Marcela Fu

Institut Català d'Oncologia, Barcino, Catalonia, Spain

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Publications (50)113.84 Total impact

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    ABSTRACT: Spain has passed two smoke-free laws in the last years. In 2005, the law banned smoking in indoor places, and in 2010 the ban was extended to outdoor areas of certain premises such as hospitals. This study assesses the impact of smoking consumption among hospital workers at a comprehensive cancer center after the passage of two national smoke-free laws. Six cross-sectional surveys were conducted among a representative sample of hospital workers at a comprehensive cancer center in Barcelona (2001-2012) using a standardized questionnaire. Logistic regression was used to compare differences in the odds of smoking after the laws took effect (baseline vs. 1st law; 2nd law vs. 1st law). Baseline smoking prevalence was 33.1%. After passage of the 1st and 2nd laws, prevalence decreased, respectively, to 30.5% and 22.2% (p for trend =0.005). Prevalence ratios (PR) indicated a significant decrease in overall smoking after the 2nd law (PR = 0.65, 95% CI = 0.47-0-89). Smoking dropped in all professional groups, more prominently among those >=35 years old, doctors, and women. Observed trends over the time included an increase in occasional smokers, a rise in abstinence during working hours but an increase in smoking dependence, and an increase in the employees' overall support for the smoke-free hospital project. A long-term tobacco control project combined with two smoke-free national laws reduced smoking rates among health workers and increased their support for tobacco control policies. The decrease was more significant after the passage of the outdoor smoke-free ban.
    BMC Public Health 11/2014; 14(1):1228. · 2.08 Impact Factor
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    ABSTRACT: There is scarce evidence about passive exposure to the vapour released or exhaled from electronic cigarettes (e-cigarettes) under real conditions. The aim of this study is to characterise passive exposure to nicotine from e-cigarettes׳ vapour and conventional cigarettes׳ smoke at home among non-smokers under real-use conditions.
    Environmental research. 09/2014; 135C:76-80.
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    ABSTRACT: Mental health units have usually been exempted from complete smoke-free policies. The aim of this study was to compare the self-reported level of exposure to secondhand smoke (SHS) of patients and staff in psychiatric units to objective measures, and examine preference for different types of smoking bans.
    Tobacco control. 09/2014;
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    ABSTRACT: We assessed and characterized the relationship among biomarkers of secondhand smoke (SHS) exposure in non-smokers according to their exposure at home as measured by airborne markers.
    Environmental research. 06/2014; 133C:111-116.
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    ABSTRACT: The aim was to assess the validity of self-reported exposure to second-hand smoke (SHS) in 50 hospitality venues of Madrid (Spain) in 2010, taking as a reference vapour-phase nicotine measured by active sampling. The questions posed in the questionnaire permitted distinguishing between the different levels of SHS. However, the moderate relationship found (Spearman׳s correlation=0.387, p<0.001) suggests that intensity of exposure to SHS in hospitality venues, based solely on self-reported information, should be used with caution.
    Environmental research. 06/2014; 133C:1-3.
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    ABSTRACT: Objetivo Describir la prevalencia y asociaciones del uso del cinturón de seguridad y teléfono móvil en vehículos en la ciudad de Barcelona. Métodos Se realizó un estudio transversal mediante observación directa de los vehículos de la ciudad de Barcelona (n = 2.442 vehículos privados, comerciales y taxis). Resultados La prevalencia del no uso del cinturón de seguridad fue del 10,5% entre los conductores, 4,6% entre los co-pilotos y 32,2% entre algunos de los pasajeros de los asientos traseros. La prevalencia fue superior en los pasajeros que en los conductores, independientemente del tipo de vehículo. La prevalencia del uso del móvil mientras se conducía en un momento del viaje en todos los vehículos fue de 3,8%. Conclusión La prevalencia del no uso del cinturón de seguridad en los asientos traseros fue notablemente alta. Además, cuatro de cada 100 conductores todavía utilizan el móvil mientras conducen en un momento del viaje.
