Trends In Tobacco Consumption Research Articles

Pattern of Smokeless Tobacco Initiation and Use among School Going Adolescents in Delhi, India: A Mixed Method Study.

With growing trends in tobacco consumption, it has been observed that the age of initiation is gradually decreasing. To combat the deep-rooted problem of the Society, we need to target the adolescents at the time of their first consumption of tobacco forms. Hence, this study was conducted to assess the pattern of smokeless tobacco use among school going adolescents in senior secondary schools with the assessment of the sociodemographic factors responsible for initiation of smokeless tobacco use by adolescents. A cross-sectional survey of total sample of 714 students across 9-11 standards in 3 schools of Delhi was done using a self-administered questionnaire after obtaining approval from Institutional Ethics Committee and School Health Scheme, Delhi. Consumption of tobacco was found to be 27.9% at a frequency of 6-9 days in a period of one month and a majority of 31 (39.2%) students initiated the use in the age group of 10-11 years. Among the different SLT products, pan masala combined with zarda with 56 (70.8%) users, was found to be the most commonly consumed SLT product. Grocery shops were preferred POS among the students as (67%) of students obtained the SLT product from this POS. 56 (70.8%) of the students wanted to quit the habit of SLT use whereas 49 (62%) students tried to quit the habit and 43 (54.4%) students sought help in order to quit the habit. Such alarming results in terms of low age of initiation in Delhi is an emerging health problem. Adequate cessation programmes and schemes must be developed and strict implementation of laws and policies to achieve a tobacco free youth is the need of hour.

Alarming trends in Tobacco use in high school Tunisian adolescents: MedSPAD2013-2021

Abstract Background Tobacco use is a global health concern, with smoking initiation often beginning in adolescence. In Tunisia, published data assessing trends of tobacco consumption at the national level only concerns middle school students aged 13 to 15 years. No data related to high school students are however published yet. We aimed to determine tobacco smoking prevalence in Tunisian adolescents and assess trends from 2013 to 2021. Methods Pooled data from three Mediterranean school surveyson alcohol and other drugs (MedSPAD surveys: 2013, 2017, and 2021) were used. Based on three-stage stratification sampling method, teenagers aged between 15 and 17 years, were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Data collection was performed using a self-administered standardized questionnaire assessing socio-demographic characteristics and risky behaviours. We studied weighted prevalence estimates of cigarettes and water pipe (WP) smoking. All statistical analysis, including trend analysis, were performed with STATA software. Results A total of 14.723 students were enrolled with sex ratio (M/F) equal to 0.6 and mean age of 16.2±0.8 years. The prevalence of cigarette smoking increased from 17.8%, to 20.2% then to 24.7% for 2013, 2017 and 2021, respectively. As for WP smoking, its prevalence increased from 14.8%, to 16.7% then to 19.9% for 2013, 2017 and 2021, respectively. Trends analysis concluded to significant increase over study period for cigarettes and WP smoking (p < 10-3). The increase was most alarming for girls regarding WP smoking (consistent increase over the study period). Conclusions Our findings underscore the alarming increasing trend for different forms of tobacco smoking among Tunisian youth. It is therefore crucial to strengthen tobacco control measures among young adolescents in order to counteract the tobacco industry’s expanding marketing of new products primarily targeting this population. Key messages • The prevalence of cigarette and water pipe smoking increased significantly among high school Tunisian adolescents from 2013 to 2021. • A better commitment to the implementation of MPOWER measures for tobacco control is therefore urgent.

Tobacco consumption trends and correlates of successful cessation in Indian females: Findings of Global Adult Tobacco Surveys

BackgroundFemale gender is being affected disproportionately by tobacco use. The correlates of tobacco use among women are different from men, which has not been studied in India. To develop gender-sensitive interventions and policies in tobacco control, it's essential to ascertain the factors that affect tobacco consumption and successful cessation among Indian women. MethodsThis secondary data analysis was done for females respondents aged >15 years using the data generated from the GATS-1 (2009–2010) and GATS-II (2016–2017). The primary dependent variables included interest in quitting smoking/SLT, attempt to quit smoking/SLT, successful quitting. The independent variables were broadly categorized as a community, household, and individual level. Simple descriptive analysis using % age relative change was used to calculate the change in tobacco consumption between two rounds of GATS, whereas; bivariate and multivariable logistic regression were used to calculate the unadjusted and adjusted odds ratio for cessation related variables (GATS-2). ResultsThere was a 29.5% relative reduction in the prevalence of tobacco use in round-2 among females. A maximum reduction in the prevalence was observed in the 15–29 years (−51.3%), those not exposed the media advertisements (−19.9%). While unadjusted OR depicted that unmarried women, young age, asked by health workers about tobacco use, and advice given by them increased the interest in quitting smoking, none of them emerged to be significant on a multivariable logistic regression except the advice given by the health care provider. Successful cessation (>6 months) of SLT products is possible in urban areas, with decreased exposure to media advertisements. ConclusionThere is an urgent need for gender-sensitive policies in tobacco control and the integration of these policies with relevant national health programs. This shall help to synergize efforts and obtain better outcomes that would support the overarching goal of tobacco-free India.

