Prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros / Smoking prevalence and lung cancer morbimortality in Brazilian states / Prevalencia del tabaquismo y morbimortalidad por cáncer de pulmón en los estados brasileños

Introdução: O câncer de pulmão é uma doença grave, sendo a segunda maior causa de morte em todo o mundo, entretanto, em alguns países desenvolvidos, tornou-se já a primeira causa de morte. Cerca de 90% dos casos de neoplasia pulmonares são causados pela inalação da fumaça do cigarro. Objetivo: Correlacionar a prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, além de demonstrar a associação destes com sexo e faixa etária. Métodos: Estudo de caráter ecológico acerca da prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, nos períodos de 2013 e 2019, dividida por sexo e faixa etária. Foram utilizados bancos de coleta de dados como o Tabnet e Pesquisa Nacional de Saúde. Resultados: As maiores taxas de mortalidade e internações hospitalares foram do público masculino, em 2013, com taxa de 2,7 e 10, respectivamente, e em 2019 com 3,3 e 11,9, respectivamente. Ademais, a maior prevalência de tabagismo foi encontrada nos homens; entretanto seu índice tem caído, enquanto a quantidade de mulheres tabagistas tem aumentado. A Região Sul demonstrou maiores números de mortalidade em ambos os períodos estudados, com taxas de 4,9 e 5,8 por 100 mil habitantes, e morbidade hospitalar com 19,9 e 23,5 por 100 mil habitantes. Já a Região Norte se configurou com as menores prevalências: em 2013 apresentou taxa de óbito por câncer de pulmão de 1,0 e morbidade hospitalar de 3,5/100 mil habitantes, em 2019 apresentou taxa de mortalidade de 4,6 e internações de 1,6/100 mil habitantes. Os coeficientes de correlação de morbidade hospitalar e prevalência de tabagismo foram R2=0,0628, r=0,251 e p=0,042, enquanto os de mortalidade e prevalência de tabagismo foram R2=0,0337, r=0,183 e p=0,140. Conclusões: Na presente pesquisa, pode-se inferir que houve associação positiva na comparação entre taxa de morbidade hospitalar e prevalência de tabagismo; em contrapartida, não foi possível observar associação positiva na correlação da taxa de mortalidade por câncer de pulmão e prevalência de tabagismo.

Introduction: Lung cancer is a serious disease, being the second leading cause of death worldwide. Moreover, in some developed countries, it has already become the leading cause of death. About 90% of lung cancer cases are caused by cigarette smoking. Objective: To correlate the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states, and to demonstrate their association with sex and age group as well. Methods: An ecological study on the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states between 2013 and 2019, divided by sex and age group. The data collection databases Tabnet and National Health Survey were used. Results: The highest rates of mortality and hospital admissions were among men, in 2013 with a rate of 2.7 and 10, respectively, and in 2019 with 3.3 and 11.9, respectively. In addition, the highest prevalence of smoking was found in men, but this rate has fallen, while the number of women smokers has increased. The South region showed higher mortality rates in both periods studied, with rates of 4.9 and 5.8 per 100,000 inhabitants, and hospital morbidity with 19.9 and 23.5 per 100,000 inhabitants. The North region had the lowest prevalence, where in 2013, it had a death rate from lung cancer of 1.0 and hospital morbidity of 3.5/100 thousand inhabitants, and where in 2019, it had a mortality rate of 4.6 and hospitalizations of 1.6/100 thousand inhabitants. The correlation coefficients for hospital morbidity and smoking prevalence were R2=0.0628, r=0.251 and p=0.042, while for mortality and smoking prevalence, these were R2=0.0337, r=0.183 and p=0.140. Conclusions: In the present study, it can be inferred that there was a positive association between hospital morbidity rate and prevalence of smoking, while it was not possible to observe a correlation between lung cancer mortality rate and prevalence of smoking.

Introducción: El cáncer de pulmón es una enfermedad grave, siendo la segunda causa de muerte en todo el mundo, sin embargo, en algunos países desarrollados, ya se ha convertido en la primera causa de muerte. Alrededor del 90% de los casos de neoplasias pulmonares están causados por la inhalación del humo del cigarrillo. Objetivo: Correlacionar la prevalencia de tabaquismo y la morbimortalidad por cáncer de pulmón en los estados brasileños, además de demostrar la asociación de estos con el género y el grupo de edad. Métodos: estudio ecológico sobre la prevalencia de tabaquismo y morbimortalidad por cáncer de pulmón en los estados brasileños, dentro de los períodos 2013 y 2019, divididos por sexo y grupo de edad. Se utilizaron bancos de recogida de datos como Tabnet y la Encuesta Nacional de Salud. Resultados: las mayores tasas de mortalidad e ingresos hospitalarios se dieron en el público masculino, en 2013 con una tasa de 2,7 y 10, respectivamente, y en 2019 con 3,3 y 11,9, respectivamente. Además, la mayor prevalencia del tabaquismo se encontró en los hombres, sin embargo, su tasa ha disminuido, mientras que la cantidad de mujeres fumadoras ha aumentado. La región Sur presentó cifras más altas de mortalidad en ambos periodos estudiados, con tasas de 4,9 y 5,8 por 100.000 habitantes, y de morbilidad hospitalaria con 19,9 y 23,5 por 100.000 habitantes. Mientras que la región Norte se configuró con las prevalencias más bajas, en 2013 presentó una tasa de mortalidad por cáncer de pulmón de 1,0 y una morbilidad hospitalaria de 3,5/100.000 habitantes, en 2019 presentó una tasa de mortalidad de 4,6 y hospitalizaciones de 1,6/100.000 habitantes. Los coeficientes de correlación para la morbilidad hospitalaria y la prevalencia del tabaquismo fueron R2=0,0628, r=0,251 y p=0,042, mientras que para la mortalidad y la prevalencia del tabaquismo fueron R2=0,0337, r=0,183 y p=0,140. Conclusiones: En la presente investigación se puede inferir que existe una asociación positiva en la comparación entre la tasa de morbilidad hospitalaria y la prevalencia de tabagismo, en contrapartida, no fue posible observar una asociación positiva en la correlación de la tasa de mortalidad por cáncer de pulmón y la prevalencia de tabagismo.

Mortality attributable to secondhand smoke exposure in the autonomous communities of Spain.

INTRODUCTION AND OBJECTIVES: Exposure to secondhand smoke (SHS) causes cardiovascular disease, respiratory disease, and cancer. The aim of this study was to estimate the mortality attributed to SHS in people aged ≥ 35 years in Spain and its autonomous communities (AC) by sex from 2016 to 2021. METHODS: Estimates of SHS-attributable mortality were calculated by applying the prevalence-dependent method where SHS exposure was derived from the adjustment of small-area models and based on the calculation of population-attributed fractions. Sex, age group, AC, and cause of death (ischemic heart disease and lung cancer) were included. The estimates of attributed mortality are presented with their 95% confidence interval (95%CI). Crude and age-standardized rates were estimated for each sex and AC. RESULTS: From 2016 to 2021, SHS exposure caused 4,970 (95%CI, 4,787-5,387) deaths, representing 1.6% of total mortality for ischemic heart disease and lung cancer. The burden of attributed mortality differed widely among the AC, with Andalusia having the highest burden of attributed mortality (crude rate: 46.6 deaths per 100 000 population in men and 17.0/100 000 in women). In all the AC, the main cause of death in both sexes was ischemic heart disease. The highest burden of mortality was observed in nonsmokers. CONCLUSIONS: The burden of SHS-attributable mortality was high and varied geographically. The results of this study should be considered to advance tobacco control legislation in Spain.

