Tobacco Free Research Institute Ireland

Completed Research Projects

Secondhand smoke Exposure and Smoke-free Legislation (SESL) Project

The European Community is dedicated to the Tobacco Policy of a Smokefree EU but its recommendations for Smokefree laws in every (MS) will not achieve this. MS may adopt laws that do not fulfil the aims of Tobacco Policy as set out particularly in Article 8 of the WHO Framework Convention for Tobacco Control (FCTC). Smokefree policies differ in MS ranging from fully comprehensive laws in countries such as Ireland, UK, Sweden, Finland Slovenia and Estonia, and nearly comprehensive laws in France, Latvia, Italy and Bulgaria whereas Spain, Portugal, Greece and Denmark have laws that can only be regarded as partial. Several countries including Germany, Austria Luxemburg and many of the Central and Eastern EU countries have yet to introduce strong Smokefree laws.

The ENSP 'Athens Declaration' having considered the effects of the Smokefree legislation urged all countries that were contemplating Smokefree laws to implement comprehensive ones.

For this Declaration to be fully evidence based it would be imperative to show that the health benefits in countries with partial laws were less than in countries with comprehensive laws. The time frame for showing the presence or absence of such health outcomes is likely to be years rather than months and the needs of TC advocates are urgent. Recognising these advocacy needs in building support for implementing Tobacco Policy in the field of Smokefree and to be consistent with the Pfizer Micro-Grant programme priority No 1 we feel the most appropriate approach to supply the clearest and most rapid support in driving advocacy for Smokefree and Article 8 of the WHO FCTC is to measure theexposure outcome from different model smokefree laws. The rationale for this project is that in all countries where comprehensive laws exist show definite exposure and health benefits and therefore it sets out to measure the reduction in exposure and relate this to the type of Smokefree law, partial or comprehensive, in place in 8 European countries.

The hypotheses is that comprehensive laws are the only laws to deliver the full potential of reduction of exposure to second hand smoke but this project now proposes to further explore if the comprehensiveness of the law itself is the sole cause of the reduction in exposure. Confounding or mediating factors may include other tobacco control policy initiatives but also may be related to factors that may be political, socio-demographic, cultural or indeed climatic. They may also be related to the health services available and the health promotion being practiced in any country. Political factors such as the participation of the population, civil obedience or indeed the type of government whether this be conservative, centrist, liberal or socialist. Other factors such as penalties and policing of the law may be independent of the model and may or may not contribute to the reduction in exposure.  We feel that these important factors must be included in the project although they were not in the initial LOI. In particular the prevalence of smoking in the MS may have a significant bearing on the reduction in exposure by influencing compliance.  The hypothesis being that if the prevalence of smoking is very high compliance may be lower than in a country where prevalence is low. This however may be more important in pre ban phase influencing political thought rather than actually adherence to the law once it is in place. We will also be able to test this aspect of mediating factors.

It is contended that the project can have a major influence on Tobacco Policy in countries that are considering introducing Smokefree laws and on countries where less than comprehensive laws exist and who recognise the need to comply with the EC regulations and Article 8 of WHO FCTC and may therefore be considering changing their laws. This applies in particular to Spain.  However we think it's essential that all countries have available the evidence base on which the need for comprehensive laws can be proposed.  The contribution of this project to achieving a Smokefree Europe could be very considerable and would meet the needs of the European region and be entirely compatible with Pfizer's Micro-Grant priority area on Tobacco Policy Infrastructure/Capacity.

All Ireland Bar Study and Dublin Bar Study

On the 29th March 2004 the Irish government introduced a comprehensive workplace smoking ban to protect the health of workers. RIFTFS co-ordinated a number of studies to evaluate the impact the ban had on levels of ETS, benzene and the respiratory health of bar workers.  In a sample of 42 bars staffing levels, customer numbers and smoking rates were analyzed along with ETS and Benzene.  In 12 Dublin bars ultrafine particles levels were measured as well as PM2.5 particles. In a study of the respiratory health of bar workers, 81 workers were tested pre and post ban.