    Gaceta Sanitaria 01/2014; · 1.12 Impact Factor
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    ABSTRACT: Currently, there is an intensive debate about the regulation of the use of electronic cigarettes (e-cigarettes) in indoor places. The aim of this study was to assess the attitudes toward e-cigarette use in indoor workplaces and selected public and private venues among the general population in Barcelona (Spain) in 2013-2014. This is a cross-sectional study of a representative sample of the population of Barcelona (n = 736). The field work was conducted between May 2013 and February 2014. We computed the prevalence and the adjusted odds ratios (OR) derived from multivariable logistic regression models. The awareness of e-cigarettes was 82.3%. Forty five percent of respondents did not agree with the use of e-cigarettes in public places and 52.3% in workplaces. The proportion of disapproval of the use of e-cigarettes in indoor places was higher at 71.5% for schools and 65.8% for hospitals and health care centers; while the prevalence of disapproval of e-cigarette use in homes and cars was lower (18.0% and 32.5%, respectively). Respondents who disagreed on the use of e-cigarettes in indoor workplaces were more likely to be older (OR = 1.64 and 1.97 for groups 45-64 and ≧65 years old, respectively), those with a high educational level (OR = 1.60), and never and former smokers (OR = 2.34 and 2.16, respectively). Increased scores in the Fagerström test for cigarette dependence were also related to increased support for their use. Based on this population based study, half of the general population of Barcelona does not support the use of e-cigarettes in indoor workplaces and public places, with the percentage reaching 65% for use in schools, hospitals and health care centers. Consequently, there is good societal support in Spain for the politicians and legislators to promote policies restricting e-cigarettes use in workplaces and public places, including hospitality venues.
    PLoS ONE 01/2014; 9(12):e114256. · 3.53 Impact Factor
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    ABSTRACT: The aim was to assess the validity of self-reported exposure to second-hand smoke (SHS) in 50 hospitality venues of Madrid (Spain) in 2010, taking as a reference vapour-phase nicotine measured by active sampling. The questions posed in the questionnaire permitted distinguishing between the different levels of SHS. However, the moderate relationship found (Spearman׳s correlation=0.387, p<0.001) suggests that intensity of exposure to SHS in hospitality venues, based solely on self-reported information, should be used with caution.
    Environmental Research. 01/2014; 133:1–3.
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    ABSTRACT: This study seeks to analyse the prevalence and correlates of electronic cigarette (e-cigarette) use, purchase location and satisfaction with its use in a sample of the general population of the city of Barcelona, Spain.
    BMJ Open 01/2014; 4(8):e005894. · 2.06 Impact Factor
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    ABSTRACT: In 2006, Spain implemented a national smoke-free legislation that prohibited smoking in enclosed public places and workplaces (except in hospitality venues). In 2011, it was extended to all hospitality venues and selected outdoor areas (hospital campuses, educational centers, and playgrounds). The objective of the study is to evaluate changes in exposure to secondhand smoke among the adult non-smoking population before the first law (2004-05) and after the second law (2011-12). Repeated cross-sectional survey (2004-2005 and 2011-2012) of a representative sample of the adult (≥16 years) non-smoking population in Barcelona, Spain. We assess self-reported exposure to secondhand smoke (at home, the workplace, during leisure time, and in public/private transportation vehicles) and salivary cotinine concentration. Overall, the self-reported exposure to secondhand smoke fell from 75.7% (95%CI: 72.6 to 78.8) in 2004-05 to 56.7% (95%CI: 53.4 to 60.0) in 2011-12. Self-reported exposure decreased from 32.5% to 27.6% (-15.1%, p<0.05) in the home, from 42.9% to 37.5% (-12.6%, p = 0.11) at work/education venues, from 61.3% to 38.9% (-36.5%, p<0.001) during leisure time, and from 12.3% to 3.7% (-69.9%, p<0.001) in public transportation vehicles. Overall, the geometric mean of the salivary cotinine concentration in adult non-smokers fell by 87.2%, from 0.93 ng/mL at baseline to 0.12 ng/mL after legislation (p<0.001). Secondhand smoke exposure among non-smokers, assessed both by self-reported exposure and salivary cotinine concentration, decreased after the implementation of a stepwise, comprehensive smoke-free legislation. There was a high reduction in secondhand smoke exposure during leisure time and no displacement of secondhand smoke exposure at home.