Trends in Tobacco Consumption – a Comparative Analysis of WHO European Region Countries

Tobacco consumption, as well as the consumption of any other psychoactive substances, lead to addictions, which is a serious problem that modern societies have to face. To reduce the negative consequences of nicotine consumption and to provide sustainable development, many governments, in both developed as well as developing countries, adopt policies to reduce tobacco production and consumption. For example, they implement various health programs to combat addiction, and they also provide appropriate financial and fiscal resolutions. Any actions taken at different decision-making levels are often bounded with economic and financial policies of a particular state, including fiscal policy. State interventionism concerning tobacco is most visible in developed countries such as the US, Canada, and European Union countries. Developing countries and Asian countries have also started to introduce regulations concerning tobacco consumption on a large scale in response to the negative effects of nicotinism. The main aim of the paper is to show consumption trends as well as the fiscal and price policies of tobacco products. The theoretical part is supplemented by data from reports and analyses presented by the World Health Organization (WHO).

DISCREPANCIES IN BELIEF, BEHAVIOR AND KNOWLEDGE TOWARDS TOBACCO CONSUMPTION

Aim and objective: Tobacco consumption is a leading cause of death, associated with significant health hazards and comprising millions of lives worldwide. India is the third-largest consumer of tobacco in the world; in-spite of adequate control measures taken by the government to cease tobacco consumption. The objective of this review is to highlight the discrepancies in belief, behavior, and knowledge towards tobacco consumption in India. The study also aims to specify factors influencing trends of tobacco consumption and to associate the extent of their influence based on the user’s perception concerning the quality of life. Study design: Review of the literature. Methods: Authors undertook a literature search in the electronic databases EMBASE, Medline, and Scopus with regard to associated disease burden and factors influencing tobacco consumption. Results: According to the review, sociodemographic, economic, personal, environmental, and healthy life indicators are the most influential variables affecting tobacco consumption. This highlights the need for revisiting the tobacco control laws in India, addressing the existing barriers to have significant impacts on the tobacco picture of the country. Although at state-levels, a certain extent of success has been achieved; in-tranquil, national-level non-prioritization of tobaccocontrol still exists. The possible reason might be a lack of awareness about health hazards owing to tobacco use. Conclusion: This dictates to improve health outcomes among individuals by including effective interventions. In all, its mandate to map the current issue of harm reduction framework through research, education, awareness, and implementation of policies for improved quality of life and health.

Understanding Alcohol and Tobacco Consumption in Asexual Samples: A Mixed-Methods Approach

Existing research suggests significant differences in alcohol and tobacco consumption trends according to one's sexual orientation. However, asexual people have not yet been included in these comparisons. In this mixed-methods, two-part study, we sought to compare group differences in alcohol and tobacco consumption among sexual orientations, focusing on asexual people, sexual people, and those in the "gray" area between asexual and sexual (i.e., "gray-asexual"). Data for Study 1 came from four British studies: National Surveys of Sexual Attitude and Lifestyles I, II, and III in 1990, 2000, and 2010 (NATSAL I, II, III) and Towards Better Sexual Health (TBSH) in 2000. Sample sizes for each study by gender are: NATSAL I-M: 1923 F: 3511; NATSAL II-M: 4604 F: 6031; NATSAL III-M: 6122 F: 7966; TBSH-M: 347 F: 552. Notably, asexual and gray-asexual respondents were found to consume significantly less alcohol and were more likely to abstain from drinking alcohol altogether, compared to allosexual respondents. Differences in tobacco consumption were only statistically significant for asexual respondents in two of three studies that included tobacco consumption. Each of the four studies also found that asexual and gray-asexual respondents were more likely to be non-drinkers (40.0-77.8%, asexual and 28.1-50.1% gray-asexual, non-drinkers, respectively) than allosexual respondents (10.2-27.2%, non-drinkers). Interviews conducted in Study 2 identified somatic, social, and psychological experiences and motivations that may shed light on the reasons for lower drinking frequencies among asexual individuals. Variability in alcohol consumption levels among asexual, lesbian, gay, and bisexual respondents, and the general population raises new questions about the motivations for why people consume alcohol.

