The frequency of photosensitizing drug dispensings in Austria and Germany: a correlation with their photosensitizing potential based on published literature.

BACKGROUND: Drug-induced photosensitivity refers to the development of cutaneous adverse events due to interaction between a pharmaceutical compound and sunlight. Although photosensitivity is a very commonly listed side-effect of systemic drugs, reliable data on its actual incidence are lacking so far. OBJECTIVES: A possible approach to evaluate the real-life extent of drug-induced photosensitivity would be an analysis of the frequency of exposure to a given photosensitizing drug combined with an indicator of its photosensitizing potential. This could serve as a basis for developing a pharmaceutical 'heatmap' of photosensitivity. METHODS: The present study investigated the number of reimbursed dispensed packages of potentially photosensitizing drugs in Germany (DE) and Austria (AT) between 2010 and 2017 based on nationwide health insurance-based databases. In addition, an indicator for the photosensitizing potential was established for each drug based on the number of reports on photosensitivity in the literature. RESULTS: This analysis includes means of 632 826 944 (+/-14 894 918) drug dispensings per year in DE and 113 270 754 (+/-1 964 690) in AT. Out of these, the mean percentage of drugs that enlist photosensitivity as a potential side-effect was 49.5% (±0.7) in DE and 48.2% (±1.2) in AT. When plotting the number of reimbursed dispensed packages vs. the number of reports on photosensitivity, two categories of drugs show high numbers for both parameters, that is diuretics and non-steroidal anti-inflammatory drugs (NSAIDs). CONCLUSIONS: Diuretics and NSAIDs appear to be responsible for the greatest part of exposure to photosensitizing drugs with potential implication on public health.

Intake of a resveratrol-containing dietary supplement has no impact on DNA stability in healthy subjects.

It has been postulated that the beneficial health effects of dietary supplements and of red wines which contain resveratrol (RES) are due to the anti-oxidative properties of this phenolic compound, but evidence for protection against reactive oxygen species is mainly based on results of in vitro experiments and high-dose animal experiments. Aim of this study was to find out if intake of a RES-containing supplement protects healthy humans against oxidative DNA-damage and alters their redox status. Therefore, an intervention trial was conducted in which the participants (n=12) consumed a RES-containing supplement over a period of five days. At the start, after one day and after five days of consumption, and after a washout period DNA stability was measured in single cell gel electrophoresis (SCGE) assays with peripheral blood lymphocytes. These tests were conducted (a) under standard conditions, which reflect single- and double-strand DNA breaks, (b) after treatment of the cells with hydrogen peroxide, which enables detection of alterations of the ROS sensitivity, and (c) by use of formamidopyrimidine DNA-glycosylase (FPG), which provides information on formation of oxidatively damaged bases (pyrimidines). Furthermore, the biochemical parameters TAC (total antioxidant capacity) and oxLDL (oxidized low-density lipoprotein), which reflect the redox status, and C-reactive protein (CRP), a marker of inflammation, were monitored. The intake of the supplement had no significant impact on the DNA stability parameters and on the different biomarkers of the redox status. Our results indicate that intake of 6mg RES per day via the supplement does not cause DNA-protective or antioxidant effects. This amount is equivalent to or lower than that reached after intake of many (ca. 50%) of the RES-containing preparations which are currently on the market in Middle Europe, and is contained in 0.3-2L red wine.

Time trends of the prevalence of asthma and allergic disease in Austrian children.

After a substantial increase in the prevalence of atopic disease in Europe, recent studies indicate that a plateau has been reached. However, variation across countries and age groups exists. We studied the prevalence and time trends of asthma and allergic disease among schoolchildren in Austria, a country with traditionally low rates of asthma, hay fever, and eczema. As part of the International Study of Asthma and Allergies in Childhood (ISAAC), symptoms and physician diagnoses of asthma and allergic disease of 13,399 Austrian children aged 6-7 yr and 1516 children aged 12-14 yr were surveyed between 1995 and 1997. A similar survey was conducted between 2001 and 2003. Among children aged 6-7 yr, significant increases were seen in the prevalence of physician-diagnosed asthma (+16%; p = 0.013), hay fever (+22%; p < 0.001), and eczema (+37%; p < 0.001) between 1995 and 2003. These changes were paralleled by an increase in the prevalence of symptoms typical for hay fever (itchy eyes and runny nose), but not by an increase in wheeze. Among children aged 12-14 yr, the lifetime prevalence of diagnosed asthma increased by 32%, of hay fever by 19%, and of eczema by 28% (all, p < 0.001). These changes were paralleled by increases in the prevalence of wheezing as documented by both questions before and after a video showing wheezing children but not by symptoms typical for hay fever such as itchy eyes and runny nose. In conclusion, in Austria, contrary to other European countries, the prevalence of asthma and allergic disease increased among schoolchildren. Additional studies are needed to continue monitoring the dynamics of the prevalence of asthma and allergic disease in Austria and to explore trends in their risk factors.

