,Humans ,030212 general & internal medicine ,Generalized estimating equation ,Hungary ,Smokers ,Cyclic thrombocytopenia ,Greece ,Romania ,Extramural ,Tobacco control ,Public Health, Environmental and Occupational Health ,EUREST-PLUS Consortium ,Tobacco Products ,Directive ,Europe ,Harm ,Geography ,England ,Spain ,Supplement Papers ,Public Health ,Poland ,0305 other medical science ,Tobacco product - Abstract
BackgroundThe European (EU) Tobacco Product Directive (TPD) was implemented in May 2016 to regulate the design and labelling of cigarettes and roll-your-own tobacco. At the same time, the UK introduced standardized packaging measures, whereas Germany, Greece, Hungary, Poland, Romania and Spain did not. This study examines the impact of introducing standardized packaging in England using a quasi-experimental design.MethodsData from adult smokers in Waves 1 (2016; N=9547) and 2 (2018; N=9724) from the International Tobacco Control Policy Evaluation surveys (England) and EUREST-PLUS surveys (Germany, Greece, Hungary, Poland, Romania and Spain) were used. Generalized estimating equations were used to estimate changes in pack/brand appeal, salience of health-warning labels (HWLs) and perceived relative harm of different brands in England (where larger HWLs and standardized packaging were implemented), vs. each EU country (where only larger HWLs were implemented).ResultsThere was an increase in the percentage of respondents from Germany, Hungary and Poland reporting they did not like the look of the pack (4.7%, 9.6%, and 14.2%, respectively), but the largest increase was in England (41.0%). Moreover, there was a statistically significant increase in the salience of HWLs in Hungary, Poland and Romania (17.0%, 13.9%, and 15.3%, respectively), but the largest increase was in England (27.6%). Few differences were observed in cross-country comparisons of the perceived relative harm of different brands.ConclusionsFindings suggest that standardized packaging reduces pack appeal and enhances the salience of HWLs over and above the effects of larger HWLs. Findings provide additional evidence and support for incorporating standardized packaging into the EU TPD.
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- 2020
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29. Support for e-cigarette policies among smokers in seven European countries: longitudinal findings from the 2016–18 EUREST-PLUS ITC Europe Surveys
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Janet Chung-Hall, Paraskevi Katsaounou, Lorraine Craig, Geoffrey T. Fong, Esteve Fernández, Witold Zatonski, Gang Meng, Ann McNeill, Krzysztof Przewoźniak, Christina N Kyriakos, Ute Mons, Tibor Demjén, Sara C. Hitchman, Constantine I. Vardavas, and Antigona Trofor
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Adult ,Male ,Longitudinal study ,Electronic Nicotine Delivery Systems ,Logistic regression ,01 natural sciences ,1117 Public Health and Health Services ,03 medical and health sciences ,0302 clinical medicine ,Germany ,Humans ,Longitudinal Studies ,Prospective Studies ,030212 general & internal medicine ,0101 mathematics ,Prospective cohort study ,Generalized estimating equation ,Hungary ,Smokers ,Cyclic thrombocytopenia ,Greece ,Romania ,Extramural ,Member states ,010102 general mathematics ,Public Health, Environmental and Occupational Health ,Country differences ,EUREST-PLUS Consortium ,Europe ,Policy ,Geography ,England ,Spain ,Supplement Papers ,Female ,Smoking Cessation ,Public Health ,Poland ,Demography - Abstract
BackgroundThe 2016 European Tobacco Products Directive (TPD) required Member States (MS) to implement new regulations for electronic cigarettes (ECs). We conducted a longitudinal study to assess changes over 2 years in smokers’ support for EC policies and identify predictors of support in seven European countries after TPD implementation.MethodsProspective cohort surveys were conducted among adult smokers in Germany, Greece, Hungary, Poland, Romania, Spain and England in 2016 (n = 9547; just after TPD) and 2018 (n = 10 287; 2 years after TPD). Multivariable logistic regression models employing generalized estimating equations assessed changes in support for four EC policies, and tested for country differences and strength of key predictors of support.ResultsBanning EC use in smoke-free places was supported by 53.1% in 2016 and 54.6% in 2018 with a significant increase in Greece (51.7–66.0%) and a decrease in Spain (60.1–48.6%). Restricting EC/e-liquid nicotine content was supported by 52.2 and 47.4% in 2016 and 2018, respectively, with a significant decrease in England (54.2–46.5%) and Romania (52.5–41.0%). An EC promotion ban was supported by 41.1 and 40.2%. A flavour ban was supported by 33.3% and 32.3% with a significant increase in Hungary (34.3–43.3%). Support was generally higher in Poland, Hungary and Greece vs. England. Support was lower among dual and EC-only users, and low-income smokers.ConclusionsSmokers in all countries strongly supported banning EC use in smoke-free places and restricting nicotine content after TPD implementation, with no clear trends for changes in policy support.