    PLoS ONE 01/2014; 9(2):e89430. · 3.53 Impact Factor
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    ABSTRACT: Objective We assessed and characterized the relationship among biomarkers of secondhand smoke (SHS) exposure in non-smokers according to their exposure at home as measured by airborne markers. Methods We conducted an observational study on exposure to SHS at home using airborne markers (nicotine and benzene) and biomarkers from the non-smokers living in these homes. We selected 49 non-smoking volunteers from different homes: 25 non-smokers living with at least one smoker and 24 non-smokers living in smoke-free homes. We installed two passive devices to measure nicotine and benzene concentrations in the main room of the house (i.e., the living room). One week later, the researcher returned to the volunteer׳s home to collect the two devices, obtain saliva and urine samples, and administer a SHS questionnaire. Results Salivary and urinary cotinine concentrations highly correlated with air nicotine concentrations measured at the volunteers׳ homes (rsp=0.738 and rsp=0.679, respectively). The concentrations of airborne markers of SHS and biomarkers in non-smokers increased with increasing self-reported intensity and duration of SHS exposure at home during the previous week (p<0.05). The multivariable regression model showed a significant association with nicotine in air at home (β=0.126, p=0.002 for saliva and β=0.115, p=0.010 for urine). Conclusions Our findings suggest that, even in countries with comprehensive smoke-free legislation, exposure to SHS at home continues to be the main source of exposure for non-smokers who live in non-smoke-free homes. Therefore, public health policies should promote smoke-free homes.
    Environmental Research. 01/2014; 133:111–116.
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    ABSTRACT: The aim of this study was to assess the relationship between particulate matter of diameter≤2.5µm (PM2.5) and airborne nicotine concentration as markers of second-hand smoke exposure with respect to the setting studied, the intensity of exposure, and the type of environment studied (indoors or outdoors). Data are derived from two independent studies that simultaneously measured PM2.5 and nicotine concentrations in the air as airborne markers of second-hand smoke exposure in public places and workplaces, including health care centres, bars, public administration offices, educational centres, and transportation. We obtained 213 simultaneous measures of airborne nicotine and PM2.5. Nicotine in the air was measured with active samplers containing a sodium bisulphate-treated filter that was analysed by gas chromatography/mass spectrometry. PM2.5 was measured with a SidePak AM510 Personal Aerosol Monitor. We calculated Spearman's rank correlation coefficient and its 95% confidence intervals (95% CI) between both measures for overall data and stratified by setting, type of environment (indoors/outdoors), and intensity of second-hand smoke exposure (low/high, according to the global median nicotine concentration). We also fitted generalized regression models to further explore these relationships. The median airborne nicotine concentration was 1.36µg/m(3), and the median PM2.5 concentration was 32.13µg/m(3). The overall correlation between both markers was high (Spearman's rank correlation coefficient=0.709; 95% CI: 0.635-0.770). Correlations were higher indoors (Spearman's rank correlation coefficient=0.739; 95% CI: 0.666-0.798) and in environments with high second-hand smoke exposure (Spearman's rank correlation coefficient=0.733; 95% CI: 0.631-0.810). The multivariate analysis adjusted for type of environment and intensity of second-hand smoke exposure confirmed a strong relationship (7.1% increase in geometric mean PM2.5 concentration per µg/m(3) nicotine concentration), but only in indoor environments in a stratified analysis (6.7% increase; 95% CI: 4.3-9.1%). Although the overall correlation between airborne nicotine and PM2.5 is high, there is some variability regarding the type of environment and the intensity of second-hand smoke exposure. In the absence of other sources of combustion, air nicotine and PM2.5 measures can be used indoors, while PM2.5 should be used outdoors with caution.