Enfermedad pulmonar obstructiva crónica y salud respiratoria / Chronic obstructive pulmonary disease and respiratory health

La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad que cursa con manifestaciones multisistémicas y agudizaciones, y que conlleva una importante carga de morbilidad, mortalidad y costes sanitarios. Distintas medidas terapéuticas y de prevención juegan un papel importante en mejorar el pronóstico y la salud respiratoria de estos pacientes. Realizar actividad física de forma generalizada, llevar a cabo unos hábitos dietéticos y nutricionales adecuados, abandonar el consumo de tabaco y alcanzar un estado de inmunización óptimo son varias de las acciones de salud recomendadas. Estas también enlentecerán el proceso de envejecimiento. Además, se recomienda realizar políticas de salud pública para reducir la contaminación del aire y el cambio climático. Por último, debemos prestar especial atención a las características del sueño de estos pacientes y llevar a cabo un abordaje terapéutico que incluya una mejor calidad del sueño. (AU)

Chronic obstructive pulmonary disease (COPD) is a disease with multisystemic manifestations and exacerbations that lead to a significant burden of morbidity, mortality, and health care costs. Various therapeutic and preventive measures play an important role in improving the prognosis and respiratory health of the patients. General physical activity, proper dietary and nutritional habits, smoking cessation, and achieving an optimal immunization status are some of the recommended health actions. They also slow down the aging process. In addition, public health policies are recommended to reduce air pollution and climate change. Finally, we should pay special attention to the sleep characteristics of these patients and carry out a therapeutic approach that includes better sleep quality. (AU)

Resiliencia y consumo de alcohol o tabaco en adolescentes de la zona este de Tijuana / Resilience and use of alcohol or tobacco among adolescents from the eastern area of Tijuana

Objetivo: describir las características de la resiliencia y su asociación con el consumo de alcohol y tabaco en adolescentes residentes en la zona este de Tijuana, frontera norte de México. Método: estudio descriptivo transversal cuya población fueron 7.611 adolescentes de 11 a 16 años escolarizados de la ciudad de Tijuana, Baja California. Se estimó una muestra de 663 participantes seleccionados mediante muestreo por conglomerados. Se recogieron variables sociodemográficas, de historia de consumo de tabaco y alcohol y la resiliencia (ER-14) (mín. 14 a máx. 98 p; muy baja, baja, normal, alta o muy alta). Se realizó estadística descriptiva, bivariante y modelos de regresión logística ajustados por sexo para la variable “consumo de alcohol o tabaco”. Resultados: participaron 710 adolescentes (50,7% mujeres). El 46% había consumido alcohol o tabaco en algún momento de su vida y el 27,1% en el último año (mujeres 31,5%; hombres 23,3%; p= 0,005). El 29% mostró alta resiliencia y el 25,5% muy alta resiliencia. Se obtuvo con más frecuencia alta puntuación en las afirmaciones: soy alguien en quien se puede confiar en emergencias (42,5%), siento orgullo de mis logros (41,3%), la vida tiene sentido (33,1%). Se encontró un efecto negativo de la resiliencia sobre el consumo de alcohol o tabaco alguna vez en la vida (ORa= 0,984; IC95% [0,978-0,990]) y en el último año (ORa= 0,987; IC95% [0,981-0,994]). Conclusión: a mayor resiliencia menor fue la probabilidad de consumo de alcohol o tabaco alguna vez en la vida y en el último año. Intervenciones futuras deben considerar estos resultados.(AU)

Objective: to describe the characteristics of resilience and its association with the use of alcohol and tobacco among adolescents living in Eastern Tijuana, in the Northern border of Mexico. Method: a descriptive cross-sectional study on a population of 7,611 adolescents from 11 to 16 years old, attending school in the city of Tijuana, Baja California. The sample was estimated in 633 participants, selected through cluster sampling. Sociodemographic variables were collected, their history of use of tobacco and alcohol, as well as resilience (RS-14) (minimum 14 to maximum 98 scores; very low, low, normal, high or very high). Descriptive bivariate statistics were used, as well as logistical regression models adjusted by gender for the “use of alcohol of tobacco” variable. Results: the study included 710 adolescents (50.7% were female); 46% of them had used alcohol or tobacco at some point in their lives, and 27.1% during the past year (31.5% female; 23.3% male; p= 0.005); 29% showed high resilience and 25.5% showed very high resilience. The most frequently obtained high scores were for the statements: I am someone who can be trusted in emergencies (42.5%), I feel proud of my achievements (41.3%), and Life makes sense (33.1%). A negative effect of resilience was found on alcohol and tobacco use at some point in life (ORa= 0.984; CI95% [0.978-0.990]) and during the past year (ORa= 0.987; CI95% [0.981-0.994]). Conclusion: the higher the resilience, the lower the likelihood of using alcohol or tobacco at some point in life and during the last year. Future interventions should consider these results.(AU)

Prevalência e Fatores de risco associados ao tabagismo e outras formas de consumo de tabaco em acadêmicos da saúde em Goiânia, Goiás / Prevalence and risk factors associated with smoking and other forms of tobacco consumption among health students in Goiânia, Goiás

Introdução: O presente estudo teve como objetivo investigar e identificar a prevalência e fatores de risco associados ao tabagismo e outras formas de consumo de tabaco entre acadêmicos da saúde. Métodos: A pesquisa contou com 407 acadêmicos dos cursos de Biomedicina, Educação Física, Enfermagem, Farmácia, Fisioterapia e Nutrição de uma Instituição de Ensino Superior. A coleta de dados foi realizada no mês de maio de 2020, por um formulário eletrônico, disponibilizado em e-mail institucional, grupos de estudos e redes sociais. O procedimento ocorreu após aprovação pelo Comitê de Ética, cujo parecer 3.966.951. Resultados: A maioria dos participantes (79,6%) eram do sexo feminino, solteiros (75,2%) com idade média de 25,32 anos. O consumo de tabaco foi confirmado por 10,8% participantes. Quanto ao consumo de produtos derivados de tabaco 24,1% dos entrevistados já consumiram produto de tabaco, 8,6% assumiram tabagismo ocasional, e 4,2% tabagismo ativo. Conclusões: A associação entre tabagismo e as variáveis sociodemográficas demonstrou que alunos do curso de Farmácia (OR: 5,25 [IC:1,34-20,22] p=0,017), homens (OR: 1,71 [IC: 1,01 ­ 2,91]), estudantes turno matutino (OR: 1,96 [IC:1,02-3,78] p=0,04) e que residem com tabagistas (OR:4,44 [IC: 2,24-8,80]) apresentaram maiores chances de serem tabagista. A associação em relação ao consumo de derivados do tabaco, os homens apresentaram maiores prevalências de consumo de derivados de tabaco (OR: 1,71 [IC: 1,01 ­ 2,91] p=0,045) bem como, alunos do curso de Farmácia (OR: 6,40 [IC:2,31-17,7] P<0,01), que estudam no turno Noturno (OR:1,85 [IC:1,16-8,82] p=0,009) e entre os que residem com tabagistas (OR: 4,49 [IC:2,24-8,80] p<0,001).