Coffee consumption protects human lymphocytes against oxidative and 3-amino-1-methyl-5H-pyrido[4,3-b]indole acetate (Trp-P-2) induced DNA-damage: results of an experimental study with human volunteers.

Aim of the study was to investigate the impact of coffee on DNA-stability in humans. DNA-damage was monitored in lymphocytes of eight individuals with single cell gel electrophoresis assays before and after consumption of 600 ml coffee (400 ml paper filtered and 200 ml metal filtered/d) for five days. Under standard conditions, no alteration of DNA-migration was seen, but a strong reduction of DNA-migration attributable to endogenous formation of oxidised purines and pyrimidines was detected with restriction enzymes; furthermore DNA-damage caused by reactive oxygen radicals (H2O2 treatment) and by the heterocyclic aromatic amine 3-amino-1-methyl-5H-pyrido[4,3-b]indole-acetate was significantly reduced after coffee consumption by 17% and 35%, respectively. Also in in vitro experiments, inhibition of H2O2 induced DNA-damage was observed with coffee at low concentrations (

Rates of postmortem examination in Austria: the effect of distance between location of death and site of examination.

BACKGROUND AND OBJECTIVE: Despite the importance of autopsies for diagnosing disease and determining cause of death, autopsy rates are decreasing in many countries. Furthermore, autopsy rates are often not distributed randomly between different regions within countries. In this study we analyzed an apparent nonrandom spatial distribution of autopsy rates in Austria for the period 1991-2000. We tested the new hypothesis that the rate of autopsies performed on people who die at home depends on the distance from the residence to the hospital or forensic institute where autopsies are performed. METHODS: Data were extracted from the official mortality records for the years 1991-2000. Only persons who deceased in private residences were included. A logistic regression model was used. RESULTS: Even controlling for variability in sex, age, date of death, and family status, the effect of distance significantly implied lower autopsy rates in the alpine parts of Austria. CONCLUSIONS: This effect of distance may lead to artificially nonrandom mortality patterns in disease maps. As a consequence, the possibility of hypothesizing incorrect health risks to explain nonrandom mortality patterns increases.

Cross-sectional study of nocturia in both sexes: analysis of a voluntary health screening project.

OBJECTIVES: To assess the prevalence of nocturia and its impact on the quality of life in both sexes by analyzing almost 2500 individuals participating in a health survey. METHODS: During a 12-month period, we included an incontinence questionnaire, which was largely based on the Bristol female lower urinary tract symptoms questionnaire, in the voluntary health examinations in the area of Vienna. In parallel, we recorded the medical history, concurrent medical therapy, physical examination findings, sociodemographic parameters, and blood laboratory study results. RESULTS: The data of 1247 women (age 49.8 +/- 13.5 years) and 1221 men (age 48.5 +/- 11.9 years) were analyzed. The percentage of individuals with nocturia of two or more times increased constantly with age: less than 30 years, 3.1% of women and 3.4% of men; 30 to 59 years, 7.2% of women and 5. 7% of men; and 60 years old or older, 26.7% of women and 32.4% of men. Age-adjusted extrapolation to the general population (older than 20 years) currently living in Austria yielded that 10.8% of men and 11.8% of women have nocturia of two or more times. Overall, 66. 9% of women and 62.2% of men reported a negative impact of nocturia on their quality of life. The correlation was close between the degree of nocturia with the quality-of-life impairment in both sexes. Several voiding symptoms correlated significantly (P <0.001) with nocturia. CONCLUSIONS: Nocturia is almost equally present in both sexes, and the incidence and severity increase constantly from early adolescence to senescence. Approximately 10% of the general population (older than 20 years) have nocturia of two or more times, which impairs the quality of life in two thirds.

