Tackling secondhand tobacco smoke and e-cigarette emissions in Europe

INTERVENTIONTackling secondhand tobacco smoke and e-cigarette emissions in Europe
Tackling secondhand tobacco smoke and e-cigarette emissions in Europe


Tackling secondhand tobacco smoke and e-cigarette emissions: exposure assessment, novel interventions, impact on lung diseases and economic burden in diverse European populations – The TackSHS Project

Background

Exposure to secondhand tobacco smoke (SHS) has been classified as a “Group  1 carcinogen (known human carcinogen) by the International Agency for Research on cancer (IARC) and has been shown to have adverse health effects on adults and children, including heart disease and respiratory disorders. Electronic cigarettes (e-cigarettes), the most common “electronic nicotine delivery system”, have irrupted in the past 5 years with sales volumes increasing considerably across the EU.

Main objective

The TackSHS Project will try to elucidate the comprehensive impact that SHS and e-cigarettes emissions have on the respiratory health of the European population and how health impacts vary according to socio-economic parameters with particular emphasis on specific vulnerable groups (patients suffering from pre-existing chronic lung diseases, heavy smokers, and other disadvantaged groups).

Methodology

By means of an integrated series of workpackages, we will investigate the determinants of SHS exposure, both assessed at the individual level and in the environment (pan-European survey and SHS assessment in 12 countries), the overall burden of disease caused (lung diseases and cardiovascular diseases), including the specific respiratory health changes in patients and healthy people, the economic impact of both mortality and morbidity caused by these exposures, the methods to characterize these exposures and novel interventions to reduce them. This comprehensive, integrated approach will enable significant step-change beyond the current state-of-the-art in understanding SHS and e- cigarette emission exposure. The participating partners have been at the forefront of cutting edge research in this discipline, with some collaboration between them in specific projects. The TackSHS Project will put together for the first time all these first-line research teams, and the conjunction of the WPs will result in a step forward to tackle exposure to secondhand tobacco smoke and e-cigarettes emissions.

Workpackages

WP1. Coordination and management (WP Leader: ICO)

WP2. Environmental assessment of SHS exposure in private settings and outdoor settings according to country-specific smoke-free policies and socioeconomic characteristics (WP Leader: ASPB)

WP3. Survey on secondhand smoke and electronic cigarettes  (WP Leader: IRFMN)

WP4 – Measuring for change: air quality feedback to reduce SHS exposure in the home and car (WP Leader: UNIABERD)

WP5.  Exposure to secondhand smoke and acute health effects in patients with chronic lung disease (WP Leader: TFRI)

WP6. Clinical impact of passive exposure to e-cigarettes emissions on the respiratory system (WP Leader: HCS)

WP7 Secondhand tobacco smoke in experimental and real-life conditions: comparison of methods of measurement.  (WP Leader: INT)

WP8. Secondhand exposure to emissions from electronic cigarettes: personal and environmental assessment in confined spaces (WP Leader: ICO)

WP 9. Attributable mortality and morbidity to secondhand smoke in Europe  (WP Leader: ISPO)

WP10. Economic impact of secondhand tobacco smoke on morbidity and mortality and Return on Investment of interventions (UPCT)

WP11.  Dissemination of project findings (ENSP)

Duration

48 months: from 11/2015 to 11/2019

Funding

Grant No. 681040. European Union’s Horizon 2020 research and innovation programme (€ 2,987,793)

Principal investigator and coordinating center

Dr. Esteve Fernández, Catalan Institute of Oncology/IDIBELL

Partners

TackSHS KoM terrace

 

 