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- 2020
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30. EVALUATION OF OXIDATIVE STRESS IN SMOKING AND NON-SMOKING PATIENTS DIAGNOSED WITH ANXIOUS-DEPRESSIVE DISORDER
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Radu Crisan-Dabija, Ioana Buculei, and Antigona Trofor
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medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,General Pharmacology, Toxicology and Pharmaceutics ,medicine.disease_cause ,business ,Oxidative stress - Published
- 2020
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31. Smokers' support for the ban on sale of slim cigarettes
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Enkeleint Mechili, Krzysztof Przewoźniak, Pete Driezen, Christina Kyriakos, Charis Girvalaki, Ute Mons, Anne Quah, Esteve Fernández, Antigona Trofor, Tibor Demjén, Paraskevi Katsaounou, Witold Zatoński, Geoffrey Fong, Constantine Vardavas, and EUREST-PLUS Consortium
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Health (social science) ,Epidemiology ,Public Health, Environmental and Occupational Health ,Health Professions (miscellaneous) - Published
- 2021
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32. Health beliefs, smoking behaviours and attitudes towards the tobacco flavor ban among smokers of menthol, other flavored and unflavored cigarettes: Findings from the EUREST-PLUS ITC Europe Surveys
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Krzysztof Przewoźniak, Mateusz Zatoński, Aleksandra Herbeć, Witold Zatoński, Kinga Janik-Koncewicz, Ute Mons, Geoffrey Fong, Anne Quah, Pete Driezen, Tibor Demjén, Yannis Tountas, Antigona Trofor, Esteve Fernández, Ann McNeill, Marc Willemsen, Karin Hummel, Christina Kyriakos, Constantine Vardavas, and EUREST-PLUS consortium
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Health (social science) ,Epidemiology ,Public Health, Environmental and Occupational Health ,Health Professions (miscellaneous) - Published
- 2021
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33. Oxidative stress induced by secondhand smoking in patients with mixed anxious-depressive disorder
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Oana-Elena Rohozneanu, Mona Dobrin, Letitia Trofor, Radu Crisan-Dabija, Antigona Trofor, and Ioana Buculei
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medicine.medical_specialty ,Secondhand smoking ,business.industry ,medicine ,In patient ,Psychiatry ,business ,medicine.disease_cause ,Oxidative stress - Published
- 2021
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34. Coping with anxiety during COVID-19 pandemics- correlations with tobacco dependence, social determinants, and COVID-19 history
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Dania Andreea Radu, Letitia Trofor, Ilinca Untu, Oana-Elena Rohozneanu, Antigona Trofor, and Mona Dobrin
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Coping (psychology) ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Pandemic ,medicine ,Anxiety ,Social determinants of health ,medicine.symptom ,business ,Clinical psychology - Published
- 2021
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35. Prospective biochemical and hematological markers to differentiation severe from non-severe COVID-19 disease
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Oana-Elena Rohozeanu, Ioana Buculei, Elena Popa, Antigona Trofor, Radu-Ionel Cernat, Mona-Elisabeta Dobrin, Radu Crisan-Dabija, and Roberta-Ionela Cernat
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Internal medicine ,Medicine ,Disease ,business - Published
- 2021
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36. Secondhand Smoke Exposure in European Countries With Different Smoke-Free Legislation: Findings From the EUREST-PLUS ITC Europe Surveys
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Geoffrey T. Fong, Olena Tigova, Ute Mons, Marcela Fu, Sarah O Nogueira, Antigona Trofor, Paraskevi Katsaounou, Esteve Fernández, Tibor Demjén, Yolanda Castellano, Pete Driezen, Krzysztof Przewoźniak, Christina N Kyriakos, Constantine I. Vardavas, and Aleksandra Herbec
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Adult ,Restaurants ,Original Investigations ,ATTENTIONAL BIAS ,1117 Public Health and Health Services ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Germany ,Background exposure ,Medicine ,CUES ,Humans ,030212 general & internal medicine ,Secondhand smoke ,Smoke free legislation ,1505 Marketing ,Public, Environmental & Occupational Health ,030505 public health ,Science & Technology ,business.industry ,Public Health, Environmental and Occupational Health ,Substance Abuse ,Survey research ,1103 Clinical Sciences ,EUREST-PLUS Consortium ,Europe ,Smoke-Free Policy ,Tobacco Smoke Pollution ,Public Health ,Smoking ban ,0305 other medical science ,business ,Life Sciences & Biomedicine - Abstract
Introduction Exposure to secondhand smoke (SHS) poses serious and extensive health and economic-related consequences to European society and worldwide. Smoking bans are a key measure to reducing SHS exposure but have been implemented with varying levels of success. We assessed changes in the prevalence of self-reported SHS exposure and smoking behavior in public places among smokers in six European countries and the influence of the country’s type of smoking ban (partial or total ban) on such exposure and smoking behavior. Aims and Methods The EUREST-PLUS ITC Europe Surveys were conducted among adult smokers in Germany, Greece, Hungary, Poland, Romania, and Spain in 2016 (Wave 1, n = 6011) and 2018 (Wave 2, n = 6027). We used generalized estimating equations models to assess changes between Waves 1 and 2 and to test the interaction between the type of smoking ban and (1) self-reported SHS exposure, (2) self-reported smoking in several public places. Results A significant decrease in self-reported SHS exposure was observed in workplaces, from 19.1% in 2016 to 14.0% in 2018 (−5.1%; 