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  • 1
    Keywords: Germany ; human ; EXPOSURE ; PARTICLES ; HEALTH ; smoking ; COUNTRIES ; RE ; TOBACCO-SMOKE ; EXTENT ; ENGLAND ; VALUES
    Abstract: This study quantified exposure to secondhand smoke in German restaurants, bars, and entertainment venues by determining the concentration of respirable suspended particles measuring 2.5 mu m or less (PM2.5) in indoor air. The measurements were taken using an inconspicuous device placed on the investigator's table in the venue. The concentration of particulate matter in the indoor air was measured for a minimum of 30min. A total of 39 restaurants, 20 coffee bars, 12 bars, 9 discotheques, and 20 restaurant cars in trains were visited throughout Germany from September 30 to October 31, 2005. The readings disclosed a median PM2.5 of 260 mu g/m(3) and an arithmetic mean PM2.5 of 333 mu g/m(3). Median values were 378 mu g/m(3) in bars, 131 mu g/m(3) in cafes, and 173 mu g/m(3) in restaurants. The highest medians were measured in discotheques and restaurant cars, with values averaging 432 mu g/m(3) and 525 mu g/m(3) PM2.5, respectively. This study was the first to show the magnitude and extent of exposure to secondhand smoke on such an extensive scale in Germany. The contaminated air due to smoking is a human carcinogenic and major health hazard, which would be prevented most effectively and completely by implementing a ban on smoking. This study is important for the ongoing national debate in Germany as well as for debates in all countries without smoke-free air legislation, which includes most countries around the world
    Type of Publication: Journal article published
    PubMed ID: 18324575
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  • 2
    Keywords: MORTALITY ; HEALTH ; CONSUMPTION ; SMOKERS ; CESSATION ; SIMULATION-MODEL ; REDUCING SMOKING ; PUBLIC-POLICIES ; MASS-MEDIA ; WARNINGS
    Abstract: INTRODUCTION: Although Germany has recently implemented some tobacco control policies, there is considerable scope to strengthen policies consistent with the MPOWER guidelines. This article describes the development of a simulation model projecting the effect of future tobacco control policies in Germany on smoking prevalence and associated premature mortality. METHODS: Germany SimSmoke-an adapted version of the SimSmoke simulation model of tobacco control policy-uses population, smoking rates, and policy data for Germany. It assesses, individually and in combination, the effect of seven types of policies: taxes, smoke-free air laws, mass media campaigns, advertising bans, warning labels, cessation treatment, and youth access policies. RESULTS: With a comprehensive set of policies, smoking prevalence within the first few years can be reduced by about 22.0% relative to the status quo and by 37.9% (40.5%) for males (females) in 30 years. By 2040, 39,548 deaths could be averted in that year alone. Without stronger policies, 700,000 additional smoking-attributable deaths (SADs) would occur in Germany over the next 30 years. CONCLUSIONS: The model indicates that the consequences of inaction are considerable; without the implementation of a stronger set of policies, smoking prevalence rates will remain relatively stable, and SADs among women will continue to rise over a 30-year horizon. Significant inroads into reducing smoking prevalence and premature mortality can be achieved through strengthening tobacco control policies in line with MPOWER recommendations.
    Type of Publication: Journal article published
    PubMed ID: 22855886
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  • 3
    Abstract: INTRODUCTION: The prevalence of smoking in Romani of both genders is significantly higher than in the general population. Our aim was to determine whether a genetic susceptibility contributes to the high prevalence of smoking among Roma in a study based on data collected from cross-sectional surveys. METHODS: Twenty single nucleotide polymorphisms known to be closely related to smoking behavior were investigated in DNA samples of Hungarian Roma (N = 1273) and general (N = 2388) populations. Differences in genotype and allele distribution were investigated. Genetic risk scores (GRSs) were generated to estimate the joint effect of single nucleotide polymorphisms in genes COMT, CHRNA3/4/5, CYP2A6, CTNNA3, DRD2, MAOA, KCNJ6, AGPHD1, ANKK1, TRPC7, GABRA4, and NRXN1. The distribution of scores in study populations was compared. Age, gender, and body mass index were considered as confounding factors. RESULTS: Difference in allele frequencies between the study populations remained significant for 16 polymorphisms after multiple test correction (p 〈 .003). Unexpectedly, the susceptible alleles were more common in the general population, although the protective alleles were more prevalent among Roma. The distribution of unweighted GRS in Roma population was left shifted compared to general population (p 〈 .001). Furthermore, the median weighted GRS was lower among the subjects of Roma population compared to the subjects of general population (p 〈 .001) even after adjustment for confounding factors. CONCLUSIONS: The harmful smoking behavior of the Roma population could not be accounted for by genetic susceptibility; therefore, interventions aimed at smoking prevention and cessation should focus on cultural and environmental factors. IMPLICATIONS: This is the first study designed to determine whether genetic background exists behind the harmful behavior of the smoking of the Roma population. Although the frequencies of susceptible and protective alleles strongly differ between the Hungarian Roma and general populations, it is shown that calculated GRSs being significantly higher in the general population, which do not support the hypothesis on the genetic susceptibility of the Roma population. Interventions aimed at smoking cessation in the Roma population should preferentially target cultural and environmental factors.