Participant No. & name of researcher Participant organisation name (short name) Country
1 Esteve Fernández Catalan Institute of Oncology (ICO) Spain
2 Maria J. López Public Health Agency of Barcelona (ASPB) Spain
3 Silvano Gallus Istituto di Ricerche Farmacologiche Mario Negri (IRFMN) Italy
4 Sean Semple University of Aberdeen (UNIABDN) Scotland, UK
5 Luke Clancy TobaccoFree Research Institute Ireland (TFRI) Ireland
6 Panagiotis Behrakis Hellenic Cancer Society (HCS) Greece
7 Roberto Boffi Fondazione IRCCS Istituto Nazionale dei Tumori (INT) Italy
8 Giuseppe Gorini Institute for Oncological Prevention (ISPO) Italy
9 Angel López-Nicolás Technical University of Cartagena (UPCT) Spain
10 Cornel Radu-Loghin European Network for Smoking/Tobacco Prevention (ENSP) Belgium
11 Joan B Soriano Instituto de Inv.Hospital Universitario de la Princesa (IISP) Spain

Web: www.tackshs.eu

Twitter: @TackSHSProject

Results

Key messages and recommendations

Videos

Second-hand smoke exposure in outdoor areas

Second-hand smoke exposure in indoor areas

Final Conference Summary

Infographics

How is the exposure to secondhand smoke in outdoor and private settings in Europe?