Introduction: The present study aimed to investigate and identify the prevalence and risk factors associated with smoking and other forms of tobacco consumption among health academics. Methods: The survey involved 407 students from Biomedicine, Physical Education, Nursing, Pharmacy, Physiotherapy and Nutrition courses at a Higher Education Institution. Data collection was carried out in May 2020, through an electronic form, available in institutional email, study groups and social networks. The entire procedure took place after approval by the Ethics Committee. Results: Most participants (79.6%) were female, single (75.2%) with a mean age of 25.32 years. Tobacco consumption was confirmed by 10.8% of the participants. As for the consumption of tobacco products, 24.1% of the interviewees had already consumed some tobacco product, 8.6% assumed occasional smoking, and 4.2% active smoking. Conclusions: The association between smoking and sociodemographic variables showed that Pharmacy students (OR: 5.25 [CI:1.34-20.22] p=0.017), men (OR: 1.71 [CI: 1.01 ­ 2.91]), morning shift students (OR: 1.96 [CI:1.02-3.78] p=0.04) and those who live with smokers (OR:4.44 [CI : 2.24-8.80]) were more likely to be smokers. The association in relation to the consumption of tobacco derivatives, men had a higher prevalence of consumption of tobacco derivatives (OR: 1.71 [CI: 1.01 ­ 2.91] p=0.045) as well as Pharmacy students (OR: 6.40 [CI:2.31-17.7] P<0.01), those who study the night shift (OR:1.85 [CI:1.16-8.82] p=0.009 ) and among those who live with smokers (OR: 4.49 [CI:2.24-8.80] p<0.001).

Fumadores y riesgo de muerte hospitalaria por COVID calculado con el procesamiento de lenguaje natural de SAVANA en el ámbito de Castilla-La Mancha / Smokers and risk of hospital death by COVID calculated with SAVANA's natural language processing in the Castilla-La Mancha area

Introducción Durante la pandemia de COVID se especuló que los pacientes con el virus que tenían relación con el tabaco podrían tener una menor probabilidad de agravamiento de la enfermedad o muerte. Para evaluar si existe una asociación entre el tabaquismo y el riesgo de mortalidad intrahospitalaria se utiliza la tecnología de Big Data y Procesamiento del Lenguaje Natural (PLN) de SAVANA. Método Se llevó a cabo un estudio de cohortes retrospectivo, observacional y sin intervención basado en datos de vida real extraídos de registros médicos de toda Castilla-La Mancha utilizando las técnicas de PLN e inteligencia artificial desarrolladas por SAVANA. El estudio abarcó toda la población de esta Comunidad con historia clínica electrónica en SESCAM que presentara diagnóstico de COVID desde el 1 de marzo de 2020 al 28 de febrero de 2021. Resultados Los fumadores tienen mayor porcentaje de factores de riesgo cardiovascular (hipertensión arterial, dislipemia y diabetes), EPOC, asma, EPID, CI, ECV, TEP, cáncer en general y cáncer de pulmón en particular, bronquiectasias, insuficiencia cardíaca y antecedentes de neumonía, de forma significativa (p<0,0001). Los pacientes exfumadores, fumadores y no fumadores tienen una diferencia de edad significativa. En cuanto a las muertes hospitalarias, fueron más frecuentes en el caso de los exfumadores, siguiendo los fumadores y luego los no fumadores (p<0,0001). Conclusión Existe un mayor riesgo de mortalidad intrahospitalaria en los pacientes infectados por SARS-CoV-2 que sean fumadores activos o hayan fumado en el pasado. (AU)

Introduction During the COVID pandemic, it was speculated that patients with the virus who were smoking-related might have a lower likelihood of disease exacerbation or death. To assess whether there is an association between smoking and risk of in-hospital mortality, SAVANA's big data and natural language processing (NLP) technology is used. Method A retrospective, observational, non-interventional cohort study was conducted based on real-life data extracted from medical records throughout Castilla-La Mancha using natural language processing and artificial intelligence techniques developed by SAVANA. The study covered the entire population of this region with Electronic Medical Records in SESCAM presenting with a diagnosis of COVID from March 1, 2020 to February 28, 2021. Results Smokers had a significantly higher percentage of cardiovascular risk factors (hypertension, dyslipidemia and diabetes), COPD, asthma, IDP, IC, CVD, PTE, cancer in general and lung cancer in particular, bronchiectasis, heart failure and a history of pneumonia (P<.0001). Former smokers, current smokers and non-smokers have a significant age difference. As for in-hospital deaths, they were more frequent in the case of ex-smokers, followed by smokers and then non-smokers (P<.0001). Conclusion There is an increased risk of dying in hospital in SARS-CoV-2-infected patients who are active smokers or have smoked in the past. (AU)

Evolution of smoking prevalence in Spain and its 17 autonomous regions (1987-2020). / Evolución de la prevalencia de consumo de tabaco en España y sus 17 comunidades autónomas (1987-2020).

BACKGROUND AND OBJECTIVES: Continuous monitoring of smoking prevalence is essential to understand the evolution of the tobacco epidemic in a population. The objective of this study was to analyze the evolution of smoking prevalence in Spain and its 17 Autonomous Regions (ARs) in population ≥15 years during the period 1987-2020. METHODS: Tobacco consumption data were derived from the National Health Survey of Spain and the European Health Survey in Spain. A smoker was defined as a person who smoked at the time of the survey. The trend in prevalences by sex in Spain and its ARs was analyzed by applying joinpoint models. Age-standardized prevalences were calculated for Spain by applying the direct method. RESULTS: In Spain, the prevalence of consumption decreased 29 percentage points in men and 4.5 in women between 1987-2020. In men, the smoking prevalence decreased in all the ARs and the absolute change varied between -19.5% in the Balearic Islands and -33.9% in Andalusia. In women, the evolution of smoking prevalence differed between ARs. The absolute change varied between -15.4% in Basque Country and 0.5% in Andalusia. CONCLUSIONS: The number of men and women smokers has decreased in Spain between 1987-2020. Different patterns of evolution of the prevalence of consumption are observed among the ARs, especially among women. This reinforces the need for policies adapted to more local contexts and that take into account the gender perspective.

Fumadores y riesgo de muerte hospitalaria por COVID calculado con el procesamiento de lenguaje natural de SAVANA en el ámbito de Castilla-La Mancha / Smokers and risk of hospital death by COVID calculated with SAVANA's natural language processing in the Castilla-La Mancha area

Introducción Durante la pandemia de COVID se especuló que los pacientes con el virus que tenían relación con el tabaco podrían tener una menor probabilidad de agravamiento de la enfermedad o muerte. Para evaluar si existe una asociación entre el tabaquismo y el riesgo de mortalidad intrahospitalaria se utiliza la tecnología de Big Data y Procesamiento del Lenguaje Natural (PLN) de SAVANA. Método Se llevó a cabo un estudio de cohortes retrospectivo, observacional y sin intervención basado en datos de vida real extraídos de registros médicos de toda Castilla-La Mancha utilizando las técnicas de PLN e inteligencia artificial desarrolladas por SAVANA. El estudio abarcó toda la población de esta Comunidad con historia clínica electrónica en SESCAM que presentara diagnóstico de COVID desde el 1 de marzo de 2020 al 28 de febrero de 2021. Resultados Los fumadores tienen mayor porcentaje de factores de riesgo cardiovascular (hipertensión arterial, dislipemia y diabetes), EPOC, asma, EPID, CI, ECV, TEP, cáncer en general y cáncer de pulmón en particular, bronquiectasias, insuficiencia cardíaca y antecedentes de neumonía, de forma significativa (p<0,0001). Los pacientes exfumadores, fumadores y no fumadores tienen una diferencia de edad significativa. En cuanto a las muertes hospitalarias, fueron más frecuentes en el caso de los exfumadores, siguiendo los fumadores y luego los no fumadores (p<0,0001). Conclusión Existe un mayor riesgo de mortalidad intrahospitalaria en los pacientes infectados por SARS-CoV-2 que sean fumadores activos o hayan fumado en el pasado. (AU)