Prostate cancer in Austria: impact of prostate-specific antigen test on incidence and mortality.

The aim of the study was to assess the impact of prostate-specific antigen (PSA) testing on prostate cancer mortality in Austria. A join-point regression model and permutation tests were used to identify changes in the slope of age-specific trends respectively calculating the annual percentage change (APC). Age-adjusted incidence increased (P < 0.01) between 1983 and 1997 by 79% from 52.2 to 93.6 cases per 100 000 men/year. Incidence in localized/regional stage disease increased in all ages by 143% from 25.7 to 62.4 cases per 100 000 men/year. Incidence in distant disease decreased (P < 0.01) between 1983 and 1997 in all ages by 38% from 9.5 to 5.9 cases per 100 000 men/year. Incidence in unstaged disease increased (P < 0.01) between 1983 and 1997 in all ages by 300% from 4.5 to 18 cases per 100 000 men/year. Age-adjusted mortality increased (P < 0.05) by 13% from 26.8 in 1983 to 30.3 deaths per 100 000 men/year in 1999. No significant changes of trends in mortality rates were detected in the age groups 50-59 years. In the age group 70-79 years the trend changed (P < 0.05) direction in 1991 and in 1994; 1983 through 1991 APC = 3.52 (95% CI 1.37, 5.72), 1991 through 1994 APC = -10.27 (95% CI -26.20, 9.1) and 1994 through 1999 APC = -0.25 (95% CI -4.55, 4.24). PSA testing increased incidence but no impact on mortality in the target population can be observed so far.

The burden of cancer in Austria.

The aim of this study was to assess the overall progress against cancer in Austria by analysing changes in age-adjusted mortality rates from 1970 to 1996. For the years 1970 to 1996, age-adjusted rates for all malignant neoplasms and for selected sites were calculated for men and women, according to year, age and sex. The number of cancer deaths were obtained from the Austrian Central Statistical Office--age-adjusted mortality rates of all malignant neoplasms decreased in men between 1971 and 1996 by 13% (from 289.1 to 251.4 deaths per 100,000), and in women between 1970 and 1996 by 19.1% (from 276.6 to 223.7 deaths per 100,000). Among older people (> or = 55 years) the mortality decreased by 13% in men and by 17% in women; among younger people (< 55 years) by 12% and 30%, respectively. The decrease in total cancer mortality is promoted by three tumour sites (the leading causes of cancer deaths in 1970). In both sexes, the decrease of stomach cancer mortality had the major impact, followed by colorectal cancer in women and by lung cancer in men. The observed changes in mortality are primarily related to changing incidence and early detection, rather than improvements in treatment. Unfortunately, there is evidence that prevention is losing ground in Austria. The implementation of the well-established knowledge of cancer prevention and the strengthening of preventative research is urgently needed.

Genetic polymorphisms of CYP1A1 and GSTM1 and lung cancer risk.

Susceptibility to lung cancer may, in part, be determined by interindividual differences in the cytochrome P450-catalysed bioactivation and the glutathione S-transferase-catalysed detoxification of procarcinogens. Therefore a lung cancer case-control study was set up to investigate the association of three polymorphisms of the CYP1A1 gene (CYP1A1*2A, CYP1A1*2B, CYP1A1*4) and GSTM1*0 genotype with lung cancer risk in Austrian Caucasians. Genomic DNA was isolated from the peripheral blood lymphocytes of 134 male lung cancer patients and 134 age-matched controls with nonmalignant conditions and PCR-based analyses were performed. There was no significant difference in risk between cases and controls, either for the CYP1A1*2A (OR=1.09, 95%CI=0.46-2.58), CYP1A1*2B (OR=1.09, 95%CL=0.46-2.58) or for the CYP1A1*4 polymorphism (OR=0.49, 95%CL=0.20-1.16). The prevalence of the GSTM1*0 genotype in the lung cancer group (47.8%) was comparable to that found in the control group (49.3%) and also had no effect on lung cancer risk (OR=0.94, 95%CL=0.54-1.57). Further, in a subgroup of male ever-smokers (n=126), no significant influence on the relative risk was found for these polymorphisms. Our results suggest that these investigated polymorphisms can not be considered as genetic susceptibility markers for lung cancer within the Austrian Caucasian population.

