Socioeconomic and gender inequalities in smoking. Findings from the Czech National Tobacco Surveys 2012-2015.

OBJECTIVE: Smoking significantly affects morbidity and mortality of the population. The incidence of smoking is determined by gender and socioeconomic status (SES) of an individual. The aim of this study is to analyse the relationship between gender and SES indicators and smoking. METHODS: The analysis is based on data from the Czech National Tobacco Surveys from 2012 to 2015 (N∼1,800 per year). The prevalence of smoking, average daily consumption of cigarettes, initiation ratio and quit ratio were monitored. Smoking habits of the respondents were surveyed using the Czech version of the standard Tobacco Questions for Surveys (TQS) questionnaire. SES was measured by a composite index comprising three variables (level of education, income and job prestige); it had four categories: low, lower-middle, upper-middle, and high. RESULTS: In comparison with women, men had a higher smoking prevalence (OR=1.41, 95% CI=1.09-1.84), higher consumption of cigarettes (B=4.11, 95% CI=1.97-6.26), and higher rate of smoking initiation (OR=1.38, 95% CI=1.10-1.74), but they did not differ in the quit rate (OR=0.85, 95% CI=0.60-1.21). Persons in the low SES category had higher prevalence of smoking and higher initiation ratio compared with those in the high SES category (OR=2.59, 95% CI=1.36-4.97; OR=2.23, 95% CI=1.26-3.95). Cigarette consumption and quit ratio did not differ according to SES. The prevalence of smoking in the years 2012-2014 did not differ; in 2015, it was lower compared to the previous three years. CONCLUSIONS: Inequalities in socioeconomic status affect smoking, which significantly contributes to morbidity and mortality. Measures aimed at reducing inequalities in health must take into account both smoking as a risk factor and socioeconomic status, which affects its occurrence. Programmes to reduce tobacco use should reflect the different needs of individuals with different SES levels. It is especially necessary to seek effective approaches for smokers with low socioeconomic status.

Good practices for the prevention of alcohol harmful use amongst the elderly in Europe, the VINTAGE project.

INTRODUCTION: There is a lack of information about initiatives aimed at preventing the harmful effects of alcohol amongst the elderly. OBJECTIVES: One of the objectives of the VINTAGE study was to collect the initiatives carried out in Europe and review the published grey literature about this topic. METHODS: Email-based survey addressed to researchers, professionals and policymakers, and internet search of grey literature. RESULTS: Three hundred nine contacts were finally made, and 21 of the 36 collected initiatives were considered as useful in preventing the harmful use of alcohol amongst the elderly. Out of the about 2900 references identified 96 were classified as relevant. CONCLUSIONS: Despite a growing interest, alcohol use in the elderly is not yet perceived as a major issue for prevention.

Changes in tobacco use among 13-15-year-olds in the Czech Republic--2002 and 2007.

BACKGROUND: The Czech Republic is a member of the European Union (EU) and the World Health Organization (WHO). The EU has made tobacco use prevention a primary health issue and WHO European Region has adopted the European Strategy for Tobacco Control. The aim of the current study is to evaluate the status of tobacco use among adolescents in the Czech Republic and relate these findings to the tobacco control programme efforts supported by the EU and WHO. METHODS: Global Youth Tobacco Survey (GYTS) data were collected from representative samples of students in grades associated with ages 13-15 in the Czech Republic in 2002 and 2007. RESULTS: Current cigarette smoking decreased from 35% to 31% overall. Exposure to second-hand smoke (SHS) in public places remained unchanged over time (75% in 2007). Almost half of respondents reported having a parent who smokes and about one third had best friends who smoked. There were significant decreases in exposure to pro-tobacco advertisements on billboards in magazines. CONCLUSIONS: Efforts to reduce the current and projected harm caused by tobacco use in the Czech Republic are urgently needed. The Czech Republic needs to expand its national comprehensive tobacco prevention and control programmes and enforce those laws already passed. Without this effort little reduction can be expected in the burden of chronic diseases and tobacco-related mortality. What this paper adds. Results from the GYTS conducted in the Czech Republic indicate a number of serious challenges to prevent and control tobacco use in the region despite a range of ongoing tobacco control activities. GYTS data can enhance countries' capacity to monitor tobacco use among youth; guide development, implementation, and evaluation of their national tobacco prevention and control programme; and allow comparison of tobacco-related data at the national, regional, and global levels.

Smoking attributable hospital treatment, treatment costs and smoking attributable mortality in the Czech Republic in 2002.

OBJECTIVES: The main objective of this work is to quantify the number of hospitalizations caused by smoking, estimate the costs of hospital treatment and to estimate contribution of smoking to mortality in the Czech Republic (CR) in 2002. METHODS: The estimate of the proportion by which smoking contributed to hospitalizations and to mortality in the CR was computed using the method of smoking-attributable fractions (SAF). The SAF was computed from relative risks established in the American study Cancer Prevention Study II and from estimates of the prevalence of smoking in the CR from a nationwide study conducted in 2002. RESULTS: In 2002, based on data provided by the General Health Insurance Company, there were 145,336 hospitalizations, and the total cost of hospital treatment was estimated as 4.727,612 (in thousands) CZK. The total number of deaths caused by smoking was 20,550 (95% CI: 18,851-22,262), 14,525 in men and 6,025 in women. Deaths caused by smoking represented 19% of the total nationwide mortality for 2002. Earlier estimates were published by Peto and Lopez for 1995 (22,300 deaths caused by smoking) and 2000 (17,746 deaths). The estimate arrived by authors using the SAF method for 2002 corresponds quite well with that by Peto and Lopez for 2000. CONCLUSIONS: The high morbidity and mortality rate related to smoking is directly connected to high prevalence of smoking in the Czech Republic. An effective tobacco control policy, including restrictive measures on availability of tobacco products combined with preventive programmes and smoking cessation programmes, could contribute to the reduction of smoking and save lives and treatment costs caused by smoking.