Abstract
BackgroundTobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations.MethodsWe pooled data from six multicentre studies involved in the Ageing Lungs in European Cohorts consortium, including overall 119,104 subjects from 17 countries (range of median ages across studies: 33–52 years). We estimated retrospectively trends in the rates of smoking initiation (uptake of regular smoking) by age group, and tested birth cohort effects using Age-Period-Cohort (APC) modelling. We stratified all analyses by sex and region (North, East, South, West Europe).ResultsSmoking initiation during late adolescence (16–20 years) declined for both sexes and in all regions (except for South Europe, where decline levelled off after 1990). By the late 2000s, rates of initiation during late adolescence were still high (40–80 per 1000/year) in East, South, and West Europe compared to North Europe (20 per 1000/year). Smoking initiation rates during early adolescence (11–15 years) showed a marked increase after 1990 in all regions (except for North European males) but especially in West Europe, where they reached 40 per 1000/year around 2005. APC models supported birth cohort effects in the youngest cohorts.ConclusionSmoking initiation is still unacceptably high among European adolescents, and increasing rates among those aged 15 or less deserve attention. Reducing initiation in adolescents is fundamental, since youngsters are particularly vulnerable to nicotine addiction and tobacco adverse effects.
Highlights
Smoking is still the leading cause of avoidable mortality and the strongest modifiable risk factor for respiratory and allergic diseases, cardiovascular diseases, and cancer.[1,2,3] The prevalence of smoking has been, and still is, declining in Europe, which is mainly related to more restrictive national regulations that have been introduced over time.[1,4,5] The Framework Convention on Tobacco Control is giving further boost to the global fight against smoking.[2]
We used the data from six large-scale multicentre studies on random samples of the general population in Europe, which were available in the Ageing Lungs in European Cohorts (ALEC) consortium (S1 Fig)
The European Community Respiratory Health Survey (ECRHS) is an international cohort study performed on subjects aged 20–44 years at enrolment in 1991–1994.[15]. In ECRHS I, random samples of subjects participating in a postal screening took part in a clinical interview, where they reported information on their smoking habits for the first time
Summary
Smoking is still the leading cause of avoidable mortality and the strongest modifiable risk factor for respiratory and allergic diseases, cardiovascular diseases, and cancer.[1,2,3] The prevalence of smoking has been, and still is, declining in Europe, which is mainly related to more restrictive national regulations that have been introduced over time.[1,4,5] The Framework Convention on Tobacco Control is giving further boost to the global fight against smoking.[2] Still, more needs to be done, and understanding trends of tobacco habits over time and across populations is essential to implementing further effective public health policies. The prevalence of smoking within a population depends on the rates of smoking initiation, cessation, and smoking-related mortality. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