[Cholesterol screening in schools--initial results]. / Cholesterinscreening in Schulen--erste Ergebnisse.

Screening for cardiovascular risk factors was performed in November 1988 among 236 school children in Sölden (Tyrol/Austria). 77.5 per cent of the children had a raised blood cholesterol (greater than or equal to 160 mg/dl = 4.14 mmol/l), and 36.4 per cent a high cardiovascular risk (cholesterol greater than 190 mg/dl = 4.91 mmol/l). The mean cholesterol level for boys was 175.4 mg/dl (4.54 mmol/l), and for girls 186.9 mg/dl (4.83 mmol/l). All children with cholesterol greater than or equal to 160 mg/dl were sent to their general practitioner for follow up.

Development of birth weight in Austria from 1970-1995.

We analysed the development of birth weight of all Austrian live births in the period 1970-1995. The relationship between birth weight and the variables maternal age, length and sex of the newborn and year of birth is described by means of a linear regression model. Over the 26 years an increase of up to 60 g was observed in the mean birth weight. This positive trend may partly be due to the extensive use of the maternity care program ("mother-and-child Passport") introduced in 1974. Maternity payment was made to the mother it she underwent at least five examinations within the antenatal care program. This payment was reduced from 15,000 AS in 1996 to 2000 AS as from January 1st 1997, a measure which may lead to a reduction in the use of this maternity care program, with consequent negative implications for the morbidity of both mother and child and for the positive trend of birth weight development over the past decades.

[Perspective in the incidence of Alzheimer's disease in Austria by the year 2050]. / Die Entwicklung der Zahl von Alzheimer-Erkrankungen in Osterreich bis zum Jahr 2050.

Population projections of the Austrian Central Statistical Office show a dramatic increase in the proportion of people of 65 years of age and over in Austria by the year 2050. Since this population group is at higher risk to develop Alzheimer's disease (AD/SDAT), it will be necessary to modify the currently available facilities for social and medical care to meet this increasing demand. Based on official demographic data and epidemiological findings of the "Eurodem" group, our computations show that the number of persons with AD/SDAT aged 65 or over will rise from 48,000 at present to over 113,500 in 2050 (1990: 614/100,000, 2050: 1505/100,000 persons of the total population), equivalent to an increase of 140%. By forecasting the number of persons affected, it should be possible to intensify (and in some areas introduce) long-term health planning with respect to the social, financial and medical care of aged, demented people in Austria.

Prevalence of self-reported screening mammography and impact on breast cancer mortality in Austria.

Mammography for breast cancer screening has been available in Austria free of charge since 1974 and has been explicitly recommended for mass screening since 1980. The type of screening is opportunistic. Evaluation has to rely on population-based data (mortality, stage distribution, screening prevalence). In a representative cross-sectional study (women aged 40-79 years, n = 566, conducted in 1995) 58% reported at least one screening mammography; the lowest prevalence was found in the age group 70-74 years: 39.3%, the highest in the age group 50-54 years: 71.4%. 23.1% reported at least 2 mammograms within an interval of less than 2 years; lowest prevalence 70-74 years: 10.7%, highest 50-54 years: 35.7%. Age-standardized mortality rate has stabilized since 1985. Since 1980 age-specific rates have increased significantly in all age groups > 54 years, but a decreasing tendency in most groups has been noted since around 1990. The incidence rates of stage II or worse tumors have increased significantly since 1982, except in the age groups 40-44 and 55-59 years; however, during the past 3 to 6 years the absolute rates of incidence of advanced tumors has decreased in alle age groups. The reduction of advanced cancers at diagnosis, followed by a reduction of mortality rates is plausible related to screening prevalence. More uniform decreasing trends should be expected in the years to come. If not, discontinuation of the current opportunistic form of screening without monitoring and evaluation, financed by public money, has to be discussed.

The effect of maternal age and birth weight on the temporal trend in stillbirth rate in Austria during 1984-1993.