95% CI: −8.0%; −2.2%). Self-reported smoking did not change significantly inside bars (22.7% in Wave 2), restaurants (13.2% in Wave 2) and discos/nightclubs (34.0% in W2). SHS exposure in public places was significantly less likely (adjusted odds ratio = 0.35; 95% CI: 0.26–0.47) in the countries with total bans as compared to those countries with partial bans. Conclusion The inverse association between smoking in public places and smoking bans indicates an opportunity for strengthening smoke-free legislation and protecting bystanders from exposure to SHS in public places. Implications Prevalence of smokers engaging in and being exposed to smoking in public places varied by type of smoke-free legislation across six European Union countries in our study; those with total smoke bans reported significantly less exposure to SHS than those with partial or no bans. Our results indicate room for improvement, not only to decrease the prevalence of exposure to SHS in Europe but also to diminish the variability between countries through common, more restrictive smoke-free legislation, and importantly, strong and sustained enforcement.
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- 2021
37. Biochemistry in Assessing the Inflammatory Response of the Respiratory System Due to Experimental Exposure to Glass Fibres
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Elena Cojocaru, Bianca Domokos-Hancu, Andrei Lesan, Carmen Monica Pop, Florina Popescu, Milena Adina Man, Cristina Maria Gavrilescu, Roxana Mihaela Barbu, Andrei Cernomaz, Antigona Trofor, and Cristian Boerescu
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Pathology ,medicine.medical_specialty ,Materials science ,Polymers and Plastics ,Mechanics of Materials ,Intratracheal instillation ,Inflammatory response ,Materials Chemistry ,medicine ,General Chemistry ,Occupational exposure ,Respiratory system - Abstract
Given the structural resemblances between glass fiber and asbestos, it is important to understand the mechanisms through which exposure to glass fibers may affect the respiratory system. To study the effect of glass fiber on rat lung through intratracheal exposure, considering the subject�s weight variation, together with haematological parameters, C-reactive protein (CRP), total number of lymphocytes, and IL8 concentration in bronchoalveolar lavage. We performed an intratracheal instillation study on four groups of 8 randomly selected Wistar rats, by administering 3 different doses of glass fiber. The hematocrit value was an indirect indicator of chronic hypoxemia; leukocytes and the C-reactive protein assessed systemic inflammation, and total number of lymphocytes and IL8 concentration in bronchoalveolar lavage fluid determined the lung�s inflammatory response. Weight variation evaluated in all 8 measurements revealed no statistically significant changes (p=0.768). The decrease in mean blood leukocytes was interpreted in relation with the glass fiber dose, with a statistically significant difference between the study groups (p=0.003). Statistically significant differences were found in the CRP values, with dose correlations (p[0.001). The bronchoalveolar lavage fluid showed increased levels of IL-8 (p[0.05), and decrease of lymphocytes (p[0.001) in correlation with the administered glass fiber dose. The inflammatory response following exposure to glass fibers in rats is correlated with administrated glass fiber dose. The alterations described as a result of intratracheal glass fiber instillation could predict the effects which occupational exposure to glass fiber may produce in humans.
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- 2019
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38. Corticosteroids in SARS-COV2 infection: certainties and uncertainties in clinical practice
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Antigona Trofor, Sabina A Antoniu, Ileana Antohe, and Radu Crisan Dabija
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0301 basic medicine ,Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,viruses ,030106 microbiology ,Pneumonia, Viral ,dexamethasone ,Review ,Microbiology ,Methylprednisolone ,corticosteroids ,03 medical and health sciences ,0302 clinical medicine ,Adrenal Cortex Hormones ,Virology ,Pandemic ,medicine ,Humans ,pneumonia ,030212 general & internal medicine ,Intensive care medicine ,Aged ,Inflammation ,SARS ,COV2 infection ,business.industry ,SARS-CoV-2 ,Public health ,fungi ,COVID-19 ,Middle Aged ,medicine.disease ,respiratory tract diseases ,COVID-19 Drug Treatment ,Clinical Practice ,Pneumonia ,Infectious Diseases ,RNA, Viral ,Female ,business ,medicine.drug - Abstract
Introduction The SARS-COV-2 pandemic is a worldwide public health problem due to the large medical burden and limited number of therapies available. Corticosteroids have a rather unclear efficacy in viral non-SARS-COV-2 pneumonias and therefore their use is not universally recommended. In SARS-COV-2 pneumonia however, it is expected that they can reduce the deleterious consequences of the virus-related systemic inflammation. Areas covered a MEDLINE search covering the period 1995–2020 was completed to identify relevant papers. SARS-COV-2 pathogenesis is very complex and is represented by the interplay of many cytokine-driven inflammation pathways. Its most severe form so called cytokine storm, is an exaggerate reaction of the host infected by the virus rapidly resulting in multiple organ dysfunction (MODS). Corticosteroids have the potential to blunt the inflammation response in such patients, but their efficacy is not the same for all patients. Further on the certainties and uncertainties regarding the efficacy of this therapy in SARS-COV-2 pneumonia are discussed Expert Opinion In patients with severe SARS-COV-2 pneumonia, corticosteroids can be efficacious, but it is still not clear if they can be safely used in patients with comorbid cardiovascular disease or how the optimal duration of therapy can be established.