    Environmental Research 10/2013; · 3.24 Impact Factor
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    European Journal of Epidemiology 08/2013; · 5.12 Impact Factor
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    ABSTRACT: OBJECTIVE: To evaluate the correlation between the implementation of tobacco control policies, particularly smoke-free bans at work and in public places, and smoking prevalence in private venues in the 27 countries of the European Union. DESIGN: Ecological study with the country as the unit of analysis. DATA SOURCES: Data analysis of tobacco control activities in European countries in 2007 as compiled in the Tobacco Control Scale (TCS) and information on the level of smoking permissiveness in houses and cars from the Special Eurobarometer on Tobacco conducted in 2009. ANALYSIS: Spearman rank-correlation coefficients (rsp) and their 95% confidence intervals (CIs) were calculated. RESULTS: The correlation between the TCS score and the prevalence of smoking in private venues (houses and cars) where smoking inside was always allowed was close to zero. A similar lack of association was observed between the TCS score of specific bans at work and in public places and smoking rules inside houses and cars. There was a non-significant direct correlation between the TCS score and the prevalence of smoke-free houses (rsp=0.21, 95% CI -0.19 to 0.55) and a non-significant inverse correlation with smoking allowed in certain rooms inside the house (rsp=-0.34; 95% CI -0.64 to 0.05). CONCLUSIONS: Smoke-free legislation in workplaces and public places is not correlated with increased smoking prevalence in private venues (houses and cars) at an ecological level.
    Tobacco control 04/2013; · 3.85 Impact Factor
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    ABSTRACT: The objective of this work was to study the feasibility of following up a representative sample of the adult population of Barcelona 8 years after the baseline study. We selected a random sample (n = 100) of the 1161 participants who consented to be re-contacted. We contacted 66 participants: 52 (78.8%) agreed to participate in the follow-up, three (4.5%) had died, four (6.1%) had moved, and seven (10.6%) declined to participate in the follow-up. The participation rate in the feasibility study was 52%. In conclusion, the results of our study show a good feasibility of conducting a follow-up study 8 years after the baseline study.
    Gaceta Sanitaria 01/2013; 27(5):463–465. · 1.12 Impact Factor
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    ABSTRACT: Objectives To assess the variability in the number of cigarettes smoked per person per day in Spain according to the information source (health surveys versus legal sales).Methods We compared cigarette consumption per person per day (population aged ≥16 years) obtained from the national health surveys in Spain and the official data on legal tobacco sales between 1993 and 2009.ResultsCigarette consumption per person per day decreased between 1993 and 2009. Over the entire period, the number of cigarettes smoked per person per day according to legal sales exceeded that reported by national health surveys (up to 46.9%).Conclusion The difference in data on the number of cigarettes smoked between national health surveys and legal sales has increased in the last few years in Spain.
    Gaceta Sanitaria 01/2013; 27(1):61–63. · 1.12 Impact Factor
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    ABSTRACT: The objective of this work was to study the feasibility of following up a representative sample of the adult population of Barcelona 8 years after the baseline study. We selected a random sample (n=100) of the 1161 participants who consented to be re-contacted. We contacted 66 participants: 52 (78.8%) agreed to participate in the follow-up, three (4.5%) had died, four (6.1%) had moved, and seven (10.6%) declined to participate in the follow-up. The participation rate in the feasibility study was 52%. In conclusion, the results of our study show a good feasibility of conducting a follow-up study 8 years after the baseline study.
    Gaceta Sanitaria 11/2012; · 1.12 Impact Factor
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    ABSTRACT: INTRODUCTION: The Spanish tobacco control law of 2006 was modified in January 2011, banning smoking in all hospitality venues. The objective of the study was to assess the impact of the 2011 Spanish smoking ban on secondhand smoke (SHS) exposure in hospitality venues, and to analyze the potential impact of outdoor smokers close to entrances on indoor SHS levels after the law came into force. METHODS: Before-and-after evaluation study with repeated measures. The study was carried out in three regions of Spain (Catalonia, Galicia, and Madrid) and included a random sample of 178 hospitality venues. We measured vapor-phase nicotine and particulate matter 2.5 micrometers or less in diameter (PM2.5) as SHS markers at baseline (November-December 2010) and at follow-up (April-June 2011). We also recorded tobacco consumption variables such as the presence of butts, ashtrays, and smokers. In the posttest assessment, we also recorded the number of outdoor smokers close to the entrance. RESULTS: A total of 351 nicotine and 160 PM2.5 measurements were taken. Both nicotine and PM2.5 concentrations decreased by more than 90% (nicotine from 5.73 to 0.57 µg/m(3), PM2.5 from 233.38 to 18.82 µg/m(3)). After the law came into force, both nicotine and PM2.5 concentrations were significantly higher in venues with outdoor smokers close to the entrance than in those without outdoor smokers. All the observational tobacco consumption variables significantly decreased (p < .001).Conclusions:SHS exposure in hospitality venues dramatically decreased after the 2011 Spanish smoking ban. SHS from outdoor smokers close to entrances seems to drift inside venues. Smoking control legislation should consider outdoor restrictions to ensure complete protection against SHS.
