Dataset Information

Study protocol of the German Study on Tobacco Use (DEBRA): a national household survey of smoking behaviour and cessation.

ABSTRACT:

Background

The prevalence of tobacco smoking in Germany is high (~27%). Monitoring of national patterns of smoking behaviour and data on the "real-world" effectiveness of cessation methods are needed to inform policies and develop campaigns aimed at reducing tobacco-related harm. In England, the Smoking Toolkit Study (STS) has been tracking such indicators since 2006, resulting in the adaptation of tobacco control policies. However, findings cannot be directly transferred into the German health policy context. The German Study on Tobacco Use (DEBRA: "Deutsche Befragung zum Rauchverhalten") aims to provide such nationally representative data.

Methods/design

In June 2016, the study started collecting data from computer-assisted, face-to-face household interviews in people aged 14 years and older. Over a period of 3 years, a total of ~36,000 respondents will complete the survey with a new sample of ~2000 respondents every 2 months (=18 waves). This sample will report data on demographics and the use of tobacco and electronic (e-)cigarettes. Per wave, about 500-600 people are expected to be current or recent ex-smokers (<12 months since quitting). This sample will answer detailed questions about smoking behaviour, quit attempts, exposure to health professionals' advice on quitting, and use of cessation aids. Six-month follow-up data will be collected by telephone.

Discussion

The DEBRA study will be an important source of data for tobacco control policies, health strategies, and future research. The methodology is closely aligned to the STS, which will allow comparisons with data from England, a country with one of the lowest smoking prevalence rates in Europe (18%).

Trial registration

This study has been registered at the German Clinical Trials Register ( DRKS00011322 ) on 25th November 2016.

SUBMITTER: Kastaun S

PROVIDER: S-EPMC5414339 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Study protocol of the German Study on Tobacco Use (DEBRA): a national household survey of smoking behaviour and cessation.

Kastaun Sabrina S Brown Jamie J Brose Leonie S LS Ratschen Elena E Raupach Tobias T Nowak Dennis D Cholmakow-Bodechtel Constanze C Shahab Lion L West Robert R Kotz Daniel D

BMC public health 20170502 1

<h4>Background</h4>The prevalence of tobacco smoking in Germany is high (~27%). Monitoring of national patterns of smoking behaviour and data on the "real-world" effectiveness of cessation methods are needed to inform policies and develop campaigns aimed at reducing tobacco-related harm. In England, the Smoking Toolkit Study (STS) has been tracking such indicators since 2006, resulting in the adaptation of tobacco control policies. However, findings cannot be directly transferred into the German ...[more]

PMID: 28464934

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Project description:BACKGROUND: Several studies have investigated attitudes to and compliance with smoking bans, but few have been conducted in healthcare settings and none in such a setting in Portugal. Portugal is of particular interest because the current ban is not in line with World Health Organization recommendations for a "100% smoke-free" policy. In November 2007, a Portuguese teaching-hospital surveyed smoking behaviour and tobacco control (TC) attitudes before the national ban came into force in January 2008. METHODS: Questionnaire-based cross-sectional study, including all eligible staff. SAMPLE: 52.9% of the 1, 112 staff; mean age 38.3 ± 9.9 years; 65.9% females. Smoking behaviour and TC attitudes and beliefs were the main outcomes. Bivariable analyses were conducted using chi-squared and MacNemar tests to compare categorical variables and Mann-Whitney tests to compare medians. Multilogistic regression (MLR) was performed to identify factors associated with smoking status and TC attitudes. RESULTS: Smoking prevalence was 40.5% (95% CI: 33.6-47.4) in males, 23.5% (95% CI: 19.2-27.8) in females (p < 0.001); 43.2% in auxiliaries, 26.1% in nurses, 18.9% among physicians, and 34.7% among other non-health professionals (p = 0.024). The findings showed a very high level of agreement with smoking bans, even among smokers, despite the fact that 70.3% of the smokers smoked on the premises and 76% of staff reported being frequently exposed to second-hand smoke (SHS). In addition 42.8% reported that SHS was unpleasant and 28.3% admitted complaining. MLR showed that smoking behaviour was the most important predictor of TC attitudes. CONCLUSIONS: Smoking prevalence was high, especially among the lower socio-economic groups. The findings showed a very high level of support for smoking bans, despite the pro-smoking environment. Most staff reported passive behaviour, despite high SHS exposure. This and the high smoking prevalence may contribute to low compliance with the ban and low participation on smoking cessation activities. Smoking behaviour had greater influence in TC attitudes than health professionals' education. Our study is the first in Portugal to identify potential predictors of non-compliance with the partial smoking ban, further emphasising the need for a 100% smoke-free policy, effective enforcement and public health education to ensure compliance and promote social norm change.

Project description:OBJECTIVE:The aim of this study was to assess public acceptance of four possible healthcare policies supporting tobacco dependence treatment in line with the Framework Convention for Tobacco Control, Article 14 recommendations in Germany. DESIGN:Cross-sectional household survey. SETTING:Data were drawn from the German population and collected through computer-assisted, face-to-face interviews. PARTICIPANTS:Representative random sample of 2087 people (>14 years) from the German population. OUTCOME MEASURES:Public acceptance was measured regarding (1) treatment cost reimbursement, (2) standard training for health professionals on offering cessation treatment, and making cessation treatment a standard part of care for smokers with (3) physical or (4) mental disorders. Association characteristics with smoking status and socio-economic status (SES) were assessed. RESULTS:Support for all policies was high (50%-68%), even among smokers (48%-66%). Ex-smokers and never-smokers were more likely to support standard training on cessation for health professionals than current smokers (OR 1.43, 95%?CI 1.07 to 1.92; OR 1.43; 95%?CI 1.14 to 1.79, respectively). Ex-smokers were also more likely than current smokers to support cessation treatment for smokers with mental disorders (OR 1.39, 95%?CI 1.11 to 1.73). Men were less likely than women to support cessation treatment for smokers with physical diseases (OR 0.74, 95%?CI 0.60 to 0.91) and free provision of treatment (OR 0.80, 95%?CI 0.66 to 0.97). Offering cessation treatment to smokers with physical disorders was generally more accepted than to those with mental health issues. CONCLUSIONS:The majority of the German population supports healthcare policies to improve the availability and affordability of tobacco dependence treatment. Non-smokers were more supportive than current smokers of two of the four policies, but odds of support were only about 40% higher. SES characteristics were not consistently associated with public acceptance. TRIAL REGISTRATION NUMBER:DRKS00011322.

Dataset Information

Study protocol of the German Study on Tobacco Use (DEBRA): a national household survey of smoking behaviour and cessation.

Background

Methods/design

Discussion

Trial registration

Publications

Study protocol of the German Study on Tobacco Use (DEBRA): a national household survey of smoking behaviour and cessation.

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