Trends of Tobacco Consumption Among Women Admitted to and Visiting the Psychiatric Inpatient Unit of a Tertiary Care Center in Mumbai: A Cross-Sectional Study.

To gain insight into the current prevalence of tobacco consumption in various forms among female psychiatric inpatients and their visiting female relatives in Mumbai, India. In this cross-sectional study, survey questionnaires were administered to 127 female inpatients and 110 of their visiting female relatives from July to October 2016. A total of 100 patients and 108 of their relatives completed responses. Additionally, a modified version of the Fagerström Test for Nicotine Dependence was incorporated into the survey to assess the level of nicotine dependence, with higher scores corresponding to higher levels of dependence. The rates of tobacco use were higher in the patients than in their relatives (χ² = 12.13, P = .0003). Patients had shorter periods of abstinence and lower World Health Organization Quality of Life Assessment parameters. This study sheds light on certain data that may be utilized for future health programs and in the development of treatment plans for women with mental illness.​​.

Changes in Alcohol and Tobacco Consumption in Response to Medical and Recreational Cannabis Legalization: Evidence from U.S. State Tax Receipt Data

Background: Whether medical or recreational cannabis legalization has impacts on alcohol or cigarette consumption is a key question as cannabis policy evolves, given the adverse health effects of these substances. However, relatively little research has examined this question. The objective of this study was to examine whether medical or recreational cannabis legalization was associated with any change in state-level alcohol or cigarette consumption. Methods: Dependent variables included state-level aggregate consumption of alcohol and cigarettes from all 50 states, estimated from state tax receipts. Independent variables included indicators for medical and recreational legalization policies. Three different types of indicators were separately used to model medical cannabis policies. Indicators for the primary model were based on the presence of active medical cannabis dispensaries. Secondary models used indicators based on either the presence of a more liberal medical cannabis policy (“non-medicalized”) or the presence of any medical cannabis policy. Difference-in-difference regression models were applied to estimate associations for each type of policy. Results: Primary models found no statistically significant associations between medical or recreational cannabis legalization policies and either alcohol or cigarette consumption. In a secondary model, both medical and recreational policies were associated with significantly decreased cigarette consumption compared to states with no medical cannabis policy. However, post-hoc analyses demonstrated that these reductions were apparent at least two years prior to policy adoption, indicating that they likely result from other time-varying characteristics of legalization states, and are not direct effects of the cannabis policy. Estimates were sensitive to inclusion of state-level covariates, such as demographics and other policy variables, and evidence for differential trends in tobacco consumption were apparent. Conclusion: We found no evidence of a causal association between medical or recreational cannabis legalization and changes in either alcohol or cigarette consumption.

The perspectives of politicians on tobacco control in Turkey.

BackgroundTobacco use is a leading but preventable cause of non-communicable diseases and premature death. The legislature has a key role in setting tobacco control policies. Smoking trends are decreasing thanks to the introduction of effective tobacco control policies in Turkey and these policies may have been shaped by how politicians’ interpreted social problems that were prominent during the development and implementation of tobacco regulations.AimThis paper explores the long-term national relationship between tobacco consumption, tobacco control policies and the associated political discourse in Turkey, considering the varying influences through national leadership on this important public health agenda. This relationship is studied by comparing a time series analysis of tobacco consumption trends with a policy analysis of the minutes of deliberations at the Grand National Assembly of Turkey (GNAT).MethodsThis study uses Bayesian time series analysis in order investigate whether the tobacco control policies and related activities influenced the annual per adult cigarette consumption in Turkey. We used a novel method to identify change points in tobacco trends and whether they correspond with key policy changes intended to alter usage after adjusting for the effect of other non-policy related covariates, such as the purchasing power. The policy analysis included an examination of the minutes of deliberations at the GNAT—which is the Turkish parliament and unicameral Turkish legislature—1 year before and 1 year after the break years associated with an increase or decrease in tobacco consumption.Results and recommendationsTobacco consumption increased with the encouragement of tobacco production and the entrance of multinational companies in the country in 1976 and 1993, respectively. The National Tobacco Law of 1996 and comprehensive amendments in 2008, including smoke-free public places and tax increases, appear to have helped reduce tobacco consumption in Turkey. The focus of Parliamentary discussions throughout this period changed, becoming less supportive of tobacco over time. However, throughout the period there remained discussions focussing on concerns around the implications for the economy and the privatization agenda, national agriculture and the welfare of farmers. Effective control appears to require certain political ingredients to be implemented: politicians who are well informed on tobacco control measures and understand the range of issues surrounding the policies (not only those directly health-related); and supportive public health information in the community. Evidence-based public health policy should be introduced to the politicians.