Introduction During the COVID pandemic, it was speculated that patients with the virus who were smoking-related might have a lower likelihood of disease exacerbation or death. To assess whether there is an association between smoking and risk of in-hospital mortality, SAVANA's big data and natural language processing (NLP) technology is used. Method A retrospective, observational, non-interventional cohort study was conducted based on real-life data extracted from medical records throughout Castilla-La Mancha using natural language processing and artificial intelligence techniques developed by SAVANA. The study covered the entire population of this region with Electronic Medical Records in SESCAM presenting with a diagnosis of COVID from March 1, 2020 to February 28, 2021. Results Smokers had a significantly higher percentage of cardiovascular risk factors (hypertension, dyslipidemia and diabetes), COPD, asthma, IDP, IC, CVD, PTE, cancer in general and lung cancer in particular, bronchiectasis, heart failure and a history of pneumonia (P<.0001). Former smokers, current smokers and non-smokers have a significant age difference. As for in-hospital deaths, they were more frequent in the case of ex-smokers, followed by smokers and then non-smokers (P<.0001). Conclusion There is an increased risk of dying in hospital in SARS-CoV-2-infected patients who are active smokers or have smoked in the past. (AU)

Policonsumo de tabaco y cannabis: Relación con la salud autopercibida y el estado de ánimo en adolescentes de la Catalunya Central-Proyecto DESKcohort / Polydrug use of tobacco and cannabis: Relationship with self-perceived health and mood state in adolescents in Central Catalonia- DESKcohort Project

El objetivo fue estimar la prevalencia del policonsumo de tabaco y cannabis y ver su relación con la salud autopercibida y el estado de ánimo en los adolescentes escolarizados de la Catalunya Central en el curso 2019- 2020. Estudio transversal con una muestra de 7.319 estudiantes, que contestaron un cuestionario auto administrado. Las variables dependientes fueron el policonsumo de tabaco y cannabis y policonsumo de tabaco y cannabis de riesgo. Las variables independientes principales fueron la salud autopercibida y el estado de ánimo. Para el análisis de prevalencia se analizaron frecuencias y porcentajes, y se usó la prueba de Chi-cuadrado. Se ajustaron modelos de regresión de Poisson con varianza robusta, obteniendo Razones de Prevalencia. La prevalencia del policonsumo de tabaco y cannabis fue de 3,5% y del policonsumo de tabaco y cannabis de riesgo 2,5%. En los chicos, cursar un curso académico superior (4º de ESO (RPa: 3,88; IC95%:2,14-7,05) vs. CFGM (RPa: 8,67; IC95%:4,51-16,67), tener peor salud autopercibida (RPa: 4,79; IC95%:3,24-7,08) y un peor estado de ánimo (RPa: 1,47; IC95%:1,05-2,08) actúan como factores asociados con el policonsumo de tabaco y cannabis. En chicas y por consumo de riesgo de cannabis siguen un patrón similar. Entre las principales conclusiones observamos que no hay diferencias en la salud autopercibida y el estado de ánimo en el policonsumo de tabaco con cannabis y con cannabis de riesgo, por lo que deben existir estrategias de reducción de riesgos tanto si el consumo de cannabis es puntual como si el consumo de cannabis es problemático. (AU)

The objective was to estimate the prevalence of polydrug use of tobacco and cannabis and to see its relationship with self-perceived health and mood state in adolescents from Central Catalonia in the 2019-2020 academic year. A cross-sectional study was carried out with a sample of 7,319 students, who answered a self-administered questionnaire. The dependent variables were the polydrug use of tobacco and cannabis and polydrug use of tobacco and high-risk cannabis. The main independent variables were self-perceived health status and mood state. Frequencies and percentages were analyzed for the prevalence analysis, and the Chi-square test was used. Poisson regression models were adjusted with robust variance, obtaining Prevalence Ratios. The prevalence of polydrug use of tobacco and cannabis was 3.5% and polydrug use of tobacco and high-risk cannabis was 2.5%. In boys, attending higher academic courses (4th of ESO (aPR: 3.88; 95% CI: 2.14-7.05) vs. CFGM (aPR: 8.67; CI95%: 4.51-16.67), having worse self-perceived health (aPR: 4.79; CI95%: 3.24-7.08) and worse mood state (aPR: 1.47; CI95%: 1.05-2.08) act as factors associated with polydrug use of tobacco and cannabis. The results for girls, and risky use of cannabis follow a similar pattern. Among the main conclusions we observe is that there are no differences in self-perceived health and mood state when comparing polydrug use of tobacco and cannabis and polydrug use of tobacco and high-risk cannabis, so risk reduction strategies must be applied whether the use of cannabis is occasional or problematic. (AU)

Efectos de la estimulación transcraneal con corriente directa (tDCS) sobre el consumo de tabaco, la motivación y la autoeficacia para dejar de fumar / Effects of transcranial direct current stimulation (tDCS) on tobacco use, motivation and self-efficacy to quit smoking

Estudios recientes de estimulación transcraneal con corriente directa (tDCS), aplicada sobre la corteza prefrontal dorsolateral (CPFDL), han demostrado que pueden reducir el craving y el consumo de tabaco. Sin embargo, existen pocas investigaciones que hayan evaluado los efectos del tDCS sobre la motivación y la autoeficacia para dejar de fumar. El objetivo de este estudio fue evaluar los efectos de la tDCS sobre el patrón de consumo, la motivación y la autoeficacia percibida para dejar de fumar en 16 personas con Trastorno por Consumo de Tabaco (TCT). Se utilizó un diseño de series temporales con replicación intrasujeto ABAB. El tratamiento consistió en la aplicación de 10 sesiones repetidas de tDCS a 1.5 mA durante 20 minutos sobre la CPFDL (cátodo F3 y ánodo F4), una sesión diaria durante dos semanas (lunes a viernes). Tras una fase de descanso de un mes, se replicó el tratamiento intrasujeto en idénticas condiciones. La intervención completa duró nueve semanas y fue completada por 10 participantes. Los resultados mostraron una reducción significativa en la dependencia a la nicotina, el número de cigarrillos fumados y los niveles de monóxido de carbono (CO) en el aire espirado. Además, observamos una mejora significativa en la motivación y la autoeficacia percibida para dejar de fumar. Estos hallazgos sugieren que el tDCS, aplicado sobre la CPFDL, puede ser una técnica efectiva para usar como terapia coadyuvante a otras estrategias farmacológicas y/o psicológicas empleadas en las Unidades de Conductas Adictivas (UCAs), u otros centros de atención a las drogodependencias. Sin embargo, se necesitan más estudios que investiguen la interacción entre los efectos de la nicotina y el tDCS para encontrar la estrategia óptima de tratamiento. (AU)

