title: Correlation between tobacco control policies, consumption of rolled tobacco and e-cigarettes, and intention to quit conventional tobacco, in Europe.
abstract: To analyse the correlation between the implementation of tobacco control policies and tobacco consumption, particularly rolling tobacco, electronic cigarettes (e-cigarettes) users and the intent to quit smoking in 27 countries of the European Union.
  
  
  
  Ecological study with the country as the unit of analysis.
  
  
  
  We used the data from tobacco control activities, measured by the Tobacco Control Scale (TCS), in 27 European countries, in 2010, and the prevalence of tobacco consumption data from the Eurobarometer of 2012.
  
  
  
  Spearman correlation coefficients (rsp) and their 95% CIs.
  
  
  
  There was a negative correlation between TCS and prevalence of smoking (rsp=-0.41; 95% CI -0.67 to -0.07). We also found a negative correlation (rsp=-0.31) between TCS and the prevalence of ever e-cigarette users, but it was not statistically significant. Among former cigarette smokers, there was a positive and statistically significant correlation between TCS and the consumption of hand-rolled tobacco (rsp=0.46; 95% CI 0.06 to 0.70). We observed a similar correlation between TCS and other tobacco products (cigars and pipe) among former cigarette smokers. There was a significant positive correlation between TCS and intent to quit smoking in the past 12 months (rsp=0.66; 95% CI 0.36 to 0.87).
  
  
  
  The level of smoke-free legislation among European countries is correlated with a decrease in the prevalence of smoking of conventional cigarettes and an increase in the intent to quit smoking within the past 12 months. However, the consumption of other tobacco products, particularly hand-rolled tobacco, is positively correlated with TCS among former cigarette smokers. Therefore, tobacco control policies should also consider other tobacco products, such as rolling tobacco, cigars and pipes.
authors.affiliation: Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Lidón-Moyano
authors.affiliation: Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Martín-Sánchez
authors.affiliation: Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
authors.forename: Patrick
authors.initials: P
authors.lastname: Saliba
authors.affiliation: Department of Statistics and Operations Research, Universitat Politècnica de Catalunya, Barcelona, Spain.
authors.forename: Jan
authors.initials: J
authors.lastname: Graffelman
authors.affiliation: Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.|Tobacco Control Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Barcelona, Spain.|Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Martínez-Sánchez
mesh_terms: D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005062:European Union; D006801:Humans; D033182:Intention; D015995:Prevalence; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000523:psychology*; D000074606:Smoking Prevention / Q000331:legislation & jurisprudence*; D018709:Statistics, Nonparametric; D062789:Tobacco Products / Q000706:statistics & numerical data
keywords: Electronic nicotine delivery devices; Hand-rolled/RYO tobacco; Public policy