    Nicotine & Tobacco Research 10/2012; · 2.48 Impact Factor
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    ABSTRACT: BACKGROUND: Numerous studies have assessed second-hand smoke (SHS) exposure but a gold standard remains to be established. This study aimed to review how SHS exposure has been assessed in adults in questionnaire-based epidemiological studies. METHODS: A literature search of original papers in English, French, Italian or Spanish published from January 2000 to May 2011 was performed using PubMed. The variables recorded for each study included target population, sample size, validation of the SHS questions, study design and phrasing of every question used to assess SHS exposure. For each item, information such as the setting where exposure was assessed or the indicator used to ascertain SHS exposure was extracted. RESULTS: We retrieved 977 articles, of which 335 matched the inclusion criteria. The main objective of 75.8% of the studies was to assess SHS exposure.The proportion of validated questions aiming to ascertain SHS exposure was 17.9%. Most studies collected data only for one (40.3%) or two settings (33.4%), most frequently the home (83.9%) and workplace (57%). The most commonly used indicator to ascertain exposure was the presence of smokers and 68.9% of the studies included an item to assess the intensity of SHS exposure. CONCLUSIONS: The variability in the indicators and items used to ascertain SHS exposure is very high, whereas the use of items derived from validated studies remains low. Identifying the diverse settings where SHS exposure may occur is essential to accurately assess exposure over time. A standard set of items to identify SHS exposure in distinct settings is needed.
    The European Journal of Public Health 06/2012; · 2.52 Impact Factor
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    ABSTRACT: The objective of this study is to describe the differences in the exposure to secondhand smoke (SHS) at home and at leisure time according to the day of the week (working and non-working day) which exposure occurs in Barcelona. We carried out a cross-sectional study of a representative sample of adult (>16 years) non-smokers in Barcelona before the Spanish smoking law came into effect (years 2004-2005). We studied the prevalence of exposure to SHS at home and leisure time by means of a questionnaire and a biomarker (salivary cotinine). The questionnaire included questions on exposure to SHS on working days and nonworking days. The prevalence of exposure to SHS at home was 27.4% (6.8% exposed only on working days, 5.7% exposed only on non-working days, and 14.9% exposed on both working and non-working days). The prevalence of exposure to SHS at leisure time was 61.3% (10.7% exposed only on working days, 13.6% exposed only on non-working days, and 37.0% exposed on both working and non-working days). The exposure to SHS only on non-working days at leisure time decreases with age (χ(2) of trend = 183.7; p<0.001) and increases with the educational level (χ(2) of trend = 78.8; p<0.001). Participants who had reported to be exposed to SHS at home on working and non-working days showed higher levels of salivary cotinine concentration, regardless of sex, age group, and educational level. In conclusion, the exposure to SHS occurs mainly during leisure time. Questions on SHS exposure according to working and non-working days allow to characterizing the exposure to SHS, especially when the exposure occurs at leisure time.
    Adicciones 01/2012; 24(2):173-7. · 1.02 Impact Factor

Publication Stats

270 Citations
113.84 Total Impact Points

Institutions

  • 2008–2014
    • Institut Català d'Oncologia
      Barcino, Catalonia, Spain
  • 2012
    • University of Santiago de Compostela
      Santiago, Galicia, Spain
  • 2009–2012
    • Catalan Institute of Oncology
      Badalona, Catalonia, Spain
    • Agència de Salut Pública de Barcelona
      Barcino, Catalonia, Spain