Trends in Tobacco Smoking among Czech School-aged Children from 1994 to 2014.

The aim of the article is to examine trends in tobacco consumption among the Czech school-age population. For the analysis, data from the Czech Health Behaviour in School-aged Children project, conducted between 1994 and 2014 were used. Trends in tobacco smoking were determined separately for boys and girls, applying the binary logistic regression with survey period as an independent variable for the smoking status. The analysis showed that there have been significant changes in adolescent tobacco smoking for the recent 20 years. While the share of current school-aged smokers was continuously increasing since the mid-1990s, the trend reached its peak in the mid-2000s. In recent years, the prevalence of adolescent smokers has significantly declined in the Czech Republic. Despite this recent decline, adolescent smoking remains a major challenge for the national health policy.

Trends of tobacco consumption and associated socioeconomic factors in the Portuguese population

Trends of tobacco consumption and associated socioeconomic factors in the Portuguese population

Different levels in alcohol and tobacco consumption in head and neck cancer patients from 1957 to 2013.

ObjectiveTo provide a precise quantification of the association between alcohol and tobacco consumption trends in head and neck cancer patients over the past 45 years.MethodsWe combined findings from all studies published until March 2014 and evaluated the association between different levels in alcohol and tobacco consumption and head and neck cancers through a meta-analytic approach.ResultsWe included 28 studies involving 13830 patients with head and neck cancer. In patients with alcohol consumption, the pooled odds ratio (OR) and 95% confidence interval (CI) were 1.29(1.06-1.57), 2.67(2.05-3.48) and 6.63(5.02-8.74) for light drinkers, moderate drinkers and heavy drinkers, respectively. In patients with tobacco consumption, the pooled OR and 95% CI were 2.33(1.84-2.95), 4.97(3.67-6.71) and 6.77(4.81-9.53) for light smokers, moderate smokers and heavy smokers, respectively.ConclusionThe increased alcohol and tobacco consumption trends increased the risk of head and neck cancer over the past 45 years. Tobacco consumption was found to be a stronger risk factor for head and neck cancer than alcohol consumption. Thus, the control should be considered to limit the intake of alcohol and tobacco.

Worldwide Burden of Gastric Cancer Attributable to Tobacco Smoking in 2012 and Predictions for 2020.

The heterogeneous patterns and trends in tobacco consumption contribute to regional and gender differences in the burden of gastric cancer attributable to smoking. To estimate the proportion and absolute number of gastric cancer cases that can be attributed to smoking in different countries, in 2012 and 2020. Population attributable fractions (PAFs) were computed for 118 countries, using data of smoking prevalence in 2002 and 2011 and published estimates of the magnitude of the association between smoking and gastric cancer, assuming a time lag of ≈10years. For men, the highest PAF estimates in 2012 were observed in Eastern Asia and the lowest in North America, whereas for women the highest were in Western Europe and the lowest in Africa. Very high Human Development Index (HDI) countries presented the lowest median PAF in men (very high vs. high, medium, and low HDI: 17.2 vs. 20.8%, p=0.014) and the highest median PAF in women (very high vs. high, medium, and low HDI: 4.3 vs. 1.8%, p<0.001). Estimates for 2020 show a decrease in median PAFs, but the estimated absolute number of cases attributable to smoking in the countries analyzed increased for men (≈154,000 vs. ≈160,000) and decreased for women (≈6200 vs. ≈5600). Smoking accounts for a larger number of gastric cancer cases among men, and gender differences are expected to increase in the next decade, despite the decrease in PAFs. Intensified efforts to control smoking are needed to further reduce the burden of gastric cancer.