Recent studies of transcranial direct current stimulation (tDCS), applied to the dorsolateral prefrontal cortex (CPFDL), have shown that they can reduce craving and smoking. However, there is little research that has evaluated the effects of tDCS on motivation and self-efficacy to quit smoking. The objective of this study was to evaluate the effects of tDCS on the pattern of consumption, motivation and perceived self-efficacy to quit smoking in 16 people with Tobacco Use Disorder (TUD). A time series design with intrasubject ABAB replication was used. The treatment consisted of applying 10 repeated sessions of tDCS at 1.5 mA for 20 minutes on the CPFDL (cathode F3 and anode F4), one daily session for two weeks (Monday to Friday). After a one-month rest phase, the intra-subject treatment was replicated under identical conditions. The entire intervention lasted nine weeks and was completed by 10 participants. The results showed a significant reduction in nicotine dependence, the number of cigarettes smoked and the levels of carbon monoxide (CO) in the exhaled air. Furthermore, we observed a significant improvement in motivation and perceived self-efficacy to quit smoking. These findings suggest that the tDCS, applied on the CPFDL, may be an effective technique to use as adjunctive therapy to other pharmacological and / or psychological strategies used in the Addictive Behavior Units, or other drug addiction care centers. However, more studies are needed to investigate the interaction between the effects of nicotine and tDCS to find the optimal treatment strategy. (AU)

Effect of tobacco smoking on outcomes of trabeculectomy / Efeito do tabagismo nos desfechos da trabeculectomia

ABSTRACT Purpose: To evaluate the effect of tobacco smoking on trabeculectomy outcomes. Methods: Charts of patients with glaucoma who underwent trabeculectomy performed by a single surgeon between 2007 and 2016 were retrospectively reviewed. Charts were screened for a documented history of smoking status before surgery. Demographic and clinical preoperative variables were recorded. Based on smoking history, subjects were divided into two groups: smokers and nonsmokers. Any bleb-related interventions (e.g., 5-flourouracil injections ± laser suture lysis) or bleb revision performed during the postoperative period were noted. Success was defined as an intraocular pressure >5 mmHg and <21 mm Hg without (complete success) or with (qualified success) the use of ocular hypotensive medications. Failure was identified as a violation of the criteria mentioned above. Results: A total of 98 eyes from 83 subjects were included. The mean age of the subjects was 70.7 ± 11.09 years, and 53% (44/83) were female. The most common diagnosis was primary open-angle glaucoma in 47 cases (47.9%). The smokers Group included 30 eyes from 30 subjects. When compared with nonsmokers, smokers had a significantly worse preoperative best-corrected visual acuity (p=0.038), greater central corneal thickness (p=0.047), and higher preoperative intraocular pressure (p=0.011). The success rate of trabeculectomy surgery at 1 year was 56.7% in the smokers Group compared with 79.4% in the Group nonsmokers (p=0.020). Smoking presented an odds ratio for failure of 2.95 (95% confidence interval, 1.6-7.84). Conclusion: Smokers demonstrated a significantly lower success rate 1 year after trabeculectomy compared with nonsmokers and a higher requirement for bleb-related interventions.

RESUMO Objetivo: Avaliar o efeito do tabagismo nos desfechos da trabeculectomia. Métodos: Uma revisão retrospectiva do gráfico de pacientes com glaucoma submetidos à trabeculectomia foi realizada por um único cirurgião entre 2007 e 2016. Os gráficos foram examinados para uma história documentada de condição de fumante antes da cirurgia. Variáveis pré-operatórias clínicas e demográficas e clínicas foram registradas. Os pacientes foram divididos em dois grupos de acordo com sua história de tabagismo em fumantes e não fumantes. Quaisquer Intervenções relacionadas à bolha, por exemplo, injeções de 5-fluorouracil + lise de sutura com laser, ou revisão da bolha realizada durante o período pós-operatório foram observadas. O sucesso foi definido como pressão intraocular > 5 mmHg e < 21 mm Hg sem (sucesso completo) ou com (sucesso qualificado) medicamentos hipotensores oculares. A falha foi identificada como violação dos critérios mencionados acima. Resultados: O estudo incluiu 98 olhos de 83 pacientes com idade média de 70,7 ± 11,09 anos, sendo 53% (44/83) dos pacientes do sexo feminino. O diagnóstico mais comum foi o glaucoma de ângulo aberto primário com 47 casos (47,9%). O Grupo de fumantes incluiu 30 olhos de 30 pacientes. Os fumantes, quando comparados aos não fumantes, apresentaram uma melhor acuidade visual pré-operatória significativamente pior (p=0,038), maior espessura central da córnea (p=0,047) e maior pressão intraocular pré-operatória (p=0,011). A taxa de sucesso de um ano para a cirurgia de trabeculectomia foi de 56,7% no Grupo de fumantes contra 79,4% no Grupo de não fumantes (p=0,020). O tabagismo apresentou razão de chances para falha de 2,95 95% de IC (1,6-7,84). Conclusão: Os fumantes demonstraram uma taxa de sucesso significativamente menor em um ano após a trabeculectomia em comparação com os não fumantes e uma maior necessidade de intervenções relacionadas à bolha.

Smokers and risk of hospital death by COVID calculated with SAVANA's natural language processing in the Castilla-La Mancha area.

INTRODUCTION: During the COVID pandemic, it was speculated that patients with the virus who were smoking-related might have a lower likelihood of disease exacerbation or death. To assess whether there is an association between smoking and risk of in-hospital mortality, SAVANA's big data and Natural Language Processing (NLP) technology is used. METHOD: A retrospective, observational, non-interventional cohort study was conducted based on real-life data extracted from medical records throughout Castilla La Mancha using Natural Language Processing and Artificial Intelligence techniques developed by SAVANA. The study covered the entire population of this region with Electronic Medical Records in SESCAM presenting with a diagnosis of COVID from March 1, 2020 to February 28, 2021. RESULTS: Smokers had a significantly higher percentage of cardiovascular risk factors (hypertension, dyslipidemia and diabetes), COPD, asthma, IDP, IC, CVD, PTE, cancer in general and lung cancer in particular, bronchiectasis, heart failure and a history of pneumonia (p < 0.0001).Former smokers, current smokers and non-smokers have a significant age difference. As for in-hospital deaths, they were more frequent in the case of ex-smokers, followed by smokers and then non-smokers (p < 0.0001). CONCLUSION: There is an increased risk of dying in hospital in SARS-COV2-infected patients who are active smokers or have smoked in the past.

Prevalence of alcohol, tobacco, and illicit drugs consumption during teenage pregnancy: an observational, prospective, and cross-sectional study.

BACKGROUND: Teenage pregnancy is a significant public health issue in Mexico; its prevalence oscillates around 20% of all pregnancies. Concurrently, alcohol, tobacco, and illicit drug use have become more common in this age group. METHODS: To estimate the prevalence of substance exposure in a population of pregnant teenagers, we conducted a prospective, observational, and cross-sectional study. The protocol was approved by the institutional review board. On informed consent, we asked 420 consecutive pregnant youngsters cared for at the outpatient obstetric service of a tertiary public regional women's and children's hospital in Nuevo León, in northeast Mexico, to answer a previously validated questionnaire to estimate the prevalence of alcohol, tobacco, or illicit drugs use during pregnancy. RESULTS: Of the 420 participants, 317 (75.5%) consumed at least one substance during pregnancy. Alcohol, either alone or in combination, was consumed by 300 (71.7%) participants. Tobacco was used by 117 (27.8%) participants, almost always in combination with other substances, while marijuana and other illicit drugs were consumed by 92 (21.9%) participants. Approximately one-fourth of the participants, 102 (24.1%) reported no substance use during pregnancy. CONCLUSIONS: In this series, the reported prevalence of alcohol, tobacco, and illicit drugs consumption during pregnancy, explored with a validated instrument, is higher than that previously reported in our country. This fact offers a worrying picture of another set of factors adding to the burden of teenage pregnancy.