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- 2021
39. Smoking cessation for patients with COPD, cardiovacular diseases and diabetes
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Sophia Papadakis, Letitia Trofor, Lucia Maria Lotrean, Constantine I. Vardavas, Panagiotis Behrakis, Cristina Gavrilescu, Antigona Trofor, and Ioana Buculei
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medicine.medical_specialty ,COPD ,Health (social science) ,Epidemiology ,business.industry ,medicine.medical_treatment ,Public Health, Environmental and Occupational Health ,medicine.disease ,Health Professions (miscellaneous) ,Internal medicine ,Diabetes mellitus ,Medicine ,Smoking cessation ,business - Published
- 2020
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40. Smoking and oxidative stress among patients with mixed anxiety and depressive disorder
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Letitia Trofor, Mona Cioroiu, Antigona Trofor, and Radu Crisan-Dabija
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Health (social science) ,Epidemiology ,business.industry ,Public Health, Environmental and Occupational Health ,medicine ,Anxiety ,medicine.symptom ,medicine.disease_cause ,business ,Health Professions (miscellaneous) ,Oxidative stress ,Clinical psychology - Published
- 2020
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41. Product transitions among smokers before and after implementation of the European Tobacco Products Directive: Cohort study findings from the EUREST-PLUS ITC Europe Surveys
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Christina Kyriakos, Constantine Vardavas, Pete Driezen, Charis Girvalaki, Katerina Nikitara, Filippos Filippidis, Esteve Fernández, Ute Mons, Krzysztof Przewoźniak, Antigona Trofor, Tibor Demjén, Paraskevi Katsaounou, Witold Zatoński, Marc Willemsen, Geoffrey Fong, and on behalf of the EUREST-PLUS Consortium
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Health (social science) ,Epidemiology ,Environmental health ,Public Health, Environmental and Occupational Health ,Product (category theory) ,Business ,Directive ,Health Professions (miscellaneous) ,Cohort study - Published
- 2020
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42. Quitting behaviours and cessation methods used in eight European Countries in 2018: findings from the EUREST-PLUS ITC Europe Surveys
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Esteve Fernández, Charis Girvalaki, Marcela Fu, Chara Tzavara, Sophia Papadakis, Aleksandra Herbec, Constantine I. Vardavas, Witold Zatonski, Filippos T. Filippidis, Christina N Kyriakos, Ann McNeill, Geoffrey T. Fong, Antigona Trofor, Pete Driezen, Ute Mons, Tibor Demjén, Karin Hummel, Marc C. Willemsen, Paraskevi Katsaounou, James Balmford, RS: CAPHRI - R6 - Promoting Health & Personalised Care, and Health promotion
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Higher education ,medicine.medical_treatment ,MEDLINE ,030508 substance abuse ,smokers ,Logistic regression ,1117 Public Health and Health Services ,03 medical and health sciences ,0302 clinical medicine ,Germany ,Surveys and Questionnaires ,Tobacco ,medicine ,media_common.cataloged_instance ,Humans ,030212 general & internal medicine ,European union ,Nicotine dependence ,media_common ,Netherlands ,Self-efficacy ,Hungary ,Greece ,business.industry ,Romania ,Tobacco control ,Public Health, Environmental and Occupational Health ,medicine.disease ,3. Good health ,Europe ,Cross-Sectional Studies ,England ,Spain ,Supplement Papers ,behavior and behavior mechanisms ,Smoking cessation ,Smoking Cessation ,Public Health ,Poland ,SMOKING ,EUREST-PLUS consortium ,0305 other medical science ,business ,Demography - Abstract
