Smoking behavior and secondhand smoke exposure among university students in northern Portugal: Relations with knowledge on tobacco use and attitudes toward smoking.

OBJECTIVES: To assess the prevalence of active smoking and secondhand smoke (SHS) exposure among college students in the north of Portugal, and analyze the relationship between knowledge about tobacco use and attitudes toward smoking. MATERIALS AND METHODS: This a cross-sectional study with a representative sample of college students (n=840) in one university in Portugal. A validated self-reported questionnaire was administered to a proportional stratified random sample during the academic year of 2018/2019. We evaluated associations between smoking status, SHS exposure, smokers peers, knowledge and attitudes toward smoking and sociodemographic variables. RESULTS: The results showed that 20.1% of the students surveyed were current smokers (7.3% occasional smokers, 2.9% regular smokers and 9.9% daily smokers). Most current smokers started smoking before the age of 17 (61.4%) and reported never having tried to quit smoking (59.7%). Only 34.4% of students reported (almost) not having been in enclosed spaces with smokers in the past 7 days. Exposure to SHS and having smoker friends contributes to the prevalence of tobacco use. In general, students showed favorable attitudes toward smoking, especially those who are smokers, have smoking friends and are more exposed to SHS. The level of knowledge about tobacco was moderate, with a higher number of correct responses by former smokers. CONCLUSIONS: These results suggests an urgent need for socio-educational programs for counseling on smoking cessation. In addition, is also strongly recommended that, throughout academic training, students develop personal and social skills for dealing with the tobacco epidemic.

Prevalence of children exposed to secondhand smoke at home and in the car in Azores (Portugal).

OBJECTIVES: To identify the prevalence of exposure to secondhand smoke (SHS) at home and in the car among children attending the 4th grade in Azores. METHODS: This is a cross-sectional study that assessed children's exposure to SHS in a convenience sample of school children attending the 4th grade in all primary schools of Azores. The entire population of 4th graders from all elementary schools in Azores were asked to participate in the study (n=2463) in 2017. A validated self-reported questionnaire was administered to 2092 students who delivered the signed informed consent form. We analyzed frequencies, contingency tables, and performed Chi-square tests. RESULTS: Results showed that 56.1% (95% CI 54.0-58.2) children reported having, at least, one smoking parent. Overall exposure to SHS at home was 38.4% (95% CI 36.3-40.6), and overall exposure to SHS in the car was 27.6% (95% CI 25.8-29.3). Children whose parents were smokers reported being more exposed to SHS at home (63.6%; 95% CI 58.6-68.3) than children whose parents were non-smokers (32.3%; 95% CI 30.2-34.6). CONCLUSION: The results showed that the children's exposure to SHS in Azores is high and it tends to be higher than the prevalence found in mainland Portugal. Having parents who smoke is a major risk factor for children's exposure to SHS at home. These data justify a population-wide intervention plan for preventing tobacco consumption and children's exposure to SHS in Azores.

Prevalence of secondhand smoke exposure in asthmatic children at home and in the car: A cross-sectional study.

OBJECTIVE: To compare secondhand smoke exposure (SHSe) prevalence at home and inside the car between asthmatic and non-asthmatic Portuguese children. MATERIALS AND METHODS: This is a cross-sectional study that assessed children's SHSe in a representative sample of nine Portuguese cities. A validated self-reported questionnaire was administered to a random sample of 4th grade students during the school year of 2010/2011. The asthma prevalence was defined by the answers to three questions regarding asthma symptoms, medication and inhaler use. We performed chi-square tests and analysed frequencies, contingency tables, confidence intervals, and odd-ratios. RESULTS: The self-reported questionnaire was administered to 3187 students. Asthma prevalence was 14.8% (472 students). Results showed that 32.3% of non-asthmatic children and 32.4% of asthmatic children were exposed to secondhand smoke as at least one of their household members smoked at home. The prevalence of parental smoking, smoking among fathers and smoking among mothers at home was also similar in both groups (asthmatic and non-asthmatic children). SHSe inside the car was 18.6% among non-asthmatic children and 17.9% among asthmatic children. CONCLUSIONS: Asthmatic and non-asthmatic children were equally exposed to secondhand smoke, because no significant differences were found between the two groups concerning the prevalence of SHSe at home and inside the car. These findings highlight the need to include SHSe brief advice in paediatric asthma management.