Trends in tobacco consumption in three different birth cohorts of elderly of São Paulo, Brazil

BackgroundThe effects of birth cohorts reflect the historical differences in physical and social environments. The objectives of the present study were to describe the tobacco consumption and to evaluate the behavioral trends with respect to smoking in three different birth cohorts of a population-based sample of elderly individuals. MethodsA series of three cross-sectional studies conducted with elderly individuals of 60–64 years of age interviewed in 2000 (birth cohort 1936–1940; n=427), 2006 (birth cohort 1942–1946; n=298) and 2011 (birth cohort 1947–1951; n=355) in a population-based sample from the city of São Paulo, Brazil. The interviewees were participating in a prospective cohort study entitled Health, Well-Being and Aging (Saúde, Bem-Estar e Envelhecimento [SABE]). Data on tobacco consumption were self-reported and interviewees were then classified as never smokers, former smokers or current smokers. Linear model for categorical data was used to test differences on tobacco consumption between three birth elderly cohorts. FindingsMen were more likely than women to be smokers. Being evangelical and having more schooling constituted protective factors against smoking. Regarding trends, the tobacco consumption of the men did not change in any of the three cohorts studied (p=0.7454), whereas there was an increase in the number of women smokers, principally former smokers, over the periods evaluated (p=0.0189). ConclusionsThese results suggest that the anti-smoking policies implemented in Brazil were effective in women of this age group; however, different prevention strategies are required to target elderly men.

Why do GDPs fail to recognise oral cancer? The argument for an oral cancer checklist

Delays in the diagnosis of oral cancer have been the subject of several cases recently reported in the media. Different types of delays include patient delays, doctor delays and system delays. Although diagnostic delays in primary care constitute a minority of these cases they are potentially modifiable and therefore an important aspect of care to address. GDPs need to be aware of several different factors when assessing the risk for oral cancer including the changing epidemiology of oral cancer and new trends in tobacco consumption, for example the increasing use of waterpipes (shishah/hookah). However several problems in fully assessing patients for oral cancer have been reported. These include time constraints, a lack of remuneration and little training in assessing risk factors and conducting a soft tissue examination. This article reviews these issues and puts forward the case for oral cancer detection as a compulsory CPD topic and a national oral cancer checklist as a tool to ensure all aspects of the oral cancer assessment are considered, which can then be audited and remunerated.

Change in tobacco use over time in urban Indian youth: the moderating role of socioeconomic status.

This study investigates socioeconomic differences in patterns and trends of tobacco consumption over time among youth in India. Additionally, the distribution of tobacco use risk factors across social class was examined. The data were derived from a longitudinal study of adolescents, Project Mobilizing Youth for Tobacco Related Initiatives. Students in eight private (high socioeconomic status [SES; n = 2,881) and eight government (lower SES; n = 5,476) schools in two large cities in India (Delhi and Chennai) were surveyed annually about their tobacco use and related psychosocial risk factors from 2004 to 2006. Results suggest the relationship between SES and tobacco use over time was not consistent. At baseline (in 2004), lower SES was associated with higher prevalence of tobacco use but the relation between SES and tobacco use reversed 2 years later (2006). These findings were mirrored in the distribution of related psychosocial risk factors by SES at baseline (in 2004), and thereafter in 2006. Implications for prevention scientists and future intervention programs are considered.

Tobacco Policymaking and Administration in Bhutan from 1991 to 2009

From 1991 to 2004, a significant grassroots campaign, in the eastern Himalayan Kingdom of Bhutan, that included urban and rural people and Buddhist monks, called for national legislation to ban tobacco sales. In 2004, Bhutan banned all tobacco sales and restricted smoking in public areas, but permitted the importation, with a high duty and sales tax, of small amounts of tobacco products for personal use. From 2004 to 2009, this novel experiment in tobacco control resulted in a strong black market, considerable tobacco smuggling, and continued tobacco use by crucial sectors of the population, particularly minors. In response, in 2009, Bhutan passed important amendments to its 2004 anti-tobacco law that tightened administration and enforcement efforts, established specific penalties for violations, and monitored tobacco consumption trends. However, if tobacco consumption trends do not improve and smuggling is not successfully counter-acted, Bhutan should consider changing, to some degree or in total, its anti-tobacco program.

Reconstruction of long-term tobacco consumption trends in Australia and their relationship to lung cancer mortality

Analysis of long-term trends in smoking and causes of death in Australia are prevented by a lack of detailed tobacco consumption data prior to World War II. The objective of this study was to reconstruct data on tobacco consumption in Australia back to 1887 and examine its relationship with population-level lung cancer mortality, corrected for biases and miscoding. Back-extrapolation techniques and existing tobacco sales data were combined to estimate tobacco consumption prior to the 1940s. The relationship of tobacco and lung cancer mortality was examined with descriptive period and cohort analyses and log-linear Poisson regression models of cumulative cohort consumption. The results show that tobacco consumption rose steadily in Australia for the majority of years from 1887 to World War II, before increasing drastically in the following years and then falling sharply to the present day. Lung cancer mortality was strongly influenced by tobacco consumption, peaking 20-25 years after the peak in tobacco consumption for men and 25-30 years for women. Regression models found cumulative consumption a very strong predictor of mortality. Period and cohort trends in smoking and lung cancer were similar to many other Western countries. The effectiveness of smoking reduction campaigns in Australia clearly reduced male lung cancer mortality and provides guidance for other countries, such as China, where smoking prevalence remains high.