BackgroundWe examined quit attempts, use of cessation assistance, quitting beliefs and intentions among smokers who participated in the 2018 International Tobacco Control (ITC) Europe Surveys in eight European Union Member States (England, Germany, Greece, Hungary, the Netherlands, Poland, Romania and Spain).MethodsCross-sectional data from 11 543 smokers were collected from Wave 2 of the ITC Six European Country (6E) Survey (Germany, Greece, Hungary, Poland, Romania and Spain—2018), the ITC Netherlands Survey (the Netherlands—late 2017) and the Four Countries Smoking and Vaping (4CV1) Survey (England—2018). Logistic regression was used to examine associations between smokers’ characteristics and recent quit attempts.ResultsQuit attempts in the past 12 months were more frequently reported by respondents in the Netherlands (33.0%) and England (29.3%) and least frequently in Hungary (11.5%), Greece (14.7%), Poland (16.7%) and Germany (16.7%). With the exception of England (35.9%), the majority (56–84%) of recent quit attempts was unaided. Making a quit attempt was associated with younger age, higher education and income, having a smoking-related illness and living in England. In all countries, the majority of continuing smokers did not intend to quit in the next 6 months, had moderate to high levels of nicotine dependence and perceived quitting to be difficult.ConclusionsApart from England and the Netherlands, smokers made few quit attempts in the past year and had low intentions to quit in the near future. The use of cessation assistance was sub-optimal. There is a need to examine approaches to supporting quitting among the significant proportion of tobacco users in Europe and increase the use of cessation support as part of quit attempts
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- 2020
43. Do smokers want to protect non-smokers from the harms of second-hand smoke in cars? Findings from the EUREST-PLUS ITC Europe Surveys
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Olena Tigova, Constantine I. Vardavas, Pete Driezen, Sarah O Nogueira, Ute Mons, Geoffrey T. Fong, Tibor Demjén, Krzysztof Przewoźniak, Christina N Kyriakos, Anne C K Quah, Antigona Trofor, Mateusz Zatoński, Paraskevi Katsaounou, Esteve Fernández, and Marcela Fu
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Adult ,Passive smoking ,Legislation ,medicine.disease_cause ,01 natural sciences ,Eu countries ,1117 Public Health and Health Services ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Environmental health ,Germany ,medicine ,media_common.cataloged_instance ,Humans ,030212 general & internal medicine ,0101 mathematics ,European union ,Child ,Generalized estimating equation ,Second hand smoke ,media_common ,Hungary ,Smokers ,Greece ,business.industry ,Romania ,010102 general mathematics ,Public Health, Environmental and Occupational Health ,EUREST-PLUS Consortium ,Non-Smokers ,Confidence interval ,Europe ,Spain ,Public Opinion ,Tobacco Smoke Pollution ,Public Health ,Poland ,business ,Automobiles - Abstract
BackgroundThere is currently no comprehensive legislation protecting non-smokers and children from second-hand smoke (SHS) exposure in private cars at the European Union (EU) level. This study aims to assess smokers’ support for smoke-free cars legislation in six EU countries.MethodsData come from the EUREST-PLUS ITC Europe Surveys: Wave 1 (2016, n = 6011) and Wave 2 (2018, n = 6027) conducted in Germany, Greece, Hungary, Poland, Romania and Spain. Support for smoke-free cars carrying pre-school children and non-smokers and voluntary implementation of smoke-free cars were assessed among adult smokers. Generalized estimating equations models were used to assess changes in support between waves.ResultsIn 2018, 96.3% [95% confidence interval (CI) 95.4–97.0%] of the overall sample supported smoke-free legislation for cars carrying pre-school children, representing an increase of 2.4 percentage points in comparison to 2016. Smoke-free legislation for cars transporting non-smokers was supported by 85.2% (95% CI 83.1–87.1%) of smokers’ in 2016 and 90.2% (95% CI 88.6–91.7%) in 2018. Among smokers who owned cars, there was a significant 7.2 percentage points increase in voluntary implementation of smoke-free cars carrying children from 2016 (60.7%, 95% CI 57.2–64.0%) to 2018 (67.9%, 95% CI 65.1–70.5%). All sociodemographic groups of smokers reported support higher than 80% in 2018.ConclusionThe vast majority of smokers in all six EU countries support smoke-free legislation for cars carrying pre-school children and non-smokers. This almost universal support across countries and sociodemographic groups is a clear indicator of a window of opportunity for the introduction of comprehensive legislation to protect non-smokers and children from SHS exposure in cars.