The fieldwork for these projects was completed in 2005 and preliminary reports of findings were available. In 2006 further statistical analysis of research findings was done by Ms Mary Dunne, RIFTFS statistician. In particular Ms Dunne explored the use of Questionnaires, Environmental Markers and Bio-markers for monitoring ETS exposure. Her review validated the questionnaires and instruments used in monitoring ETS exposure in the above studies.

The findings from these studies were very positive and have now been published in peer reviewed journals.

Re-testing of Bar Workers

The positive results of pulmonary function tests on bar workers showed some surprising changes which challenge the expected effects of ETS on lung mechanics. The studies were carried out from 6 to 12 months after the ban but the time course and duration and magnitude of the changes are unknown. For this reason two years after the ban in late 2006 work commenced on the re-testing of bar workers. This work continued throughout 2007.  73 workers were invited for retesting. Full pulmonary function studies and exhaled breath carbon monoxide (CO) is being conducted along with respiratory symptom questionnaire.

Re- testing of the bar workers is now complete and in 2008 these data will be analyzed.  Results will be written up and will be published and disseminated along with previous findings.

Study of ETS Exposure in Cars

Environmental tobacco smoke (ETS) is a major preventable contributor to acute and chronic adverse health outcomes that affect children disproportionately.

A number of international studies have been conducted examining the levels of ETS produced while volunteers have smoked in cars. Studies have also looked at attitudes and behaviours to establishing smokefree cars and in the home.

TFRI have already conducted research to estimate the prevalence of ETS exposure in cars.  This was done through an examination of traffic monitoring video footage, provided by Dublin City Council and by direct observation.

Study of Exempted Workplaces/Psychiatric Hospitals and Prisons

Introduction

One of the main objectives of this research is to investigate Environmental Tobacco Smoke (ETS) exposure levels in special hospitals (psychiatric) within the Republic of Ireland where there is an exemption to the smoking ban.

The exposure measurements are used to quantify and address the following questions:

1. How do exposure levels in locations where a ban is in operation, compare to hospitals and other areas which are exempted from the ban, and
2. How do these exposure levels compare with pre and post ban levels in a selection of dwellings?

Methodology

In order to complete the objectives, the following indoor air quality metrics were recorded and logged within each hospital for a period of minimum 2-3 hours per 'smoking area'.

• The measurement of airborne particles (both concentration and mass) inside designated 'smoking areas' of these hospitals
• The measurement of carbon monoxide (CO) gas levels in each location.
• The measurement of nicotine in the air in each location using passive samplers.

In conjunction with these measurements, the following factors were qualitatively assessed: (a) the number of subjects present within these 'smoking areas' and the number of subjects smoking, (b) the structural characteristics of the 'smoking area', such as the presence of windows or any active ventilation systems.

Study of Exempted Workplaces/Psychiatric Hospitals and Prisons

One of the main objectives of this research is to investigate Environmental Tobacco Smoke (ETS) exposure levels in special hospitals (psychiatric) within the Republic of Ireland where there is an exemption to the smoking ban.

The exposure measurements are used to quantify and address the following questions:

1. How do exposure levels in locations where a ban is in operation, compare to hospitals and other areas which are exempted from the ban, and
2. How do these exposure levels compare with pre and post ban levels in a selection of dwellings?

Methodology

In order to complete the objectives, the following indoor air quality metrics were recorded and logged within each hospital for a period of minimum 2-3 hours per 'smoking area'.

• The measurement of airborne particles (both concentration and mass) inside designated 'smoking areas' of these hospitals
• The measurement of carbon monoxide (CO) gas levels in each location.
• The measurement of nicotine in the air in each location using passive samplers.

In conjunction with these measurements, the following factors were qualitatively assessed: (a) the number of subjects present within these 'smoking areas' and the number of subjects smoking, (b) the structural characteristics of the 'smoking area', such as the presence of windows or any active ventilation systems.

ISAAC Study

ISAAC, the International Study of Asthma and Allergies in childhood, was formed in 1991 to facilitate research into asthma, allergic rhinitis and eczema by promoting a standardised methodology. ISAAC is a unique project which has attracted worldwide interest and unprecedented large scale participation.