Survival from cancer of the lung in England and Wales up to 2001

Lung cancer is still the most common cancer in the world. Following the steady decline in incidence in men in England and Wales for over 20 years, it is now the second most common cancer in men (19 000 cases a year, 8% lifetime risk) after prostate cancer, and it causes 17 000 deaths a year. In women, the long-term increase in incidence has recently flattened off, but lung cancer is now the third most common cancer (13 000 cases a year, 4% lifetime risk) after cancers of the breast and large bowel, and it causes 11 500 deaths a year (Quinn et al, 2001; Office for National Statistics, 2005). Lung cancer is the commonest cause of death from cancer in both men and women. Most lung cancers are caused by tobacco smoking, and incidence trends follow the trends of tobacco consumption, with an approximate 20-year time lag. In turn, mortality trends closely mirror the lung cancer incidence trends, with very little time lag, because survival has been so poor for so long. Lung cancer alone accounts for approximately 5% of all deaths in England and Wales. Screening has not been shown to reduce mortality. Survival from lung cancer has not improved much for decades, and even in European countries with the highest survival, 5-year relative survival remains less than 15% (Berrino et al, 1995b; Sant et al, 2003). The most deprived group has a lung cancer incidence almost double that of the most affluent group, in both men and women (Quinn et al, 2001). Trends in incidence show a decline of approximately 20% since the late 1980s in men, and a plateau in the late 1990s for women: the trends are parallel, affecting all socioeconomic groups about equally (data not shown). The survival analyses reported here relate to 392 000 patients diagnosed with a first, primary, invasive malignancy of the trachea, bronchus or lung in England and Wales during the period 1986–1999, who were followed up to 31 December 2001, some 79% of the 497 000 patients potentially eligible for inclusion. Of these, 1.5% were excluded because their vital status was unknown at 5 November 2002, when the data were extracted for analysis, and a further 16% because their survival was unknown (or zero): most of those were registered solely from a death certificate. A further 16 000 (3.2%) patients were excluded because they previously had cancer in another organ at some time since 1971. Lung cancers assigned to the upper lobe comprised 23% of cases in the late 1980s, rising to 29% by the late 1990s, with a commensurate drop in the proportion with an unspecified lobe of origin, from 54 to 46%, suggesting improvement in the recording of pathology rather than changing patterns of disease. The lower lobe accounted for 12% of cases and the middle lobe 3%, with 8% assigned to the main bronchus. Bronchus and lung cancers predominate: those of the trachea accounted for only 0.3% of cases, unchanged since the 1970s. Approximately 28% were papillary or squamous carcinomas, 13% small cell or oat cell carcinomas and 12% adenocarcinomas, but 40% were poorly specified carcinomas.

Diferencias de género en la evolución del tabaquismo adolescente en España (1986-2002)

This work pursues two objectives: 1) to analyse time trends in tobacco consumption among Spanish schoolchildren aged 11, 13, 15 and 17 for the period 1986-2002; and 2) to study the evolution of gender differences regarding tobacco consumption in each of these age groups throughout this period. On the basis of a research with a sequential cross-sectional design, data were collected in four nation-wide studies (in 1986, 1990, 1994 and 2002), using representative samples of Spanish schoolchildren. The sub-samples used for this paper add up 14,570 subjects (51.2% girls and 48.8% boys). The analysis of temporal trends has been performed separately for each gender, within each age group. Among 11-year-olds, a growing homogeneity between genders concerning tobacco consumption has been proved, with a general trend to a decrease in the problem. Among 13-year-olds, time trends are very similar to 11-year-olds, except for the period 1994-2002, where there has been an increase in the prevalence of smoking among girls. As for the 15 and 17-year-olds, a growing differentiation between genders has been proved, with a marked rising tendency among girls in all aspects studied. Regarding boys of those ages, the situation is relatively stable since 1990. The spreading of this problem among girls will probably strengthen in the future the current trend toward an increase in tobacco consumption among Spanish adult women.