title: Smoking prevention and cessation programme in cystic fibrosis: integrating an environmental health approach.
abstract: BACKGROUND
  There have been several studies assessing the epidemiology and effects of tobacco smoke in the cystic fibrosis (CF) population, but few address the efforts of smoking cessation interventions. Our objective is to present one tobacco prevention and cessation programme targeting patients with CF in the Mediterranean region of Murcia (Spain).
  
  
  METHODS
  All registered patients in the Regional CF unit (n=105) in 2008 were included in a cross-sectional and prospective uncontrolled study of tobacco use and exposure in CF patients using a baseline and 1-year follow-up. Target population includes both patients and other family members living at home. The study included an initial telephone questionnaire, measurement of lung function, urinary cotinine levels, and several telephone counselling calls and/or personalised smoking cessation services.
  
  
  RESULTS
  Of the 97 contacted patients, 59.8% (n=58) were exposed to environmental tobacco smoke (ETS), 12.4% (n=12) had smoked at one time, and 14.3% (n=8) of patients over the age of 15 actively smoked. The mean age was 31.13 (range: 19-45). Of the non-smokers (n=89), 56.2% reported ETS and 26.9% live with at least one smoker at home. 49.2% had urinary cotinine levels >10 ng/ml. The correlation found between patients' cotinine levels and their reported tobacco exposure was (0.77, p<0.0001). Active smoking by mothers during pregnancy was associated with significantly lower lung function in young CF patients (-0.385, p=0.04). At the 1-year follow-up, 13 individuals made attempts to stop smoking, 6 of which are now ex-smokers (12.5% of all smokers).
  
  
  CONCLUSIONS
  Smoking during pregnancy adversely affects lung function in individuals with CF. Tobacco prevention and cessation programmes are an effective and vital component for CF disease management. The trained professionals in prevention and smoking cessation services could provide patients with adequate follow-up, integrating an environmental health approach into CF patients' healthcare.
authors: Paediatric Environmental Health Speciality Unit, University Hospital Virgen of Arrixaca, Murcia, Spain. ortega@pehsu.org
authors: Juan Antonio
authors: JA
authors: Ortega-García
authors: María Trinidad
authors: MT
authors: López-Fernández
authors: Rayden
authors: R
authors: Llano
authors: María Dolores
authors: MD
authors: Pastor-Vivero
authors: Pedro
authors: P
authors: Mondéjar-López
authors: Miguel Felipe
authors: MF
authors: Sánchez-Sauco
authors: Manuel
authors: M
authors: Sánchez-Solís
mesh_terms: D000328:Adult; D015897:Comorbidity; D003367:Cotinine / Q000652:urine; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis; D019468:Disease Management; D004782:Environmental Health; D005192:Family Health; D005260:Female; D015438:Health Behavior; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology* / Q000503:physiopathology; D000074606:Smoking Prevention; D013030:Spain / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data; D020340:Tobacco Use Cessation; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution; D003367:Cotinine