Documento técnico de consenso sobre la atención sanitaria al tabaquismo en España, un avance importante del movimiento de prevención y control del tabaquismo en España / No disponible

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Condicionantes del consumo de tabaco en España / Determinant factors of tobacco consumption in Spain

El incremento del tabaquismo en España ha estado directamente relacionado con las tácticas de expansión de mercado desarrolladas por la industria tabacalera nacional y multinacional durante el S.XX. En este artículo se analizan los factores que históricamente han contribuido a la expansión de la epidemia, así como al mantenimiento de altos niveles de consumo de tabaco en nuestro país. Se revisa también el grado de desarrollo alcanzado en la aplicación de estrategias de control (legislativas, económicas, educativas y sanitarias), cuya eficacia ha sido probada en diversos contextos socio-culturales a lo largo del último medio siglo. Finalmente se señalan los principales retos a los que España deberá hacer frente para poder alcanzar los objetivos marcados por el Plan Nacional de Prevención y Control del Tabaquismo 2003-2007 del Ministerio de Sanidad y Consumo (AU)

The increase of tobacco consumption in Spain during the XX Century was directly related to the strategies developed by the tobacco industry to expand its market. This article reviews the main factors contributing to the expansion of the smoking epidemic, as well as the maintenance of high prevalence rates in the Spanish population. It also reviews the degree of development achieved by control strategies (legislation, taxation, education and treatment). Finally it points out the challenges to be faced in Spain in order to achieve the objectives of the recently approved National Plan for Smoking Control and Prevention 2003-2007 (AU)

Morbilidad, mortalidad y costes sanitarios evitables medianteuna estrategia de tratamiento del tabaquismo en España / The effects of implementing a smoking cessation intervention in Spain on morbidity, mortality and health care costs

Objetivo: Se valoran los efectos que tendría una intervención destinada a reducir el uso de tabaco en la población española de fumadores sobre la morbilidad, la mortalidad y los costes asociados al consumo de tabaco. Método: Se ha adaptado el modelo Health and Economic Consequences of Smoking patrocinado por la OMS y desarrollado por The Lewin Group. La intervención propuesta incluye el acceso a asistencia farmacológica de un 35% de los fumadores que intentan dejar de fumar, y obtienen una tasa global de cesación al año del 7,2%. Las enfermedades estudiadas son: cáncer de pulmón, enfermedad coronaria, enfermedad cerebrovascular, EPOC, asma y bajo peso al nacer. Se estiman los casos de enfermedad y muerte atribuibles al consumo de tabaco evitados y la reducción en el coste sanitario debidos a la intervención, proyectados a 20 años. Resultados: Sin intervención, en el año 1 del modelo 2.136.094 fumadores padecen alguna de las condiciones clínicas atribuibles al consumo de tabaco, el coste asistencial es de 4.286 millones de euros y las muertes atribuibles son 26.537. La intervención propuesta evita 2.613, 9.192, 17.415 y 23.837 casos de enfermedad atribuible al consumo de tabaco en los años 2, 5, 10 y 20 del modelo, respectivamente. Los costes asistenciales acumulados evitados son 3,5 millones de euros en el año 2 y 386 millones de (..) (AU)

Objective: We estimated the effect that a smoking cessation intervention in the Spanish population of smokers would have on smoking-related morbidity, mortality and healthcare costs. Methods: We adopted the model Health and Economic Consequences of Smoking sponsored by the WHO Health Organization and developed by the The Lewin Group. The smoking cessation intervention proposed incluides pharmacological treatment to 35% of smokers who are trying to quit smoking and obtains a quit rate of 7.2%. The diseases studied are: lung cancer, heart disease, stroke, chronic obstructive pulmonary disease, asthma exacerbation, and low birth weight. The smoking-related cases of disease and of averted death and the reduction in healthcare expenditure due to the intervention were estimated. Results: Without intervention, at year 1 of the model, 2,136,094 smokers would be affected by some smoking-related disease; healthcare expenditure would be 4,286 million € and deaths attributable to smoking would total 26,537. The proposed intervention (..) (AU)

[The effects of implementing a smoking cessation intervention in Spain on morbidity, mortality and health care costs]. / Morbilidad, mortalidad y costes sanitarios evitables mediante una estrategia de tratamiento del tabaquismo en España.

OBJECTIVE: We estimated the effect that a smoking cessation intervention in the Spanish population of smokers would have on smoking-related morbidity, mortality and health care costs. METHODS: We adopted the model Health and Economic Consequences of Smoking sponsored by the WHO Health Organization and developed by the The Lewin Group. The smoking cessation intervention proposed includes pharmacological treatment to 35% of smokers who are trying to quit smoking and obtains a quit rate of 7.2%. The diseases studied are: lung cancer, heart disease, stroke, chronic obstructive pulmonary disease, asthma exacerbation, and low birth weight. The smoking-related cases of disease and of averted death and the reduction in health care expenditure due to the intervention were estimated. RESULTS: Without intervention, at year 1 of the model, 2,136,094 smokers would be affected by some smoking-related disease; health care expenditure would be 4,286 million e and deaths attributable to smoking would total 26,537. The proposed intervention would prevent 2,613, 9,192, 17,415 and 23,837 cases of smoking-related disease at years 2, 5, 10 and 20 of the model, respectively. The saving in accumulated health care costs would amount to 3.5 million e at year 2 and 386 million e over 20 years. The accumulated prevented deaths are 284 at year 2 and 9,205 over 20 years. The intervention would save a total of 78,173 life-years by the end of the period considered. CONCLUSIONS: The availability of new effective smoking cessation interventions and the increase in accessibility to such interventions may contribute significantly to reducing morbidity, mortality and health care costs associated with smoking in Spain.

Importancia de los espacios sin humo en centros dedicados a atender las necesidades de las personas mayores / The importance of no-smoking spaces in elderly care centers

Este artículo presenta una revisión del estado actual del conocimiento referido al impacto para la salud del aire contaminado por humo de tabaco (ACHT). Es este marco, este trabajo enfatiza la necesidad de tener en cuenta los efectos adversos del ACHT para la salud humana en general, y para la salud y bienestar de las personas mayores en particular, y plantea la necesidad de atender este problema en las instalaciones y espacios compartidos y frecuentados por personas mayores, como son casinos, hogares del pensionista, clubes de actividades, talleres para la tercera edad, y espacios comunes en residencias y viviendas tuteladas. La falta de legislación específica para proteger los derechos de las personas mayores plantea la necesidad de contemplar este problema por parte de gestores y responsables de centros dedicados a atender las necesidades de la tercera edad (AU)

This article presents a revision of the actual situation of the knowledge reffered to the health impact with air contaminated by tobacco smoke. This work gives the importance of bearing in mind the adverse effects of air contaminated by tobacco smoke for the human health generally spoken and for elderly well-being in particular. This work poses the necessity of attending this problem in places by elderly like casinos, elderly homes, clubs, nursing homes, etc. The absence of legislation in order to protect the elderly rights gives the necessity of bearing in mind this problem by the responsible people who attend the necessity of elderly people (AU)