    Type of Publication: Journal article published
    PubMed ID: 27613936
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  • 4
    Keywords: Germany ; RESPONSES ; TRIAL ; TRIALS ; IDENTIFICATION ; PATTERNS ; CARE ; HEALTH ; CLINICAL-TRIALS ; smoking ; RATES ; STRATEGIES ; DOUBLE-BLIND ; SMOKERS ; RANDOMIZED-TRIAL ; RE ; PATTERN ; MS ; analysis ; ENGLAND ; WAVES ; ABSTINENCE ; BUPROPION ; REIMBURSEMENT ; TRANSDERMAL NICOTINE PATCH
    Abstract: In the statistical analysis of smoking cessation trials, participants with missing outcome data are commonly assumed to be continued smokers. Using algebraic formulas, a numerical example, and a real-life example, we evaluated the implications of nonresponse patterns on results obtained with a "missing = smoking" (MS) analysis compared with results obtained with an "available case" (AC) analysis, which excludes participants with missing outcome data. The algebraic formulas showed that MS and AC analysis provide consistent estimates of relative quit rates (RQR) when response rates in the treatment and control group are equal, regardless of the validity of the underlying assumption of both approaches. However, as shown in our numerical example, RQR estimated with both approaches can differ substantially in case of differential response rates. In the real-life example the proportion abstinent decreased from 16% to 5% in later response waves but did not reach zero. The estimates of the intervention effect from MS analysis and AC analysis converged when high and comparable response rates were achieved in both the treatment and control groups after multiple reminders. We conclude that smoking cessation studies should aim for high and equal response rates in the compared groups to ensure identification of all successful quitters and to be less susceptible to potential bias related to violation of the assumptions underlying the analytic strategies
    Type of Publication: Journal article published
    PubMed ID: 18569764
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  • 5
    Keywords: EXPOSURE ; WORKERS ; QUALITY ; ENVIRONMENTAL TOBACCO-SMOKE ; SECONDHAND SMOKE ; PUBS ; AREAS ; RESTRICTIONS
    Abstract: Introduction: The present study examined the reduction in exposure to tobacco smoke in German hospitality venues following the implementation of a partial smoking ban by measuring the indoor air concentration of PM(2.5) in 2005 and 2009, that is, before and after the legislation was implemented. Methods: The concentration of respirable suspended particles (PM(2.5)) in the indoor air of German hospitality venues was measured using a laser photometer (AM510). The prelegislation sample from 2005 included 80 venues of which 58 could be revisited in 2009. After replenishment, the postlegislation sample consisted of 79 venues. Results: Compared with the prelegislation measurement, the concentration of PM2.5 in hospitality venues was reduced significantly after introduction of the smoke-free legislation. The median mass concentration of PM(2.5) was reduced by 87.1% in coffee bars, by 88.7% in restaurants, by 66.3% in bars, and by 90.8% in discotheques. Notably, legal exemptions to the smoking ban are an issue: At the postlegislation measurement in 2009, the mass concentrations of PM(2.5) were substantially higher in venues allowing smoking in the whole venue or in a designated smoking room than in completely smoke-free venues. Conclusions: The German smoke-free legislation significantly reduced the levels of respirable suspended particles in the indoor air of hospitality venues, benefiting the health of employees and patrons alike
    Type of Publication: Journal article published
    PubMed ID: 21622497
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