We assessed the risk of stillbirth in Austria during 1984-1993 in dependence of the variables maternal age, birth weight, year of birth and sex. All children born in Austria between 1984 and 1993 were included in the study (905,939 births). The risk of stillbirth was estimated by means of a logistic regression model. During the study period, stillbirths decreased significantly in Austria. Both birth weight and maternal age had a non-linear association with the risk of stillbirth. The lowest stillbirth rate was in the birth weight category of 3300-3899 grams (g). Of all stillbirths 62% occurred in infants weighing < or = 2500 g at birth. We also found a significant interaction between birth weight and year of birth suggesting that the effect of birth weight was not stable over the years. The proportion of young mothers (< 20 years) decreased clearly over the observation period. The proportion of low birth weight (< = or 2500 g) infants remained around 7.5% during the 10-year period, but the stillbirth rate decreased linearly over time in this group. In infants weighing > 2500 g at birth the stillbirth risk decreased during first five years but started to increase thereafter. Since over 60% of stillbirths in Austria occur in the low birth weight category, it is obvious that more effective strategies are needed for prevention of low birth weight births and fetal immaturity. In addition, further efforts are needed to prevent also high birth weight of newborns particularly in diabetic mothers.

Prevalence of self-reported cervical cancer screening and impact on cervical cancer mortality in Austria.

Pap smear screening was introduced in Austria in the late 1960's and was recommended annually for all women older than 20 years ever since. This is an opportunistic screening. The evaluation has to rely on population based data (mortality, stage distribution, screening prevalence). In a representative cross-sectional study (women aged 20-69 years, n = 933, conducted in 1995), 76% reported at least one Pap screening during their life; the highest prevalence (88%) was reported by women aged 50-59 years, the lowest prevalence (65%) by women aged 60-69 years. Forty-eight per cent of all women reported that they had undergone screening at least 4 times (40-49 years: 57%, 20-29 years: 34%). Between 1980 and 1996, mortality due to cancer of the uterus, part unspecified (ICD-9: 179), decreased by 54% (P = 0.0001) and that of cancer of the cervix (ICD-9: 180) by 44% (P = 0.0001). Since 1980, age-specific incidence rates of invasive disease decreased (P = 0.0001) in all 10-year age groups (20-29 years: -59%, 30-39 years: -48%, 40-49 years: -34%, 50-59 years: -62%, 60-69 years: -59%). The incidence of preinvasive disease increased significantly (P = 0.001) in the age groups 20-29 years by 30% and 30-39 years by 45%, respectively. No significant changes are observed in other age groups. Opportunistic screening has reduced mortality from cervical cancer and particularly limited the increase among younger women, but the high proportion of cancer deaths from uterine cancer, in part unspecified, obscures the actual trend. We estimate that the true mortality from cervical cancer has been nearly halved between 1980 and 1996. Most of this reduction must be attributed to the screening activities in the 1970's and we expect a further decrease as a result of the expanded screening activities in the 1980's.

[Epidemiologic development of AIDS in Austria]. / Die epidemiologische Entwicklung von AIDS in Osterreich.

AIDS statistics as released by the Austrian Health Authorities refer to the notification date of the disease, but not the time of diagnosis which is essential for descriptive analysis. We present for the first time data on the exact time of diagnosis of, and death from AIDS. Between 1981 and 1992 altogether 899 AIDS cases were registered (747 men, 152 women), of whom 547 persons have already died (462 men, 85 women). At present there are 352 patients with AIDS in Austria (285 men, 67 women). The incidence, prevalence, and mortality rates of AIDS in Austria, both in absolute and relative (per 100,000 men/women 1990) figures are presented in a table.

Indoor factors and their association to respiratory symptoms suggestive of asthma in Austrian children aged 6-9 years.

The ISAAC (International Study of Asthma and Allergy in Childhood) was founded in 1990 in order to maximise the value of epidemiological research into asthma and allergic diseases, to describe the prevalence of asthma and allergic disease in children living in different locations, to make comparisons within and between countries, to provide a framework for further etiological research and to find prevention strategies. We analysed a sub-sample of a population-based study (1995 to 1997) in Upper Austria. The aim of our study was to investigate the influence of indoor risk factors on wheezing in children 6-9 years old. Our calculations were based on the results of a questionnaire answered by parents about their children's indoor environment at home. Smoking of the mother during pregnancy and/or during breastfeeding (OR 1.28; 95% CI 1.08-1.48), smoking of the mother at the present time (OR 1.25; 95% CI 1.12-1.41), a bird (OR 1.40; 95% CI 1.06-1.85) or rabbit (OR 1.37; 95% CI 1.03-1.82) as a domestic pet, synthetic bedding (OR 1.33; 95% CI 1.18-1.49) and dampness or mould at home (OR 1.43; 95% CI 1.24-1.65) are associated with a significantly increased risk of childhood wheezing in the last 12 months. Other variables such as "smoking of the father", "cooking with gas", "gas central heating" and other "pets" do not achieve statistical significance.