This study is a follow up on the Irish arm of an international study carried out in 1995 - the International Study of Asthma and Allergies in Childhood (ISAAC study).

Over 10 years on, the new follow-up study for Ireland is aiming to find out just how much things have changed since the original ISAAC study. The smoking part of the study is focusing on the effects of both cigarette smoking, and passive smoking. Parental smoking is a known cause of asthma while smoking is a known trigger of asthma. Our previous ISAAC study showed bronchitic symptoms in smoking children and non smoking children exposed to smoking in the home.  In this regard the survey is assessing prevalence of smoking in 3000 schoolchildren but also secondhand smoke exposure at home, in cars and smoking among siblings and friends. The relationship between smoking and respiratory symptoms in general as well as asthma is being assessed.  The strength of this study is that this is the 3^rd time this survey has been performed and this will allow us to look at the possible effect of the workplace ban.

This study was undertaken by TFRI in collaboration with the Asthma Society of Ireland.

Statistical Analysis of Existing Prevalence Data

A paper was prepared by Ms Mary Dunne, statistician, which presents studies outlining the prevalence of smoking in Ireland.  All known studies since the 1970s are presented with the prominence given to studies undertaken in the last 15 years.  Firstly, findings from a European/ International perspective are outlined, highlighting how Ireland performs in relation to other countries. Secondly, the results from a number of other national prevalence studies are described and finally studies conducted at local and regional level throughout the country are reviewed.

It is important to bear in mind that these studies are not homogeneous; rather they vary in terms of methodology, sample size, types of questions asked, geographical location as well as the specific age-groups surveyed. It is therefore difficult to make meaningful comparison between the studies.  Nonetheless, it is useful to examine the findings of each study in the light of what has been found in other studies conducted nationally and across Europe.

This paper has been reviewed by the RIFTFS scientific sub committee and a number of revisions have been recommended

Smoking and Health Inequalities

This paper prepared by Ms Dunne, presents studies outlining the relationship between smoking and health inequalities in Ireland.  All known studies since the 1970s are presented.

Evidence suggests that mortality from tobacco related causes is higher in Ireland than in other EU countries. Standardised death rates from circulatory system diseases were 21% higher in Ireland than the EU-15 average in 2001, while mortality rates from diseases of the respiratory system were more than twice the EU-15 average. In 2001, mortality rates in general were 16% higher in Ireland than the EU-15 average but since diseases of the circulatory and respiratory systems accounted for approximately half of all deaths in Ireland in 2001 (and about 44% in the EU-15 on average) it is clear that tobacco related illness is a problem with particular relevance here.  For women standardized death rates from malignant neoplasms of larynx and trachea/bronchus/lung were 58% higher in Ireland than the EU-15 average.

This paper has been reviewed by the TFRI scientific sub committee and they suggested approaching IPHI which has a special interest in the topic

Professor Luke Clancy met with Dr. Helen McEvoy of the IPHI and they agreed that TFRI and IPHI have developed a collaborative project to further this important subject.

Economic Factors Effecting Smoking

Ms Dunne prepared a paper examining Consumer Price Index (CPI) and tax on cigarettes

This paper gives a summary of the

• rationale for tobacco taxation
• the situation regarding receipts on tobacco products according to statistics issued by the Revenue Commissioners
• the Consumer Price Index (CPI) and its use as a benchmark for inflation
• the European Legislation on excise duties for tobacco

This paper was reviewed by the TFRI scientific sub committee and it was agreed that TFRI collaborate with ASH Ireland to convene a conference on this subject where all the relevant partners could take part. This conference was titled "Taxation health & Tobacco" and was held in Dublin in June 2007

A study of Environmental Tobacco Smoke exposure within exempted premises -Nursing Homes as defined in the Pubic Health Acts 2002&2004.

In 2006 TFRI submitted a research proposal titled "A study of Environmental Tobacco Smoke exposure within exempted premises -Nursing Homes as defined in the Pubic Health Acts 2002 & 2004"   under the MRCG/HRB joint awards scheme. The Principal Investigator for the project is  Dr Pat Goodman, Lecturer in the Physics Department in DIT, Kevin Street, Dublin.   The application was successful and RIFTFS received €15,089 from the HRB/MRCG scheme for Year 1 of the project.  Matching funding is being provided by TFRI.

