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Trends in smoking in an urban population over recent decades
Tendencias en la distribución del tabaquismo en una población urbana en las últimas décadas
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"apellidos" => "Villalbí" "email" => array:1 [ 0 => "jrvillal@aspb.cat" ] "referencia" => array:5 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 4 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Xavier" "apellidos" => "Bartoll" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "Maica" "apellidos" => "Rodríguez-Sanz" "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 3 => array:3 [ "nombre" => "Carme" "apellidos" => "Borrell" "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Agència de Salut Pública de Barcelona, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Institut d’Investigació Biomèdica Sant Pau, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Universitat Pompeu Fabra, Barcelona, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tendencias en la distribución del tabaquismo en una población urbana en las últimas décadas" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1236 "Ancho" => 2168 "Tamanyo" => 162256 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribution of smoking by age and sex groups. Figure 2011.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Smoking is the major causative factor of premature and preventable morbidity.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Understanding the state of the epidemic is crucial, and surveys by interviewing samples of the population are an important contribution to this knowledge.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> This paper provides recent population-based data on smoking, stratified by age and sex, with a perspective of its temporal evolution. This paper is aimed at analyzing its characteristics from the Barcelona health survey (ESBA), 2011, and assessing changes from the first, in 1983, focusing on differences by sex.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">The data have been obtained from ESBA 2011, a stratified district population sample extracted from the local census of the same year.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> It is therefore a descriptive cross-sectional observational study. The study population is noninstitutionalized individuals over 14 years old, residing in the city (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3509). For some variables, the data are compared with previous surveys in 1983, 1992, 2000 and 2006, performed with comparable methodology, so that its evolution is obtained by 5 observations over 28 years.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Variables.</span> The survey includes relevant variables such as sex and age. Regarding the consumption of tobacco, the survey identifies people who have been smokers at some point and those who have never smoked. Those who have been smokers at some point are asked if they have quit smoking or are current smokers, being classified in daily or occasional smokers. Therefore, the variable regarding behavior toward smoking is built at the time of the interview, within 4 categories: smoking a cigarette or more daily; smoking occasionally; being an ex-smoker; and never have smoked throughout life. Thus, we have estimated the prevalence of people who smoke daily, that of smokers (daily and occasionally), and the rate of occasional smokers in the group of smokers (smokers who do not smoke daily divided by the overall number of daily and occasional smokers. This accounts for the weight of occasional smokers within the group of smokers).</p><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Analysis.</span> The analysis uses weights that take into account the sampling design. The software used is STATA 13. For 2011 the distribution of behavior regarding smoking is reported by age and sex. We report the evolution of prevalence adjusted by age throughout the period 1983–2011, taking the population of year 2000 as baseline population. Changes are analyzed in the 28 years from 1983 to 2011, divided into 4 periods of 9, 8, 6 and 5 years. Linearity and constant changes in each period are accepted to estimate the absolute annual changes in prevalence (from the different rates and years of each period between surveys) and relative annual changes in prevalence (regarding the rates in the survey at the beginning of each period). The number of non-daily smokers within the group of smokers is estimated by sex for the period from 2000 to 2011 from the last 3 surveys, calculating the <span class="elsevierStyleItalic">P</span> for trend with a <span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span> test.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0025" class="elsevierStylePara elsevierViewall">The overall prevalence of daily smokers in Barcelona in 2011 is 18.8% in people aged over 14 years: 22.2% in men and 15.9% in women. The distribution by age and sex is reported in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>: Smoking is minority in all age and sex groups. Groups with most smokers are men aged 25–34 and women aged 15–24. There are more people who are or have been smokers among men over 65 and 45–54-year old women.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the changes in prevalence (smoking daily and occasionally) in the 28 years from 1983 to 2011 (that the surveys divide into 4 stages), showing annual absolute and relative declines by sex. The relative decline has been increasing in men since 2000. In women the pattern changes: after an increase in the eighties, it was stabilized, and then it descended (in relative terms like in men before 2000).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Currently, occasional smokers represent 18.5% of male smokers and 20.1% of female smokers, figures significantly higher than in 2006 (13.9 and 16.6%) and 2000 (8.3 and 6.7%) (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.0001 in both sexes).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">This paper shows how the decline of smoking continues in men and women, although in women this starts later. It also describes an increase in occasional female smokers, with no evidence of concentration of smokers with highest criteria of addiction (which has been called the hardening hypothesis): the number of non-daily smokers is growing.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> These findings are relevant to advance to the final phase of the epidemic.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Cohorts of men who have smoked most have been born earlier; among women, the smoker generation was born around 1960 (in 2011 it was the 44–54-year-old group): those born later have not smoked so much any more.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">5,6</span></a> The traditional sex difference disappears in younger ages, where there are more female smokers. For years, surveys with teenage students have shown more female smokers, portending more female smoking in adults.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> In both sexes, the number of ex-smokers increases with age, and from age 55, most people who have smoked, have quit. The estimate of the National Health Survey of Spain (prevalence of daily smokers of 27.9% in men and 20.2% in women) is comparable to that of Barcelona en previous years.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Therefore, the information arising from ESBA provides elements of proven validity to understand the situation in Spain and anticipate trends.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">This study has some limitations; the major limitation is that trends are measured over a long period of time starting from successive cross-observations. The nature of the phenomenon studied, due to the addictive nature of nicotine (which slows down the changes) and the influence of age, sex and cohort, does not evidence fluctuations in the periods between surveys. Another limitation is that the comparative surveys were conducted with similar methodology, except for determining the daily tobacco use, which was not performed in the same way in the first surveys. This would underestimate the daily tobacco use in these surveys, without affecting the estimation of total smokers throughout this period. We should take into account that the population has changed, integrating a large number of immigrants, many from societies smoking less. Therefore, this might have contributed to the decline in prevalence.