[Vaccination status and sociodemographic variables in Viennese public school students]. / Impfstatus und soziodemographische Variablen bei Wiener Volksschülern.

A representative sample of 585 children, attending 2nd grade elementary school in Vienna, was examined. Vaccination certificates were collected, the parents' attitudes towards recommended vaccinations and data on sociodemographic variables were obtained by questionnaire. Compared to 95.9% of the less educated only 90.4% of the higher educated parents are interested that their children receive all vaccinations recommended (p < 0.01). When the dominant country equals "Austria", parents are more reluctant (p < 0.05) to have their children vaccinated (80.4%), compared to others (former Yugoslavia 92%, Turkey 90.9%, other countries 93.1%). A complete immunization against Diphtheria, Tetanus and Poliomyelitis (DT/OPV) was observed in 65.3% of the children. DT/OPV and additionally Mumps and Measles (MM) in 54% and DT/OPV + MM and Pertussis in 43.8% respectively. The immunization coverage is significantly higher (p < 0.01) in children with the dominant country = Austria (DT/OPV 70.7%, DT/OPV + MM 61.8%, DT/OPV + MM + Pertus sis 51.1%) compared to children from former Yugoslavia (DT/OPV 56.3%, DT/OPV + MM 34.5%, DT/OPV + MM + Pertussis 24.1%), Turkey (DT/OPV 54.5%, DT/OPV + MM 40.9%, DT/OPV + MM + Pertussis 33.3%), and "other countries" (DT/OPV 41.4%, DT/OPV + MM 34.5%, DT/OPV + MM + Pertussis 24.1%).

[Cellular immunodeficiency (including AIDS): incidence and length of stay of hospitalized cases in Austria in 1990]. / Zellulärer Immundefekt (inklusive AIDS): Inzidenz und Aufenthaltsdauer stationär behandelter Fälle in Osterreich im Jahr 1990.

The incidence of cellular immunodeficiency (including AIDS), treated at hospitals in Austria in the year 1990, was 3.8 per 100,000 (n = 294, males 6.3 per 100,000, females 1.5 per 100,000). On the average every patient with this diagnosis was admitted to the hospital 3.6 times per year. The average hospitalization time was 7.5 days, summing up to a mean of 27.3 days of stay per case per year. A total of 8031 days was necessary for the hospital care of these patients, costing AS 86873 for care per person in 1990 (AS 3,180 per day in the hospital). In relation to the grand total of approximately 1.8 million admissions to Austrian hospitals, patients with the diagnosis "cellular immunodeficiency (including AIDS)" cover only 0.06% of all admission and 0.03% of patient days per year respectively.

[Prevalence of smoking habits of Upper Austria students of the 7th and 8th grade and effect of smoking habits of family and peers]. / Prävalenz der Rauchgewohnheiten von oberösterreichischen Schülern der 7. und 8. Schulstufe und Einfluss der Rauchgewohnheiten von Familie und Peers.

The aim of the study was to explore the prevalence of different smoking habits in a population of Austrian pupils, 12 to 15 years old, and the relationship of familial and peer group smoking customs with these habits. In 1997 a population-based survey (International Study of Asthma and Allergies in Childhood, ISAAC) was conducted of all 7th and 8th grade school children of a district of Upper Austria. Information on the smoking habits of the adolescents, the family members, and of the peer as well as smoking habits of the teacher, gender, and age of the children was collected. The overall-prevalence of having ever smoked in this population is 57.8%. The percentage of eversmokers among the 12-year-olds is 50%. This amount increases to 63.8% among the 14- to 15-year-olds. The odds ratios for smoking daily is highest among those whose best friend smokes (OR: 70.63, CI: 9.19, 542.40). The risk of daily smoking increases also if the siblings of the juvenile (OR: 4.71, CI: 1.15, 19.35) or the mother (OR: 4.95, CI: 1.67, 14.70) smoke. If the father smokes the risk to smoke monthly is increased (OR: 2.09, CI: 1.28, 3.40). These results point to the fact that smoking prevention programes should take into account the influence of peers and family of the adolescents.