Project Overview

When the highly successful workplace smoking ban came into force in 2004, there were a number of areas which were exempted from the ban.  One could argue that staff working in such exempted areas as prisons, psychiatric hospitals and nursing homes are being unfairly treated by continuing to be exposed to ETS while going about their daily duties. This study will examine 40 Nursing Homes in order to determine levels of exposure to Environmental Tobacco Smoke (E.T.S.) for both staff and occupants. This will involve using equipment to measure particulate levels in the smoking areas within the premises.  Measurements will also be conducted in other areas which are designated as no smoking areas. These particulate exposure measurements will be determined by use of an Aerocet 531 monitor (or similar device), which will monitor continuously for two or more hours in a room where the consumption of Tobacco products takes place.  In addition benzene concentrations will also be monitored using passive absorption diffusion tubes.  The number of people smoking, the dimensions of each room, the presence and or use of ventilation systems will also be recorded, together with any other sources of particulates such as cooking etc.  A questionnaire will also be used to further determine exposure of staff to E.T.S. with regard to if they are smokers or non-smokers, and some other details.  There will be at least two visits to each venue as part of the exposure assessment. A qualitative and quantitative questionnaire will be carried out on the staff and will determine exposure outside of work and attitudes towards tobacco consumption.

The effect of the Irish workplace smoking ban on birth weight and gestational age at birth.

In 2006 TFRI submitted a research proposal titled "The effect of the Irish workplace smoking ban on birth weight and gestational age at birth" under the MRCG/HRB joint awards scheme. This is a collaborative project with TFRI and Dr Sean Daly Consultant Obstetrician and Gynaecologist in the Coombe Hospital in Dublin. The application was successful and TFRI received €50,000 from the HRB/MRCG scheme for this year long project.

Project Aim

This study aims to assess the effect of the smoking ban on birth weight, gestational age at birth and preterm/ premature birth

Project Overview

Research shows that exposure to Environmental Tobacco Smoke (ETS) can have harmful effects on the unborn infant. There are foetal effects to pregnant women who do not smoke but who are exposed to ETS, for example an excess risk of 20-50% for low birth weight (LBW) at term.  Infants with LBW, defined as weighing less than 2,500 g at birth, have a higher risk of subsequent infant morbidity, mortality, and longer-term childhood and adult adverse consequences. There is evidence to link prenatal ETS exposure with low birth weight, preterm/ premature birth and intrauterine growth retardation (IUGR). A small decrement in birth weight (e.g., 25 to 50 g) may not be clinically significant for an otherwise healthy infant, but may put infants who are already compromised by other health conditions or risk factors at even higher risk.  All babies born preterm are at risk for serious health problems as the earlier a child is born, the less she will weigh, the less developed her organs will be, and the more complications she is likely to face.

In addition, exposure may increase the risk of spontaneous abortion, sudden infant death syndrome, and development of childhood cancers and cognition and behavioural problems.

The proportion of babies of low birth weight (below 2,500 grams) increased from close to 4 per cent of all births in Ireland in 1993 to almost 5 per cent in 2002. The rate of low birth weight among unskilled manual groups was twice that of the professional groups in the early 1990s (see background section).

In March 2004 the workplace smoking ban was introduced in Ireland. This made it illegal to smoke in almost all workplaces with a few exceptions which include prisons and nursing homes. This study aims to assess the effect of the smoking ban on birth weight, gestational age at birth and preterm/ premature birth.

Smoking Cessation Services in Ireland - An evaluation of services available and their effectiveness.

In 2006 TFRI submitted a research proposal titled "Smoking Cessation Services in Ireland - An evaluation of services available and their effectiveness".  This is s two year project, the application was successful and RIFTFS received a €30,000 Partnership award from the HRB scheme for Year one in 2006 and €30,000 for year two in 2007.