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- 2020
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44. Effectiveness of tobacco warning labels before and after implementation of the European Tobacco Products Directive-findings from the longitudinal EUREST-PLUS ITC Europe surveys
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Geoffrey T. Fong, Ute Mons, Tibor Demjén, Esteve Fernández, Paraskevi Katsaounou, Witold Zatonski, Sara C. Hitchman, Constantine I. Vardavas, Sarah Aleyan, Sarah O Nogueira, Sarah Kahnert, Krzysztof Przewoźniak, Christina N Kyriakos, Pete Driezen, James Balmford, and Antigona Trofor
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Adult ,Male ,Smoking Prevention ,Product Labeling ,Gee ,1117 Public Health and Health Services ,03 medical and health sciences ,Tobacco Use ,0302 clinical medicine ,Environmental health ,Germany ,Tobacco ,media_common.cataloged_instance ,Humans ,030212 general & internal medicine ,European union ,education ,Generalized estimating equation ,media_common ,education.field_of_study ,Hungary ,030505 public health ,Salience (language) ,Greece ,Romania ,Public Health, Environmental and Occupational Health ,Cognition ,EUREST-PLUS Consortium ,Tobacco Products ,Directive ,3. Good health ,Europe ,Spain ,Supplement Papers ,Warning label ,Female ,Public Health ,Poland ,0305 other medical science ,Psychology - Abstract
BackgroundTobacco product packaging is a key part of marketing efforts to make tobacco use appealing. In contrast, large, prominent health warnings are intended to inform individuals about the risks of smoking. In the European Union, since May 2016, the Tobacco Products Directive 2014/40/EU (TPD2) requires tobacco product packages to carry combined health warnings consisting of a picture, a text warning and information on stop smoking services, covering 65% of the front and back of the packages.MethodsKey measures of warning label effectiveness (salience, cognitive reactions and behavioural reaction) before and after implementation of the TPD2, determinants of warning labels’ effectiveness and country differences were examined in a longitudinal sample of 6011 adult smokers from Germany, Greece, Hungary, Poland, Romania and Spain (EUREST-PLUS Project) using longitudinal Generalized Estimating Equations (GEE) models.ResultsIn the pooled sample, the warning labels’ effectiveness increased significantly over time in terms of salience (adjusted OR = 1.18; 95% CI: 1.03–1.35), while cognitive and behavioural reactions did not show clear increases. Generally, among women, more highly educated smokers and less addicted smokers, the effectiveness of warning labels tended to be higher.ConclusionWe found an increase in salience, but no clear increases for cognitive and behavioural reactions to the new warning labels as required by the TPD2. While it is likely that our study underestimated the impact of the new pictorial warning labels, it provides evidence that health messages on tobacco packaging are more salient when supported by large pictures.
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- 2020
45. Transitions in product use during the implementation of the European Tobacco Products Directive: cohort study findings from the EUREST-PLUS ITC Europe Surveys
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Antigona Trofor, Katerina Nikitara, Esteve Fernández, Paraskevi Katsaounou, Filippos T. Filippidis, Pete Driezen, Krzysztof Przewoźniak, Christina N Kyriakos, Constantine I. Vardavas, Ute Mons, Tibor Demjén, Geoffrey T. Fong, Witold Zatonski, Charis Girvalaki, Marc C. Willemsen, Health promotion, and RS: CAPHRI - R6 - Promoting Health & Personalised Care
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COUNTRIES ,Adult ,AWARENESS ,Eu countries ,1117 Public Health and Health Services ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Germany ,Surveys and Questionnaires ,media_common.cataloged_instance ,Humans ,030212 general & internal medicine ,European union ,media_common ,Hungary ,030505 public health ,Cyclic thrombocytopenia ,Greece ,Romania ,Tobacco control ,Public Health, Environmental and Occupational Health ,EUREST-PLUS Consortium ,ADULTS ,Tobacco Products ,CIGARETTES ,Directive ,Product (business) ,Europe ,SUDAAN ,Spain ,Supplement Papers ,Government Regulation ,Business ,Public Health ,Poland ,0305 other medical science ,Cohort study - Abstract
BackgroundThe emergence of new types of tobacco and tobacco-related products on the European Union (EU) market has precipitated the possibility for both poly-tobacco use and transitions between products. In the EU, the regulatory environment has shifted with the implementation of the European Tobacco Products Directive (TPD) in May 2016, which may influence consumer transitions between products.MethodsThe aim of this paper was to examine trends and transitions in tobacco products from 2016 to 2018 -before and after implementation of the TPD in the EU. Data come from Wave 1 (pre-TPD) and Wave 2 (post-TPD) of the EUREST-PLUS ITC Six European Country Survey, a cohort study of adults who at the time of recruitment were smokers from six EU countries- Germany, Greece, Hungary, Poland, Romania, and Spain. D (N = 3195). Bivariate and logistic regression analyses of weighted data was conducted using SAS-callable SUDAANResultsOverall, among those who smoked factory-made cigarettes (FM) only at Wave 1, 4.3% switched to roll-your-own tobacco (RYO) only. Among RYO only users at Wave 1, 17.0% switched to FM only, however compared to all other countries, respondents from Hungary had the highest percentage of FM only users at Wave 1 switch to RYO only at Wave 2 (18.0%).ConclusionsThe most prominent transition overall was from smoking RYO exclusively at Wave 1 to smoking FM tobacco exclusively at Wave 2, however this varied across countries. As the tobacco control regulatory environment of the EU develops, it is important to continue to monitor transitions between types of products, as well as trends in cessation.