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The evolution of the epidemic shows a clear decline, consistent with the progressive adoption of preventive policies. It is difficult to attribute the decline of smoking to an isolated action. The successive adoption of a number of measures has been accompanied by a decline, in the extent that one after another have been decreasing tobacco use.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,9</span></a> With a simple projection of the estimated decline in 2006–2011, in 2025 the prevalence of daily smokers would be below 10% in both sexes, a scenario of very low prevalence.</p><p id="par0060" class="elsevierStylePara elsevierViewall">From an epidemiological perspective, Lopez et al. have suggested four phases in the smoking epidemic.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Their model appears appropriate to describe its evolution in Spain, although our context has some peculiarities: we are at phase 4, with significant decrease both in prevalence and mortality in men, and a decline in prevalence in women, where mortality is still increasing.</p><p id="par0065" class="elsevierStylePara elsevierViewall">In conclusion, the evolution of smoking in Spain in recent years shows encouraging trends. The data do not support the hypothesis that current smokers are more addicted than in the past. Smoking is becoming an increasingly minority, but to improve public health it would be desirable that the process would go faster.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interests</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors report no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres728355" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec732553" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres728354" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec732552" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-05-28" "fechaAceptado" => "2015-11-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec732553" "palabras" => array:5 [ 0 => "Smoking" 1 => "Prevalence" 2 => "Survey" 3 => "Epidemiology" 4 => "Risk factors" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec732552" "palabras" => array:5 [ 0 => "Tabaco" 1 => "Prevalencia" 2 => "Encuesta" 3 => "Epidemiología" 4 => "Factores de riesgo" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The objective of this study is to describe the distribution of smoking in the population and to assess changes and trends over recent decades.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cross sectional study in a sample of the non-institutionalized resident population (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3,509) in Barcelona (Catalonia, Spain) using data from persons over 14 years of age from the health survey of 2011, and assessing trends for 1983–2011 using previous surveys. Dependent variables are having ever been a smoker, having quit, being a current smoker, and smoking daily. Independent variables include sex, age, and time. Prevalence and proportions are estimated, stratifying or adjusting for age.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The prevalence of daily smokers is 18.8% in 2011: 22.2% for men and 15.9% for women. The age groups with higher smoking prevalence are 25–34 years for men and 15–24 for women. From 1983 to 2011 the reduction among men has been intense, and for women the prevalence has been decreasing since the survey of 2000. Among smokers, the proportion of both genders who do not smoke daily has increased.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The smoking epidemic over the last years shows promising trends. The data do not lend support to the hardening hypothesis for current smokers. Smokers are a shrinking minority, although to improve public health it would be desirable to speed the process of change.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este trabajo es presentar la distribución del tabaquismo en la población y valorar los cambios y tendencias en las últimas décadas.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y método</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal en una muestra de población residente no institucionalizada (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.509) en Barcelona (Cataluña, España), a partir de los datos de los mayores de 14 años de la encuesta de salud de 2011, analizando tendencias entre 1983 y 2011 mediante encuestas anteriores. Las variables dependientes son haber sido alguna vez fumador/a, haber dejado de fumar, fumar actualmente y fumar diariamente. Las variables explicativas son el sexo, la edad y el período. Se estiman prevalencias y proporciones, estratificando o ajustando por edad.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de personas fumadoras diarias es de un 18,8% en 2011: un 22,2% en hombres y un 15,9% en mujeres. Los grupos de edad más fumadores son el de 25-34 años en hombres y el de 15-24 años en mujeres. Entre 1983 y 2011 la disminución de la prevalencia en hombres ha sido intensa y en mujeres se aprecia el descenso desde 2000. En ambos sexos la proporción de personas fumadoras que no fuman diariamente es cada vez mayor.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La evolución de la epidemia tabáquica en los últimos años muestra tendencias esperanzadoras. Los datos no apoyan la hipótesis de que las personas fumadoras actualmente sean más adictas. Fumar es cada vez más minoritario, aunque para mejorar la salud pública sería deseable que el descenso fuera más rápido.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Villalbí JR, Bartoll X, Rodríguez-Sanz M, Borrell C. Tendencias en la distribución del tabaquismo en una población urbana en las últimas décadas. Med Clin (Barc). 2016;146:389–391.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1236 "Ancho" => 2168 "Tamanyo" => 162256 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribution of smoking by age and sex groups. Figure 2011.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Prevalences adjusted taking the 2000 population as baseline.</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Percentage of absolute annual change: (initial prevalence<span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>final prevalence)/years.</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Percentage of relative annual change: (initial prevalence<span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>final prevalence)/initial prevalence<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>years.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Sex \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Period between surveys \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Set prevalence (%)</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage of annual changes</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Absolute \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Relative \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " rowspan="4" align="left" valign="top">Men</td><td class="td" title="table-entry " align="left" valign="top">1983–1992 (9 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42.94 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−1.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−2.02 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1992–2000 (8 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42.94 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.89 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−2.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2000–2006 (6 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−1.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−3.24 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2006–2011 (5 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.89 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−3.09 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="4" align="left" valign="top">Women</td><td class="td" title="table-entry " align="left" valign="top">1983–1992 (9 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.90 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1992–2000 (8 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.41 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2000–2006 (6 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−1.82 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2006–2011 (5 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−1.89 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1200884.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Changes in the prevalence of smokers (daily and occasional smokers), by sex Barcelona, 1983–2011.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Public health advocacy and tobacco control. 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