Project Aim

The aim of this research project is to assess the range, the availability and the effectiveness of smoking cessation services throughout the country.  RIFTFS is undertaking this work in partnership with the Health Promoting Hospital Network, the Institute of Public Health and the HSE.

Project Overview

Tobacco is the major preventable cause of death and chronic disability in Ireland today and a major cause of health inequality. Tobacco related cardiovascular and respiratory diseases and cancer cause approximately 6,500 deaths p.a. in Ireland. Evidence suggests that mortality from tobacco related causes is higher in Ireland than in other EU countries (Burke et al., 2004).  A recent study found that, between 1985 and 2000, Coronary Heart Disease (CHD) mortality rates in Ireland fell by 47% in those aged 25-84 and 25.6% of the observed decrease in mortality was attributed to declining smoking prevalence (Bennett et al. 2006).

Smoking prevalence has been decreasing since the 1980's with the current national rate being 24% (OTC /TNS MRBI).  Rates among women are increasing whereas among young men they are decreasing (HBSC 2001/02).  The 1998 European Community Household Panel Survey found that young Irish women (aged 16-24) had prevalence rates of 35% (2^nd highest of the 11 countries) for those with "low" educational attainment compared to 24% for those with "high" educational attainment.  The 2000 ECHP found that there have actually been increases in smoking among lower income and social class groups. Smoking among manual working class groups are twice those of professional and managerial groups.  The fact that many studies show that smoking is more prevalent in the lower socio-economic groups suggests that tobacco control policies should focus specifically on these groups.

Tobacco is highly addictive and the difficulties associated with quitting are well documented.

In the government's strategy document, "Towards a tobacco Free Society", a key strategic objective is to significantly increase the number of people who stop smoking each year.  A key method of achieving this target is the provision of cessation programmes to assist smokers to quit. The Minister for Health and Children launched the National Smoking Cessation campaign, 'Every Cigarette is Doing You Damage' in November 2003.  Smoking cessation services are available throughout Ireland and are provided in both community and hospital settings. Different types of services exist and are provided by health care professionals and community workers.

Smoking cessation interventions are effective and are extremely cost effective (Tilson et al. 2004).

The aim of this research project is to assess the range, the availability and the effectiveness of smoking cessation services throughout the country.

Smoking Prevalence in the Gay and Lesbian Community.

It was decided to gather prevalence data on minority groups in Ireland to enable better targeting of resources and services, one of the groups identified was the Irish Gay and lesbian Community.  In consultation with a statistician a mini questionnaire was produced covering areas such as age at which smoking commenced, amount smoked at present, desire to quit, number of quit attempts, aids services or medications used to aid cessation attempts.  The best circulation method available to us was through the GCN Magazine which was conducting a general survey of its readership both on line and in magazines purchased. After consultation with GCN Magazine it was agreed that our questions be included in their survey.

In 2007 the survey was completed and statistical analysis of the findings was performed. Findings were presented at the ECToH Conference in Basel in October 2007, which stated that in Ireland smoking in the Gay/Lesbian community is related to income age and S/E group as is found in the general population.  There is no evidence in this country to suggest that smoking is significantly more common in this community when due care is taken to match for these demographic data.

Development of a PhD studentship on the Economics of Tobacco Control

The workplace smoking ban introduced into Ireland in March 2004 and has subsequently been shown to be an effective public health policy measure.  It is argued however to have a negative economic impact on the hospitality industry and on the economy overall. To examine this issue further RIFTFS undertook to fund a PhD studentship and in December 2006 Ms Laura Maran was appointed as a PhD student under the direction of Prof Charles Normand, Professor of Health Policy and Management, Trinity College Dublin. It is planned that RIFTFS will fund the studentship for a further year to November 2008. Ms laura Maran has been awarded her PhD in 2011.

European Network of Smoking Prevention/ Media Studies

Under the ENSP Framework Project Scheme 2004 - 2005, the Research Institute for a Tobacco Free Society (RIFTFS) undertook a comprehensive health impact assessment of the Workplace Tobacco Ban in Ireland. As part of this project RIFTFS collaborated with the School of Communications in DCU and a study of the media coverage of the Irish workplace smoking ban was conducted with the aims of analyzing the themes and trends of the coverage generally as well as evaluating the effectiveness of the pro-ban advocates' communication campaign. The study provides potential lessons for public health advocates seeking to engage in the policy process more effectively through the news media.  The findings can be used to increase awareness of the strategies used by the hospitality and tobacco industries to counteract any campaign for a workplace smoking ban.