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- 2020
46. Changes in electronic cigarette use and label awareness among smokers before and after the European Tobacco Products Directive implementation in six European countries: findings from the EUREST-PLUS ITC Europe Surveys
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Antigona Trofor, Filippos T. Filippidis, Esteve Fernández, Charis Girvalaki, Krzysztof Przewoźniak, Christina N Kyriakos, Pete Driezen, Constantine I. Vardavas, Ute Mons, Tibor Demjén, Paraskevi Katsaounou, Katerina Nikitara, Geoffrey T. Fong, Witold Zatonski, Sarah Kahnert, and Sara C. Hitchman
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Adult ,Health Knowledge, Attitudes, Practice ,Health (social science) ,Epidemiology ,030508 substance abuse ,Electronic Nicotine Delivery Systems ,Product Labeling ,Eu countries ,Health Professions (miscellaneous) ,1117 Public Health and Health Services ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Surveys and Questionnaires ,Medicine ,media_common.cataloged_instance ,Humans ,Product (category theory) ,030212 general & internal medicine ,European union ,Generalized estimating equation ,media_common ,030505 public health ,Smokers ,Greece ,business.industry ,Member states ,Vaping ,Public Health, Environmental and Occupational Health ,EUREST-PLUS Consortium ,Tobacco Products ,Directive ,Electronic Cigarette Use ,Europe ,SUDAAN ,Supplement Papers ,Public Health ,Poland ,business ,0305 other medical science - Abstract
BackgroundArticle 20 of the European Tobacco Product Directive (TPD), which went into effect in May 2016, regulates electronic cigarettes (e-cigarettes) in the European Union (EU). The aim of this study was to evaluate changes in e-cigarette use, design attributes of the products used and awareness of e-cigarette labelling and packaging among smokers from six EU Member States (MS) before and after TPD implementation.MethodsData come from Wave 1 (2016, pre-TPD) and Wave 2 (2018, post-TPD) of the ITC Six European Country Survey among a sample of smokers and recent quitters who use e-cigarettes from six EU MS. Weighted logistic generalized estimating equations regression models were estimated to test the change in binary outcomes between Waves 1 and 2 using SAS-callable SUDAAN.ResultsIn 2018, current daily/weekly e-cigarette use among adult smokers was just over 2%, but this varied from the highest in Greece (4%) to lowest in Poland (1.2%). From Waves 1 to 2, there was a significant increase in respondents reporting noticing and reading health and product safety information on leaflets inside e-cigarette packaging (8.39–11.62%, P Conclusionse-cigarette use among smokers in these six EU countries is low. Although reported noticing and reading leaflets included in the packaging of e-cigarettes increased significantly from before to after the TPD, there was no significant change in reported noticing and reading of warning labels. Findings indicate the importance of continued monitoring of TPD provisions around e-cigarettes.
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- 2020
47. Smoking and oxidative stress markers useful for improving anxiety and depression disease outcomes
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Ioana Buculei, Ionela-Alina Grosu-Creanga, Antigona Trofor, Mona Cioroiu, and Letitia Trofor
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Disease outcome ,business.industry ,medicine ,Anxiety ,medicine.symptom ,medicine.disease_cause ,business ,Oxidative stress ,Depression (differential diagnoses) ,Clinical psychology - Published
- 2020
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48. Evidence-implementation gaps in low- and middle-income countries' COPD guidelines
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William Checkley, Job F M van Boven, Gonzalo Gianella, Tarana Ferdous, John R. Hurst, Erick Wan-Chun Huang, David Meharg, Niels H. Chavannes, Jennifer A. Alison, Jaime Correia de Sousa, Patricia Alupo, Oscar Flores Flores, Antigona Trofor, Aizhamal Tabyshova, Joan B. Soriano, Maarten J. Postma, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Microbes in Health and Disease (MHD), and Groningen Research Institute for Asthma and COPD (GRIAC)
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COPD ,business.industry ,Low and middle income countries ,Environmental health ,medicine ,COPD - management ,Primary care ,medicine.disease ,business - Published
- 2020
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49. Perceptions, Predictors of and Motivation for Quitting among Smokers from Six European Countries from 2016 to 2018: Findings from EUREST-PLUS ITC Europe Surveys
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Antigona Trofor, Constantine I. Vardavas, Filippos T. Filippidis, Krzysztof Przewoźniak, Christina N Kyriakos, Geoffrey T. Fong, Sophia Papadakis, Paraskevi Katsaounou, Esteve Fernández, Charis Girvalaki, Aleksandra Herbec, Ute Mons, Tibor Demjén, Enkeleint A. Mechili, and Pete Driezen