INTRODUCCIÓN: El embarazo en la adolescencia ha adquirido gran importancia en la salud pública en México; su prevalencia oscila alrededor del 20% de los embarazos. Paralelamente, el consumo de alcohol, tabaco y drogas ilícitas en este periodo es cada vez más común en estas jóvenes. MÉTODOS: Para estimar la prevalencia de exposición a estas substancias en adolescentes embarazadas, se llevó a cabo un estudio prospectivo, observacional y transversal. El protocolo fue aprobado por los Comités de Ética e Investigación. Previo consentimiento informado, se solicito a 420 jóvenes embarazadas atendidas en la clínica prenatal del hospital materno-infantil más grande en Nuevo León, que respondieran un cuestionario previamente validado para estimar la prevalencia del consumo de substancias. RESULTADOS: De 420 participantes, 317 (75.5%) consumieron al menos una de estas sustancias durante el embarazo. El alcohol, solo o en combinación, fue consumido por 300 (71.5%). El tabaco fue usado por 117 (27.8%), casi siempre en combinación con otras sustancias, mientras que la mariguana y otras drogas ilícitas fueron consumidas por 92 (21.9%) participantes. Alrededor de una cuarta parte del grupo estudiado (24.1%) reportó no haber consumido ninguna de estas substancias en su embarazo. CONCLUSIONES: En nuestra serie, la prevalencia de consumo de alcohol, tabaco y drogas ilícitas durante el embarazo, explorada con un instrumento validado, es mayor de la reportada en estimaciones previas en nuestro país. Estos datos ofrecen un panorama preocupante de una serie de factores que se agregan a la carga del embarazo en la adolescencia.

Síntomas del tracto urinario inferior en pacientes con hipertensión arterial. Riesgo cardiovascular e impacto en su calidad de vida / Lower urinary tract symptoms in patients with arterial hypertension. Cardiovascular risk and impact on their quality of life

Objetivos: Determinar la prevalencia de síntomas del tracto urinario inferior en pacientes hipertensos, el riesgo cardiovascular y el impacto en la calidad de vida. Material y métodos: Ámbito: Centro de Salud (Vilagarcía, Pontevedra). Periodo: abril del 2015-junio del 2017. Criterios de inclusión: varones hipertensos con consentimiento informado. Mediciones: Variables sociodemográficas, hábitos tóxicos, comorbilidad, presión arterial, riesgo cardiovascular, parámetros analíticos y de exploración. Cuestionarios: escala internacional síntomas prostáticos (IPSS), índice internacional función eréctil (IIEF-15), calidad de vida en hipertensión arterial (MINICHAL). Tamaño muestral: n=262 (± 6% precisión, 95% seguridad). Análisis estadístico bivariado y multivariado de regresión logística. Aprobado por el Comité Ético de Investigación (2014/237). Resultados: La edad media fue de 65,84 (12,70), con una media de evolución de la hipertensión de 13,25 (9,84) años. El 76,7% refirió síntomas del tracto urinario inferior, siendo el 91,6% de grado leve. El análisis bivariado mostró asociación con: edad, nivel estudios, profesión, actividad laboral, tabaco, hipertrofia benigna de próstata, años de diagnóstico, medicación concomitante, score de Framingham-Wilson, electrocardiograma, hemoglobina glicosilada, filtrado glomerular (Cockroft-Gault), LDL-colesterol, manifestaciones somáticas (MINICHAL), disfunción eréctil. El análisis multivariante mostró aumento del riesgo con: obesidad abdominal, electrocardiograma patológico, riesgo alto del score de Framingham-Wilson, disfunción eréctil, uso de hipouricemiantes y disminuía con no fumar y uso de diuréticos. (AU)

Objetives: To determine the prevalence of erectile lower urinary tract symptoms in hypertensive patients, cardiovascular risk and the impact on quality of life. Material and methods: Setting: Health Center (Vilagarcia, Pontevedra). Period: April 2015-June 2017. Inclusion criteria: Hypertensive patient with informed consent. Measurements: sociodemographic variables, toxic habits, comorbidity, blood pressure, cardiovascular risk, analytical and examination parameters. Questionaries: International Prostate Symptom Scale (IPSS), International Index of Erectile Function (IIEF-15) and quality of life in arterial hypertension (MINICHAL). Sample size: n=262 (± 6% accuracy, 95% confidence). Statistical analysis: Bivariate and multivariate statistical analysis. Informed consent and ethics committee approval were obtained (2024/237) Results: The mean age was 65.84 (12.70), and mean hypertension duration of 13.25 (9.84) years. 76.7% reported lower tract urinary symptoms, 91.6% being mild. The bivariate analysis showed an association with the variables: age, educational level, profession, work activity, tobacco, benign prostatic hypertrophy, years of diagnosis, concomitant medication, Framingham-Wilson score, electrocardiogram, glycated hemoglobin, glomerular filtration (Crockroft-Gault), LDL-cholesterol, somatic manifestations (MINICHAL), erectile dysfunction. The multivariate analysis showed increased risk with:abdominal obesity, pathological electrocardiogram, high risk of Framingham-Wilson score, erectile dysfunction, use of hypouricemics agents and decreased with not smoking and use diuretics. (AU)

Assessment of the relationship between smoking and meniscal injury / Avaliação da relação entre tabagismo e lesão meniscal

Abstract Objective: To determine whether being a smoker and the years of smoking correlate with the presence and degree of meniscal injury. Materials and Methods: Individuals who underwent magnetic resonance imaging of the knee were divided into two groups: smokers and nonsmokers. For each smoker, the total smoking history was calculated by multiplying the daily consumption (packs/day) by the years of smoking, and the result is expressed as pack-years. In the evaluation of meniscal injury, the grade of injury was recorded. The thickness of the subcutaneous adipose tissue, as an indicator of obesity, was measured at the medial knee on axial plane images. The relationships that smoking and obesity had with meniscal injury were analyzed statistically. Results: A total of 156 individuals were included in the study. The smoker group consisted of 48 individuals (30.8%), and the nonsmoker group consisted of 108 (69.2%). The meniscus was normal in one (2.1%) of the smokers and in 32 (29.6%) of the nonsmokers (p < 0.0001). The median subcutaneous adipose tissue thickness was 23 mm and 24 mm in the smokers and nonsmokers, respectively (p = 0.900). A moderate but statistically significant correlation was observed between packs/day and injury grade, as well as between pack-years and injury grade (r = 0.462, p = 0.001 and r = 0.523, p = 0.001, respectively). Smoking and age significantly increased the risk of meniscal injury, by 31.221 times (p = 0.001) and 1.076 times (p < 0.001), respectively. Conclusion: Our findings indicate that current smoking and smoking history correlate significantly with meniscal injury grade.