The study was completed in 2007 and results of the study showed that the pro-ban strategy to consistently and repeatedly frame the ban as a worker safety and public health issue proved effective.

The anti-ban lobby almost entirely avoided health and scientific arguments. They did succeed temporarily in diverting the focus of the ban away from health using economic, political and legislative arguments. In addition the anti-ban lobby used tactics similar to those used fighting other international bans.  Emphasis of negative economic impact, erosion of cultural or national identity and freedom of choice were arguments frequently used against the ban.

fMRI Study to Examine Neurocognitive Processes in Nicotine Dependence

The goal of this research is to investigate the role of specific neurocognitive processes in nicotine dependence.  The processes in question are those involved in the control of behaviour and have been associated with specific cortical loci including the anterior cingulate cortex and dorsolateral prefrontal cortex.  Using functional Magnetic Resonance Imaging (fMRI), a non-invasive technique for visualising brain function in vivo, we will investigate:

• If neurocognitive deficits that have previously been observed in abusers of drugs other than nicotine are present in nicotine dependent individuals;
• If the presence or magnitude of these deficits are predictive of relapse for those nicotine dependent individual enrolled in smoking cessation programmes.

This research is being carried out in partnership with Dr Hugh Garavan, Director of Functional Imaging, Institute of Neuroscience, Trinity College Dublin and Professor Luke Clancy, Director General, RIFTFS

The Development of an agreed national definition of a smoker and a telephone survey instrument capable of delivering a national estimate of smoking prevalence by sex, age and socio-economic group.

Project Aim

To create an agreed definition of a smoker, and to develop a telephone survey instrument capable of delivering a national estimate of smoking prevalence by sex, age, socio-economic group and HSE Regional area.

Project Overview

Tobacco is the major preventable cause of death and chronic disability in Ireland today and a major cause of health inequality. Tobacco related cardiovascular and respiratory diseases and cancer cause approximately 6,500 deaths p.a. in Ireland. Evidence suggests that mortality from tobacco related causes is higher in Ireland than in other EU countries (Burke et al., 2004).  A recent study found that, between 1985 and 2000, Coronary Heart Disease (CHD) mortality rates in Ireland fell by 47% in those aged 25-84 and 25.6% of the observed decrease in mortality was attributed to declining smoking prevalence (Bennett et al. 2006).

Smoking prevalence has been decreasing since the 1980's at least, but the rate is slowing since the mid-1990s, particularly among women.  Rates among young Irish women are higher than the international average (HBSC 2001/02; ESPAD 2003).  The 2000 ECHP found that there have actually been increases in smoking among lower income and social class groups. Smoking among manual working class groups are twice those of professional and managerial groups.

Tracking changes in smoking prevalence over time provides important information in aiding current primary prevention efforts and in predicting future adult disease consequences. The EU Council Recommendation on prevention of smoking and on initiatives to improve tobacco control, 2002, recommends that member states continue developing strategies and measures to reduce the prevalence of smoking, such as general programmes to overcome tobacco addiction.  To evaluate and monitor the effectiveness of these strategies (workplace smoking ban, taxation, cessation strategies, labeling and packaging etc.) it is crucial that we can accurately measure prevalence and disseminate the results nationally and internationally.

The main national studies that have sampled the whole population (rather than young people only) and have attempted to measure the prevalence of smoking in Ireland (SLÁN, the OTC/ TNS mrbi survey, the Drug Use in Ireland and Northern Ireland Drug Prevalence Survey and the ECPH (European Community Household Panel Survey based on the Living in Ireland Panel Survey (LII)) have found differing results for smoking prevalence.  These studies used different methodologies and samples and asked different questions to elicit information on smoking prevalence.