[Smoking prevalence in Portuguese school-aged adolescents by gender: can we be optimistic?]. / Prevalência do consumo de tabaco em adolescentes escolarizados portugueses por sexo: podemos estar otimistas?

INTRODUCTION: According to the MPOWER approach adopted in 2008 by the WHO, monitoring smoking epidemics is necessary in order to assess the effectiveness of the preventive measures used in smoking control in adolescents and adults. OBJECTIVES: To determine the prevalence of smoking in Portuguese school-aged adolescents by region. MATERIAL AND METHODS: The sample is made up of 8764 students, 4060 boys and 4704 girls, and is representative of the Portuguese students in regular public education. The data was collected in the 2008/2009 academic year, through a quantitative self-report questionnaire. RESULTS: In the total sample, 10.2% of boys and 9.1% of girls are regular smokers. Smoking increases with age. At 15 years old 12.3% of the boys and 8.6% of the girls are regular smokers and 6.1% of the boys and 4.0% of the girls are occasional smokers. Looking at prevalence by region, the highest prevalence of regular smoking is found in Alentejo (14.7%), followed by Azores (11.8%) and the lowest is found in Algarve (4.1%). CONCLUSIONS: The prevalence of smokers among Portuguese school-aged adolescents varies within the several regions of the country, similar to what happens in the adult Portuguese population.

Exposición de niños a la contaminación ambiental por humo del tabaco en el domicilio. Un estudio transversal en Portugal / Exposition of children to environmental contamination due to tobacco smoke in the home. A cross-sectional study in Portugal

En la introducción y en el articulado del Convenio Marco de la OMSpara el Control del Tabaco se reconoce que la ciencia demostró de formainequívoca que el consumo y la exposición al humo del tabaco soncausas de mortandad, morbidez e incapacidad1.El hecho de que varios estudios demostrasen que el humo ambientaldel tabaco causa cáncer en humanos condujo al InternationalAgency for Research on Cancer (IARC) a clasificarlo en el Grupo Ade carcinógenos, es decir, con efecto reconocido para la especie humana.Además de tener en cuenta la gravedad de la exposición al humoambiental del tabaco especialmente en niños y adolescentes son prácticamenteinexistentes los estudios realizados en Portugal sobre la exposiciónde los niños al humo procedente de terceros. Estos hechosllevaron a los autores a realizar un estudio para determinar la prevalenciade niños expuestos pasivamente al humo del tabaco en el domicilio.Para alcanzar este objetivo se realizó, al final del año escolar de2002/2003, una encuesta a una muestra representativa constituida por1.141 alumnos de 7 escuelas del 3º ciclo de Educación Básica de Braga– Portugal (562 niñas y 579 niños, de 11-16 años).Los datos muestran que un elevado porcentaje (38%) de alumnosestán expuestos al humo ambiental del tabaco (19% diariamente y 19%ocasionalmente) debido al hecho de que los parientes más próximos fumanen casa (padre, madre o hermano/a).Ante los resultados observados y la evidencia científica disponible,se puede concluir que un elevado porcentaje de padres fumadores quefuman diaria y/u ocasionalmente en casa colocan en serio riesgo la saludde sus hijos

The WHO Framework Convention on Tobacco Control acknowledges that science has shown that smoking as well as exposition to second-hand smoke cause mortality, morbidity and incapacity1. The fact that several studies show that the Environmental Tobacco Smoke causes cancer to humans, led the International Agency for Research on Cancer (IARC) to classify it in Group Aof cancerigeneous substances. Despite the seriousness of the consequences in people (specially children and teenagers) exposure to environmental tobacco smoke, studies on the exposure of Portuguese children to second-hand smoke are rare. Thus, a piece of research focusing on the study of children’s exposure to second-hand smoke at home was carried out. To fulfill the objectives of the research, in 2003 a questionnaire was handed out to 1141 portuguese students (562 girls and 579 boys) from seven junior high secondary schools (12-16 years students) located in the area of Braga. The results show that a high percentage (38%) of students is exposed to environmental tobacco smoke due to the fact that close relatives (father, mother or sibling) smoke at home. The results of this study, together with the scientific evidence available, indicate that a high percentage of parents who smoke daily or occasionally at home put their children at serious health risk