Resumo Objetivo: Determinar a correlação do tabagismo e do tempo de tabagismo com a presença e o grau de lesão do menisco. Materiais e Métodos: Foram incluídos pacientes submetidos a ressonância magnética do joelho e divididos em dois grupos: fumantes e não fumantes. O consumo total de cigarros dos pacientes foi calculado multiplicando-se a quantidade diária de cigarros (maços/dia) pelo tempo de tabagismo (anos). O grau mais alto de lesão foi registrado na avaliação da lesão meniscal. A espessura do tecido adiposo subcutâneo foi medida com base em imagem do joelho em plano axial, como indicador de obesidade. A relação entre tabagismo, obesidade e lesão meniscal foi analisada estatisticamente. Resultados: Foram incluídos no estudo 156 indivíduos. O grupo de fumantes consistiu de 48 (30,8%) indivíduos e o grupo de não fumantes, de 108 (69,2%) indivíduos. O menisco estava normal em um (2,1%) fumante e em 32 (29,6%) não fumantes (p < 0,0001). A espessura média do tecido adiposo subcutâneo em fumantes foi 23 mm e nos não fumantes foi 24 mm, com valor de p = 0,900. Foi observada correlação moderada e estatisticamente significante entre o grau de lesão por pacote/dia (r = 0,462, p = 0,001) e o grau de lesão por pacote × ano (r = 0,523, p = 0,001). O tabagismo e a idade afetaram significativamente o risco de lesão do menisco (31,221 vezes, p = 0,001 e 1,076 vez, p < 0,001, respectivamente). Conclusão: Foi encontrada correlação significativa entre tabagismo/dia e grau de lesão do menisco e pacote de tabagismo × ano e grau de lesão do menisco.

Prevalence of alcohol, tobacco, and illicit drugs consumption during teenage pregnancy: an observational, prospective, and cross-sectional study / Prevalencia del consumo de alcohol, tabaco y drogas ilícitas durante el embarazo en adolescentes: un estudio observacional, prospectivo y transversal

Abstract Background: Teenage pregnancy is a significant public health issue in Mexico; its prevalence oscillates around 20% of all pregnancies. Concurrently, alcohol, tobacco, and illicit drug use have become more common in this age group. Methods: To estimate the prevalence of substance exposure in a population of pregnant teenagers, we conducted a prospective, observational, and cross-sectional study. The protocol was approved by the institutional review board. On informed consent, we asked 420 consecutive pregnant youngsters cared for at the outpatient obstetric service of a tertiary public regional women´s and children´s hospital in Nuevo León, in northeast Mexico, to answer a previously validated questionnaire to estimate the prevalence of alcohol, tobacco, or illicit drugs use during pregnancy. Results: Of the 420 participants, 317 (75.5%) consumed at least one substance during pregnancy. Alcohol, either alone or in combination, was consumed by 300 (71.7%) participants. Tobacco was used by 117 (27.8%) participants, almost always in combination with other substances, while marijuana and other illicit drugs were consumed by 92 (21.9%) participants. Approximately one-fourth of the participants, 102 (24.1%) reported no substance use during pregnancy. Conclusions: In this series, the reported prevalence of alcohol, tobacco, and illicit drugs consumption during pregnancy, explored with a validated instrument, is higher than that previously reported in our country. This fact offers a worrying picture of another set of factors adding to the burden of teenage pregnancy.

Resumen Introducción: El embarazo en la adolescencia ha adquirido gran importancia en la salud pública en México; su prevalencia oscila alrededor del 20% de los embarazos. Paralelamente, el consumo de alcohol, tabaco y drogas ilícitas en este periodo es cada vez más común en estas jóvenes. Métodos: Para estimar la prevalencia de exposición a estas substancias en adolescentes embarazadas, se llevó a cabo un estudio prospectivo, observacional y transversal. El protocolo fue aprobado por los Comités de Ética e Investigación. Previo consentimiento informado, se solicito a 420 jóvenes embarazadas atendidas en la clínica prenatal del hospital materno-infantil más grande en Nuevo León, que respondieran un cuestionario previamente validado para estimar la prevalencia del consumo de substancias. Resultados: De 420 participantes, 317 (75.5%) consumieron al menos una de estas sustancias durante el embarazo. El alcohol, solo o en combinación, fue consumido por 300 (71.5%). El tabaco fue usado por 117 (27.8%), casi siempre en combinación con otras sustancias, mientras que la mariguana y otras drogas ilícitas fueron consumidas por 92 (21.9%) participantes. Alrededor de una cuarta parte del grupo estudiado (24.1%) reportó no haber consumido ninguna de estas substancias en su embarazo. Conclusiones: En nuestra serie, la prevalencia de consumo de alcohol, tabaco y drogas ilícitas durante el embarazo, explorada con un instrumento validado, es mayor de la reportada en estimaciones previas en nuestro país. Estos datos ofrecen un panorama preocupante de una serie de factores que se agregan a la carga del embarazo en la adolescencia.

Consumo de tabaco de liar en el País Vasco: magnitud, desigualdades socioeconómicas y evolución en el periodo 2013-2018 / Use of Roll Your Own Tobacco in the Basque Country: magnitude, socio-economic inequalities and evolution in the period 2013-2018

Fundamentos: A pesar de la reducción del número de personas fumadoras a nivel mundial, el consumo de tabaco de liar ha aumentado en los últimos años en muchos países, lo que puede frenar la tendencia descendente del hábito tabáquico. El objetivo de este trabajo fue analizar la evolución del número de personas que consumen tabaco de liar y tabaco de cualquier tipo entre 2013 y 2018 en el País Vasco y determinar si existían desigualdades socioeconómicas en su consumo. Métodos: Se realizó un estudio observacional y transversal de una muestra representativa de la población residente en el País Vasco de dieciséis a cincuenta y nueve años (n 2013=6.929 y n 2018=7.961) a partir de la Encuesta de Salud del País Vasco (años 2013 y 2018) y de la Encuesta sobre Adicciones de Euskadi (2018). Se calcularon las prevalencias de consumo habitual de tabaco en general y de tabaco de liar según diferentes variables socioeconómicas para los años 2013 y 2018, así como las razones de prevalencia para la estimación del cambio entre esos años y según las variables anteriores mediante modelos de regresión de Poisson robusto. Los análisis se estratificaron por sexo y por dos grupos de edad. RESULTADOS // La prevalencia de consumo de tabaco en general disminuyó entre 2013 (hombres=27,7% y mujeres=24,1%) y 2018 (hombres=24,1% y mujeres=18,6%), pero se mantuvo en el caso del consumo de tabaco de liar (en 2013, hombres=5,1% y mujeres=3,2%; en 2018, 5,4% y 3,5%, respectivamente). A diferencia del consumo de tabaco en general, que presentó un claro gradiente socioeconómico, el consumo de tabaco de liar fue más prevalente entre las personas jóvenes (en 2018, hombres=6,4% y mujeres=4,1%), grupo en el que el patrón por posición socioeconómica era menos evidente. Conclusiones: Considerando la persistencia en el consumo de tabaco de liar, es preciso dirigir también la lucha contra el tabaquismohacia...(AU)

Background: Despite the global reduction in smoking, the consumption of roll-your-own tobacco has increased in recent years in many countries, which may be slowing down the downward trend in smoking. The aim of this paper was to analyse the evolution of the number of people who use roll-your-own tobacco and tobacco of any type between 2013 and 2018 in the Basque Country and measure whether there were socioeconomic inequalities in its consumption. Methods: We carried out an observational and cross-sectional study of a representative sample of the population living in the Basque Country aged 16 to 59 years (n2013=6929 y n2018=7961) from the Basque Health Survey (2013 and 2018) and the Basque Addictions Survey (2018). We calculated prevalences of regular tobacco smoking in general and of roll-your-own cigarettes according to different socioeconomic variables for the years 2013 and 2018, as well as prevalence ratios for the estimation of change between these years and according to the above variables through robust Poisson regression models. We stratified analyses by sex and two age groups.Results: Overall smoking prevalence decreased between 2013 (men=27.7% and women=24.1%) and 2018 but remained the same for those who used roll-your-own tobacco (in 2013, men=5.1% and women=3.2%; in 2018=5.4% and 3.5%, respectively). In contrast to tobacco in general, which showed a clear socio-economic gradient, roll-your-own tobacco use was more prevalent among young people (in 2018, men=6.4% and women=4.1%), a group where the pattern by socio-economic status was less evident.Conclusions: Considering the persistence of roll-your-own tobacco consumption, we also should direct tobacco control towards this kind of product, and its use should be monitored and supervised, especially among young people.(AU)

[Lower urinary tract symptoms in patients with arterial hypertension. Cardiovascular risk and impact on their quality of life]. / Síntomas del tracto urinario inferior en pacientes con hipertensión arterial. Riesgo cardiovascular e impacto en su calidad de vida.