Publications

  1. Stival C, Lugo A, Odone A, van den Brandt PA, Fernandez E, Tigova O, Soriano JB, López MJ, Scaglioni S, Gallus S; TackSHS Project Investigators. Prevalence and correlates of overweight and obesity in 12 European Countries in 2017-2018. Obes Facts. 2022 Aug 2. doi: 10.1159/000525792.
  2. Gallus S, Lugo A, Stival C, Cerrai S, Clancy L, Filippidis FT, Gorini G, Lopez MJ, López-Nicolás Á, Molinaro S, Odone A, Soriano JB, Tigova O, VAN DEN Brandt PA, Vardavas CI, Fernandez E; TackSHS Project Investigators. Electronic cigarette use in 12 European countries. Results from the TackSHS survey. J Epidemiol. 2021 Nov 13. doi: 10.2188/jea.JE20210329.
  3. Nogueira SO, Fu M, Lugo A, Tigova O, Henderson E, López MJ, Clancy L, Semple S, Soriano JB, Fernandez E, Gallus S; TackSHS Project Investigators. Non- smokers’ and smokers’ support for smoke-free legislation in 14 indoor and outdoor settings across 12 European countries. Environ Res. 2022 Mar;204(Pt C):112224. doi: 10.1016/j.envres.2021.112224.
  4. Henderson E, Continente X, Fernández E, Tigova O, Cortés-Francisco N, Gallus S, Lugo A, Semple S, Dobson R, Clancy L, Keogan S, Ruprecht A, Borgini A, Tzortzi A, Vyzikidou VK, Gorini G, López-Nicolás A, Soriano JB, Geshanova G, Osman J, Mons U, Przewozniak K, Precioso J, Brad R, López MJ; TackSHS project Investigators. Secondhand smoke exposure assessment in outdoor hospitality venues across 11 European countries. Environ Res. 2021 Sep;200:111355. doi: 10.1016/j.envres.2021.111355.
  5. Amalia B, Fu M, Tigova O, Ballbè M, Castellano Y, Semple S, Clancy L, Vardavas C, López MJ, Cortés N, Pérez-Ortuño R, Pascual JA, Fernández E. Environmental and individual exposure to secondhand aerosol of electronic cigarettes in confined spaces: Results from the TackSHS Project†. Indoor Air. 2021 Sep;31(5):1601-1613. doi: 10.1111/ina.12841.
  6. Borgini A, Veronese C, De Marco C, Boffi R, Tittarelli A, Bertoldi M, Fernández E, Tigova O, Gallus S, Lugo A, Gorini G, Carreras G, López MJ, Continente X, Semple S, Dobson R, Clancy L, Keogan S, Tzortzi A, Vardavas C, Nicolás ÁL, Starchenko P, Soriano JB, Ruprecht AA; TackSHS Project Investigators. Particulate matter in aerosols produced by two last generation electronic cigarettes: a comparison in a real-world environment. Pulmonology. 2021 Apr 17:S2531-0437(21)00079-9. doi: 10.1016/j.pulmoe.2021.03.005.
  7. TackSHS Project Investigators, Henderson E, Lugo A, Liu X, Continente X, Fernández E, López MJ, Gallus S. Secondhand smoke presence in outdoor areas in 12 European countries. Environ Res. 2021 Apr;195:110806. doi: 10.1016/j.envres.2021.110806. Erratum in: Environ Res. 2021 Aug;199:111337. PMID: 33515582.
  8. Gallus S, Lugo A, Liu X, Borroni E, Clancy L, Gorini G, Lopez MJ, Odone A, Przewozniak K, Tigova O, van den Brandt PA, Vardavas C, Fernandez E; TackSHS Project Investigators. Use and Awareness of Heated Tobacco Products in Europe. J Epidemiol. 2022 Mar 5;32(3):139-144. doi: 10.2188/jea.JE20200248.
  9. Carreras G, Lachi A, Cortini B, Gallus S, López MJ, López-Nicolás Á, Soriano JB, Fernandez E, Tigova O, Gorini G; TackSHS Project Investigators. Burden of disease from second-hand tobacco smoke exposure at home among adults from European Union countries in 2017: an analysis using a review of recent meta- analyses. Prev Med. 2021 Apr;145:106412. doi: 10.1016/j.ypmed.2020.106412.
  10. Amalia B, Rodríguez A, Henderson E, Fu M, Continente X, Tigova O, Semple S, Clancy L, Gallus S, Fernández E, López MJ; TackSHS Project Investigators. How widespread is electronic cigarette use in outdoor settings? A field check from the TackSHS project in 11 European countries. Environ Res. 2021 Feb;193:110571. doi: 10.1016/j.envres.2020.110571.
  11. Henderson E, Continente X, Fernández E, Tigova O, Cortés-Francisco N, Gallus S, Lugo A, Semple S, O’Donnell R, Clancy L, Keogan S, Ruprecht A, Borgini A, Tzortzi A, Vyzikidou VK, Gorini G, López-Nicolás A, Soriano JB, Geshanova G, Osman J, Mons U, Przewozniak K, Precioso J, Brad R, López MJ; TackSHS project investigators. Secondhand smoke exposure in outdoor children’s playgrounds in 11 European countries. Environ Int. 2021 Apr;149:105775. doi: 10.1016/j.envint.2020.105775.
  12. Carreras G, Lachi A, Cortini B, Gallus S, López MJ, López-Nicolás Á, Lugo A, Pastor MT, Soriano JB, Fernandez E, Gorini G; TackSHS Project Investigators. Burden of disease from exposure to secondhand smoke in children in Europe. Pediatr Res. 2021 Jul;90(1):216-222. doi: 10.1038/s41390-020-01223-6.
