title: Manufactured and roll-your-own cigarettes: A changing pattern of smoking in Barcelona, Spain.
abstract: The objectives of the present study were to describe smoking prevalence and compare the smoking attributes of adult smokers according to the type of tobacco product consumed.
  
  
  
  Repeated cross-sectional surveys (2004-2005 and 2011-2012) of a representative sample of the adult (≥16 years) population in Barcelona, Spain, were used to assess self-reported tobacco consumption, smoking attributes, and salivary cotinine concentration. The survey conducted in 2004-2005 included information on 1245 subjects and the survey in 2011-2012 on 1307 individuals.
  
  
  
  Smoking prevalence decreased over the study period (from 26.6% to 24.1% in self-reported daily smokers). The prevalence of daily smokers who reported the use of manufactured cigarettes declined from 23.7% in 2004-2005 to 17.3% in 2011-2012. The prevalence of roll-your-own cigarette users increased from 0.4% to 3.7%. According to data obtained in 2011-2012, the proportion of self-reported roll-your-own cigarette users was higher among men (19.8% vs. 9.5% of women), participants aged 16-44 years (22.9% vs. 5.8% of participants aged 45-65 years and 4.0% of participants aged ≥65 years), and participants with secondary and university education (17.7% and 18.5% vs. 7.9% of participants with less than primary and primary education). We did not observe differences in cotinine concentrations according to the type of tobacco product consumed.
  
  
  
  Systematic collection of data on smoking prevalence and smoker attributes from representative samples of the population is necessary for policymakers to develop efficient tobacco control interventions. Considering the increase of roll-your-own cigarette users and the unclear health consequences of their use, policymakers should aim to implement tax policies to equalize the prices of different types of tobacco products.
authors.affiliation: Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Crta. de Madrid-Barcelona, Km. 33,600, 28871 Alcalá de Henares, Madrid, Spain; Tobacco Control Unit, Cancer Prevention and Control Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain. Electronic address: francisca.sureda@uah.es.
authors.forename: Xisca
authors.initials: X
authors.lastname: Sureda
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Ctra. Feixa llarga s/n., 08907 L'Hospitalet del Llobregat (Barcelona), Spain.
authors.forename: Marcela
authors.initials: M
authors.lastname: Fu
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Biostatistic Unit, Department of Basic Science, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Carrer Josep Trueta s/n., 08915 Sant Cugat del Valles, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Martínez-Sánchez
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Department of Nursing, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Carrer Josep Trueta s/n., 08915 Sant Cugat del Valles, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Martínez
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona, C. Villarroel 170, 08036 Barcelona, Spain.
authors.forename: Montse
authors.initials: M
authors.lastname: Ballbé
authors.affiliation: Group of Integrative Pharmacology and Systems Neuroscience, Programme of Neurosciences, IMIM-Hospital del Mar Medical Research Institute, Barcelona Biomedical Research Park, Barcelona, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Pérez-Ortuño
authors.affiliation: Direcció General de Planificació i Recerca en Salut,Salut, Generalitat de Catalunya, Travessera de les Corts, 131-159, 08028 Barcelona, Spain; Department of Public Health, School of Medicine, Universitat de Barcelona, Carrer Casanova 143, 08036 Barcelona, Spain.
authors.forename: Esteve
authors.initials: E
authors.lastname: Saltó
authors.affiliation: Group of Integrative Pharmacology and Systems Neuroscience, Programme of Neurosciences, IMIM-Hospital del Mar Medical Research Institute, Barcelona Biomedical Research Park, Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Pascual
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Ctra. Feixa llarga s/n., 08907 L'Hospitalet del Llobregat (Barcelona), Spain.
authors.forename: Esteve
authors.initials: E
authors.lastname: Fernández
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002947:Cities / Q000453:epidemiology; D003367:Cotinine / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012463:Saliva / Q000378:metabolism; D012907:Smoking / Q000453:epidemiology* / Q000378:metabolism; D013030:Spain / Q000453:epidemiology; D062789:Tobacco Products / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D003367:Cotinine
keywords: Cotinine; Cross-sectional study; Manufactured cigarettes; Roll-your-own cigarettes; Smoking; Tobacco policies