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Male ,Health, Toxicology and Mutagenesis ,lcsh:Medicine ,030508 substance abuse ,Intention ,Smoking cessation ,Toxicology ,Logistic regression ,Cohort Studies ,perceptions ,0302 clinical medicine ,Surveys and Questionnaires ,030212 general & internal medicine ,Public, Environmental & Occupational Health ,media_common ,GENERAL-POPULATION ,Smokers ,European Union countries ,SUCCESS ,Middle Aged ,POLICY ,DEPRESSION ,PREVALENCE ,3. Good health ,Europe ,European policies ,ADULT SMOKERS ,TOBACCO CONTROL ,Cohort ,behavior and behavior mechanisms ,Female ,TPD ,0305 other medical science ,Psychology ,Life Sciences & Biomedicine ,Cohort study ,Adult ,Adolescent ,media_common.quotation_subject ,Environmental Sciences & Ecology ,Sample (statistics) ,Països de la Unió Europea ,World Health Organization Framework Convention on Tobacco Control (WHO FCTC) ,Article ,03 medical and health sciences ,Tractament del tabaquisme ,medicine ,Humans ,media_common.cataloged_instance ,European union ,quit smoking ,Motivation ,Science & Technology ,Data collection ,Addiction ,lcsh:R ,Public Health, Environmental and Occupational Health ,SMOKING-CESSATION ,CIGARETTES ,medicine.disease ,Health Surveys ,Comorbidity ,STOP ,predictors ,reasons ,Smoking Cessation ,Environmental Sciences ,Demography - Abstract
The European Tobacco Products Directive (TPD) was introduced in 2016 in an effort to decrease prevalence of smoking and increase cessation in the European Union (EU). This study aimed to explore quitting behaviours, motivation, reasons and perceptions about quitting, as well as predictors (reported before the TPD implementation) associated with post-TPD quit status. A cohort study was conducted involving adult smokers from six EU countries (n = 3195). Data collection occurred pre-(Wave 1, 2016) and post-(Wave 2, 2018) TPD implementation. Bivariate and logistic regression analyses of weighted data were conducted. Within this cohort sample, 415 (13.0%) respondents reported quitting at Wave 2. Predictors of quitting were moderate or high education, fewer cigarettes smoked per day at baseline, a past quit attempt, lower level of perceived addiction, plans for quitting and the presence of a smoking-related comorbidity. Health concerns, price of cigarettes and being a good example for children were among the most important reasons that predicted being a quitter at Wave 2. Our findings show that the factors influencing decisions about quitting may be shared among European countries. European policy and the revised version of TPD could emphasise these factors through health warnings and/or campaigns and other policies.
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- 2020
50. Social norms for e-cigarettes and smoking: associations with initiation of e-cigarette use, intentions to quit smoking and quit attempts: findings from the EUREST-PLUS ITC Europe Surveys
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Ann McNeill, Katherine A. East, Kinga Janik-Koncewicz, Máirtín S. McDermott, Aleksandra Herbec, Antigona Trofor, Ute Mons, Constantine I. Vardavas, Tibor Demjén, Esteve Fernández, Sara C. Hitchman, Geoffrey T. Fong, and Yannis Tountas
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Male ,Demographics ,Longitudinal data ,medicine.medical_treatment ,Cigarette use ,Intention ,Electronic Nicotine Delivery Systems ,Logistic regression ,Quit smoking ,Intention to quit ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,medicine ,Social Norms ,Humans ,030212 general & internal medicine ,Prospective Studies ,030505 public health ,Smoking Tobacco ,Vaping ,Smoking ,Public Health, Environmental and Occupational Health ,Europe ,Cross-Sectional Studies ,England ,Supplement Papers ,Smoking cessation ,Female ,Smoking Cessation ,0305 other medical science ,Psychology ,Demography - Abstract
Background Social norms have received little attention in relation to electronic cigarettes (EC). The current study examine social norms for EC use and smoking tobacco, and their associations with (i) initiation of EC use, (ii) intention to quit smoking and (iii) attempts to quit smoking. Methods Cross-sectional and longitudinal data analysis from Waves 1 and 2 of the ITC 6 European Country Survey and corresponding waves from England (the ITC Four Country Smoking and Vaping Survey). Current smokers at baseline, who heard of ECs and provided data at both waves were included (n = 3702). Complex samples logistic regression examined associations between the outcomes and descriptive (seeing EC use in public, close friends using ECs/smoking) and injunctive (public approves of ECs/smoking) norms, adjusting for country, demographics, EC use and heaviness of smoking. Results In longitudinal analyses, seeing EC use in public at least some days was the only social norm that predicted initiation of EC use between waves (OR = 1.66, 95%CI = 1.08–2.56). In the cross-sectional analysis, having an intention to quit was associated with seeing EC use in public (OR = 1.37, 95%CI = 1.04–1.81) and reporting fewer than three close friends smoke (OR = 0.59, 95%CI = 0.44–0.80). There was no association between any social norm and making a quit attempt between waves. Conclusions Initiation of EC use is predicted by seeing EC use in public, which was also associated with greater intention to quit smoking. Friends’ smoking was associated with lower intention to quit. These findings may allay concerns that increased visibility of ECs is renormalizing smoking amongst current smokers.
- Published
- 2020
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