We therefore propose to create an agreed definition of a smoker, and to develop a telephone survey instrument capable of delivering a national estimate of smoking prevalence by sex, age, socio-economic group and HSE Regional area.  Differences in prevalence and patterns of tobacco use in specific population subgroups can be used to demonstrate the need for focused interventions.

Prevalence of Smoking in Immigrants - Polish

There are 250,000 eastern European Immigrants in Ireland.  Most of these are within the 18 to 35 age group.  It is also known that the prevalence of smoking in Ireland within this age group has increased.  Research relying on large population surveys has largely ignored the hetrogenicity in tobacco use patterns that exists within racial and ethnic groups especially by immigrant status.  It is therefore of great importance to identify the smoking prevalence within this group of Immigrants. This will allow for better targeting of resources and services

PESCE

RIFTFS was collaborating partner in the PESCE project.  This project was part funded by the European Commission (60%) and part funded by RIFTFS (40%).

General Objectives PESCE PROJECT

The general objective of the project was to

• motivate increased smoking cessation interventions of GP's in Europe by addressing the socio-economic environment of GP's practice
• Highlight long term health benefits and economic growth brought about by increased smoking cessation interventions by GP's, taking into account the effects on the health sector and the improvement of productivity and economic conditions of citizens in general.
• Develop evidence based policy  recommendations and implementation strategies to change the socio-economic environment in a way to motivate greater involvement  of GP's in smoking cessation interventions

RIFTFS role initially in this project was to conduct a review of the "grey literature" available in Ireland, appraising the factors that hinder or promote GP's smoking cessation interventions.  It is planned that RIFTFS will also contribute to evidence based policy recommendations and practice based implementation strategies relating to cessation interventions by GP's. Prof Luke Clancy has been appointed to the project advisory committee.

IMCA (Indicators for monitoring COPD and Asthma in the EU) II

Asthma and COPD are major chronic disease that have an important impact on quality of life of individuals suffering the disease and also have important consequences into social and health care cost. The information available today either to prevent risk factors or to improve clinical management and outcomes is still very limited. The objective of the IMCA 1 project was to develop indicators to monitor asthma and COPD in the European Union, to describe the prevalence of COPD related symptoms, asthma at tacks, physician diagnosed COPD by age group, gender, socioeconomic status and geographical area and to monitor changes over time on the indicators proposed.

The aim of the IMCA 11 project is to extend the work on indicators already carried out by the IMCA I project by collecting or using already available data and producing reports/papers on all groups of indicators recommended by the project (mortality, prevalence, risk factors, clinical management/health services and outcomes). It is planned that routine data on mortality and hospital discharges will be collected to estimate the indicators defined by the IMCA I project (for a period of ten years) for all countries involved in the project and to analyze geographical variations and time trends on these indicators. Data on health care, human resources and health care utilization costs to estimate the indicators defined by the IMCA I project will also be collected.

Available data from completed European-wide research projects (ECRHS and ISAAC) will be used to describe the most relevant indicators.

Joint Research Fellowships in Cancer - HRB/NCI

RIFTFS, in collaboration with Prof Gregory Connolly, Harvard School of Public Health,

submitted a research application under the Joint Research Fellowships in Cancer - HRB/NCI scheme in 2005.  The research project was titled "Tobacco Control Policies, Lung Cancer and Smoking Patterns: Ireland and Massachusetts."

In the application Dr Zubair Kabir, Post Doctoral Research Fellow/Epidemiologist applied for a two year fellowship to study smoking patterns and smoking related diseases in the context of the Massachusetts Tobacco Control Programme (MTCP).

Following international peer review and interview of Dr Kabir, this application proved successful. Funding was approved and the project commenced in September 2006 with Dr Kabir taking up post for the first year at the Harvard School of Public Health, Boston.  In September 2007 Dr Kabir took up post for year two of the project in The Research Institute for a Tobacco Free Society, Dublin.  Dr Kabir is being supervised by Prof Luke Clancy and Prof Gregory Connolly for the duration of the study. As part of the project collaboration Prof Clancy visited Harvard in July 2007 and Prof Connolly is planned to visit RIFTFS in 2008.

Background to Project