OBJETIVES: To determine the prevalence of erectile lower urinary tract symptoms in hypertensive patients, cardiovascular risk and the impact on quality of life. MATERIAL AND METHODS: Setting: Health Center (Vilagarcia, Pontevedra). PERIOD: April 2015-June 2017. INCLUSION CRITERIA: Hypertensive patient with informed consent. MEASUREMENTS: sociodemographic variables, toxic habits, comorbidity, blood pressure, cardiovascular risk, analytical and examination parameters. Questionaries: International Prostate Symptom Scale (IPSS), International Index of Erectile Function (IIEF-15) and quality of life in arterial hypertension (MINICHAL). SAMPLE SIZE: n=262 (± 6% accuracy, 95% confidence). STATISTICAL ANALYSIS: Bivariate and multivariate statistical analysis. Informed consent and ethics committee approval were obtained (2024/237) RESULTS: The mean age was 65.84 (12.70), and mean hypertension duration of 13.25 (9.84) years. 76.7% reported lower tract urinary symptoms, 91.6% being mild. The bivariate analysis showed an association with the variables: age, educational level, profession, work activity, tobacco, benign prostatic hypertrophy, years of diagnosis, concomitant medication, Framingham-Wilson score, electrocardiogram, glycated hemoglobin, glomerular filtration (Crockroft-Gault), LDL-cholesterol, somatic manifestations (MINICHAL), erectile dysfunction. The multivariate analysis showed increased risk with:abdominal obesity, pathological electrocardiogram, high risk of Framingham-Wilson score, erectile dysfunction, use of hypouricemics agents and decreased with not smoking and use diuretics. CONCLUSIONS: Three quarters of hypertensive men presented lower urinary tract symptoms, increasing the risk of cardiovascular disease early according to the Framingham-Wilson score. Other predictive factors were: abdominal obesity, tobacco, pathological electrocardiogram, high Framingham-Wilson score, erectile dysfunction, use of hypouricemics agents.

Urban and social determinants of alcohol and tobacco consumption among adolescents in Madrid.

OBJECTIVE: This study aims to describe the accessibility to and promotion of alcohol and tobacco around secondary schools in Madrid and its distribution in relation with area-level socioeconomic deprivation; analyze the relationship between this exposure and individual consumption characteristics of students between 14 and 18 years old; and explore other facilitators of this consumption. METHOD: Mixed-methods study conducted in three phases: 1) we collected data on accessibility to and promotion of alcohol and tobacco in the environment using systematic social observation around 55 secondary schools; 2) we administered 2287 questionnaires among the students in these centers to gather information about characteristics and determinants of consumption; and 3) we conducted 20 semi-structured interviews and one discussion group to deepen in the results obtained in surveys and systematic social observation. We will use Geographic Information Systems to integrate and analyze the data from a spatial perspective.

Mortalidad atribuible al consumo de tabaco en la Provincia de Buenos Aires. Estimación a partir de las Encuestas Nacionales de Factores de Riesgo / Mortality Attributable to Tobacco Consumption in the Province of Buenos Aires. Estimation from the National Surveys of Risk Factors

RESUMEN Introducción : El consumo de tabaco es la principal causa de defunción por enfermedades no transmisibles como las cardiopatías, las neumopatías y el cáncer. Estimar la mortalidad atribuida al consumo de tabaco dependiente de su prevalencia se basa en el conocimiento previo del número de fumadores, exfumadores y no fumadores en la población. Estos datos provienen de las cuatro Encuestas Nacionales de Factores de Riesgo (ENFR). Objetivos : El presente trabajo pretende mostrar la carga de mortalidad por consumo de tabaco en la Provincia de Buenos Aires en los períodos de relevamiento de las cuatro ENFR (2005-2009-2013-2018). Material y métodos : La mortalidad atribuible fue calculada utilizando un método dependiente de la prevalencia, y asumiendo los riesgos asociados al consumo en las 19 causas clasificadas como asociadas al tabaquismo según el estudio Cancer Prevention Study II (CPSII). Las defunciones fueron agrupadas en períodos equivalentes a los relevamientos de cada ENFR. Las fracciones atribuibles del CSPII se aplicaron entonces calculando las defunciones absolutas y atribuibles de mortalidad por causa y sus agrupamientos: tumores, circulatorias y respiratorias. Resultados : Globalmente, para todas las edades de 18 años y más, se pasó de una prevalencia de tabaquismo del 29,5% en 2005 al 23,1% en 2018 (reducción absoluta de 6,4% y porcentual del 21,7%). De las 18 255 muertes producidas por enfermedades cardiovasculares coincidentes con los cuatro relevamientos, 6293 fueron atribuibles al tabaquismo (34,4%), frente al 68% de las muertes por tumores y el 40% de las muertes de causa respiratoria. Conclusión : Se hace necesario fortalecer aún medidas para reducir la exposición al tabaco.

ABSTRACT Background : Tobacco consumption is the leading cause of death from non-communicable diseases, such as heart disease, lung disease and cancer. Estimating prevalence-based mortality attributed to tobacco consumption is based on prior knowledge of the number of smokers, ex-smokers, and non-smokers in the population. These data derive from the four National Surveys of Risk Factors (Encuestas Nacionales de Factores de Riesgo, ENFR). Objectives : This study aims to show the burden of mortality due to tobacco consumption in the Province of Buenos Aires in the assessed periods of the four ENFRs (2005, 2009, 2013, 2018). Methods : Mortality attributable to tobacco consumption was estimated by using a prevalence-based method and assuming the risks associated with smoking in the 19 causes classified as associated with smoking, in accordance with the Cancer Prevention Study II (CPSII). The deaths were grouped into periods equivalent to those relevant to each ENFR. The CSPII attributable fractions were then applied by estimating the absolute deaths and attributable fractions of mortality by cause and groupings: tumours, circulatory diseases and respiratory diseases. Results : Overall, in persons aged 18 years or older, there was a decrease in smoking prevalence from 29.5% in 2005 to 23.1% in 2018 (an absolute reduction of 6.4% and a percentage reduction of 21.7%). A total of 6293 out of 18 255 deaths from cardiovascular diseases in the four surveys were attributed to smoking, that is, 34.4%, compared to 68% of deaths from tumours and 40.0% of deaths from respiratory diseases. Conclusion : It is necessary to further strengthen measures to reduce exposure to tobacco.