  13. Henderson E, Continente X, Fernández E, Tigova O, Cortés-Francisco N, Gallus S, Lugo A, Semple S, O’Donnell R, Clancy L, Keogan S, Ruprecht A, Borgini A, Tzortzi A, Vyzikidou VK, Gorini G, López-Nicolás A, Soriano JB, Geshanova G, Osman J, Mons U, Przewozniak K, Precioso J, Brad R, López MJ; TackSHS project Investigators. Secondhand smoke exposure and other signs of tobacco consumption at outdoor entrances of primary schools in 11 European countries. Sci Total Environ. 2020 Nov 15;743:140743. doi: 10.1016/j.scitotenv.2020.140743.
  14. Keogan S, Alonso T, Sunday S, Tigova O, Fernández E, López MJ, Gallus S, Semple S, Tzortzi A, Boffi R, Gorini G, López-Nicolás Á, Radu-Loghin C, Soriano JB, Clancy L; TackSHS Project Investigators (all listed in Appendix). Lung function changes in patients with chronic obstructive pulmonary disease (COPD) and asthma exposed to secondhand smoke in outdoor areas. J Asthma. 2021 Sep;58(9):1169-1175. doi: 10.1080/02770903.2020.1766062.
  15. Dobson R, O’Donnell R, Tigova O, Fu M, Enríquez M, Fernandez E, Carreras G, Gorini G, Verdi S, Borgini A, Tittarelli A, Veronese C, Ruprecht A, Vyzikidou V, Tzortzi A, Vardavas C, Semple S; TackSHS investigators. Measuring for change: A multi-centre pre-post trial of an air quality feedback intervention to promote smoke-free homes. Environ Int. 2020 Jul;140:105738. doi: 10.1016/j.envint.2020.105738.
  16. Carreras G, Lachi A, Boffi R, Clancy L, Gallus S, Fernández E, López MJ, Soriano JB, López Nicolás Á, Semple S, Behrakis P, Gorini G; TackSHS Project Investigators. Burden of disease from breast cancer attributable to smoking and second-hand smoke exposure in Europe. Int J Cancer. 2020 Nov 1;147(9):2387-2393. doi: 10.1002/ijc.33021.
  17. Gallus S, Lugo A, Liu X, Behrakis P, Boffi R, Bosetti C, Carreras G, Chatenoud L, Clancy L, Continente X, Dobson R, Effertz T, Filippidis FT, Fu M, Geshanova G, Gorini G, Keogan S, Ivanov H, Lopez MJ, Lopez-Nicolas A, Precioso J, Przewozniak K, Radu-Loghin C, Ruprecht A, Semple S, Soriano JB, Starchenko P, Trapero-Bertran M, Tigova O, Tzortzi AS, Vardavas C, Vyzikidou VK, Colombo P, Fernandez E; TackSHS Project Investigators. Who Smokes in Europe? Data From 12 European Countries in the TackSHS Survey (2017-2018). J Epidemiol. 2021 Feb 5;31(2):145-151. doi: 10.2188/jea.JE20190344.
  18. Amalia B, Liu X, Lugo A, Fu M, Odone A, van den Brandt PA, Semple S, Clancy L, Soriano JB, Fernández E, Gallus S; TackSHS Project Investigators. Exposure to secondhand aerosol of electronic cigarettes in indoor settings in 12 European countries: data from the TackSHS survey. Tob Control. 2021 Jan;30(1):49-56. doi: 10.1136/tobaccocontrol-2019-055376.
  19. Tzortzi A, Teloniatis S, Matiampa G, Bakelas G, Tzavara C, Vyzikidou VK, Vardavas C, Behrakis P, Fernandez E; TackSHS Project Investigators. Passive exposure of non-smokers to E-Cigarette aerosols: Sensory irritation, timing and association with volatile organic compounds. Environ Res. 2020 Mar;182:108963. doi: 10.1016/j.envres.2019.108963.
  20. Fernández E, López MJ, Gallus S, Semple S, Clancy L, Behrakis P, Ruprecht A, Gorini G, López-Nicolás Á, Radu-Loghin C, Soriano JB; TackSHS Project Investigators; TackSHS Project Investigators. Tackling second-hand exposure to tobacco smoke and aerosols of electronic cigarettes: the TackSHS project protocol. Gac Sanit. 2020 Jan-Feb;34(1):77-82. doi: 10.1016/j.gaceta.2019.07.002.
  21. Carreras G, Lugo A, Gallus S, Cortini B, Fernández E, López MJ, Soriano JB, López-Nicolás A, Semple S, Gorini G; TackSHS Project Investigators. Burden of disease attributable to second-hand smoke exposure: A systematic review. Prev Med. 2019 Dec;129:105833. doi: 10.1016/j.ypmed.2019.105833.

PhD Theses (completed)

Ruaraidh Dobson. Can air quality feedback be an effective tool to encourage parents and caregivers to “take smoking right outside”? (2019).

Beladenta Amalia. Environmental and bystanders’ exposure to secondhand aerosols of electronic cigarettes in the European population (2021).

Sarah O. Nogueira. Beyond the current tobacco control legislation. Do Europeans support further policies? Attitudes and associated factors (2021).

Elisabet Henderson. Secondhand smoke exposure in outdoor settings in Europe (2021).

Silvano Gallus. The role of electronic cigarettes and heated tobacco products in tobacco control in Italy and Europe (2022).

PhD Theses (in progress)

Chiara Stival. Obesity prevalence trends in Europe.

Olena Tigova. Burden and Prevention of Smoking and Second-hand Smoke Exposure in Private Settings