title: Prevalence and determinants of current and secondhand smoking in Greece: results from the Global Adult Tobacco Survey (GATS) study.
abstract: Greece is one of the leading tobacco-producing countries in European Union, and every year over 19 000 Greeks die from tobacco-attributable diseases. The aim of the present study was to provide nationally representative estimates on current and secondhand smoking prevalence in Greece and their determinants.
  
  
  
  Cross-sectional.
  
  
  
  Greece.
  
  
  
  A total of 4359 individuals participated in the Global Adult Tobacco Survey (GATS), a household survey of adults ≥15 years old (overall response rate 69%). They were selected through a multistage geographically clustered sampling design with face-to-face interview.
  
  
  
  In 2013, we investigated the prevalence of current and secondhand smoking and their determinants. Univariate and logistic regression analysis was used in order to identify possible risk factors associated with the prevalence of current and secondhand smoking.
  
  
  
  The prevalence of current smoking was 38.2% (95% CI 35.7% to 40.8%), and the mean number of cigarettes smoked per day was 19.8. Multivariate analysis confirmed that male gender (OR=3.24; 95% CI 2.62 to 4.00), age groups (25-39, OR=4.49; 95% CI 3.09 to 8.46 and 40-54, OR=3.51; 95% CI 1.88 to 5.87) and high school education (OR=1.97; 95% CI 1.41 to 2.74) were independently associated with the current smoking. Remarkably, responders with primary or less education had the lowest prevalence of current smoking (p<0.001). The prevalence of exposure to secondhand smoke at work, home and restaurants, was 52.3%, 65.7% and 72.2%. In total, 90.0% (95% CI 87.8% to 91.9%) of Greek population is exposed to tobacco smoke (current smoking and secondhand smoke).
  
  
  
  Our results revealed an extremely high prevalence of current smoking and exposure to secondhand smoke among the adult population and a positive gradient between education and current smoking. These findings are alarming and implementation of comprehensive tobacco control and prevention strategies could be impactful in fighting the tobacco epidemic in Greece.
authors.affiliation: Faculty of Medicine, Department of Hygiene and Epidemiology, University of Thessaly, Larissa, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Rachiotis
authors.affiliation: Department of Public and Administrative Health, National School of Public Health, Athens, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Barbouni
authors.affiliation: Faculty of Medicine, Department of Hygiene and Epidemiology, University of Thessaly, Larissa, Greece.
authors.forename: Antonis
authors.initials: A
authors.lastname: Katsioulis
authors.affiliation: Department of Public and Administrative Health, National School of Public Health, Athens, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Antoniadou
authors.affiliation: Faculty of Medicine, Department of Hygiene and Epidemiology, University of Thessaly, Larissa, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kostikas
authors.affiliation: Department of Public and Administrative Health, National School of Public Health, Athens, Greece.
authors.forename: Kyriakoula
authors.initials: K
authors.lastname: Merakou
authors.affiliation: Faculty of Medicine, Department of Hygiene and Epidemiology, University of Thessaly, Larissa, Greece.
authors.forename: Kallirrhoe
authors.initials: K
authors.lastname: Kourea
authors.affiliation: Regional Office for Europe, World Health Organization, Copenhagen, Denmark.
authors.forename: Rula N
authors.initials: RN
authors.lastname: Khoury
authors.affiliation: Regional Office for Europe, World Health Organization, Copenhagen, Denmark.
authors.forename: Agis
authors.initials: A
authors.lastname: Tsouros
authors.affiliation: Department of Public and Administrative Health, National School of Public Health, Athens, Greece.
authors.forename: Jenny
authors.initials: J
authors.lastname: Kremastinou
authors.affiliation: Faculty of Medicine, Department of Hygiene and Epidemiology, University of Thessaly, Larissa, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Hadjichristodoulou
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000073865:Cigarette Smoking / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012147:Restaurants / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution
keywords: GATS; Greece; current smoking; second-hand smoking