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Avlonitou E.,Sleep Laboratory | Kapsimalis F.,Sleep Laboratory | Varouchakis G.,Sleep Laboratory | Vardavas C.I.,Smoking and Lung Cancer Research Center | And 2 more authors.
Sleep and Breathing | Year: 2012

Purpose: The aim of the study was to asses quality of life and symptoms of obstructive sleep apnea syndrome (OSAS) patients after adhering to 6 months of continuous positive airway pressure (CPAP) treatment. Methods: A group of 50 patients (41 men and 9 women) were diagnosed by polysomnography and treated with CPAP therapy for 6 months. Their symptoms and healthrelated quality of life were assessed by administering a validated and translated version of the sleep apnea quality of life index (SAQLI). Sleepiness was measured using the Epworth Sleepiness Scale (ESS) and through electronic monitoring of CPAP usage per night of sleep. Results Mean CPAP usage was 4.5±0.5 h per night. Comparisons between quality of life indexes before and after CPAP treatment showed an improvement in the total SAQLI score (3.8±0.9 vs. 5.8±0.8 after CPAP, p<0.01), in daily functioning (4.2±1.4 vs. 6.0±0.9, p<0.01), social interactions (4.8±1.3 vs.6.3±0.7, p<0.01), emotional functioning (4.4±1.4 vs. 5.7±1.0, p<0.01), symptoms (1.6±0.8 vs. 5.8±1.2, p<0.01), and in the ESS (13.7±6.5 vs. 3.9±3.8, p<0.01). Regarding the patients' symptoms, improvement was noticed for "sleepiness while watching a spectacle" (96%), "reading" (95%), "carrying on a conversation"(95%), "driving" (92.9%), "restless sleep" (87.8%), and "urinating more than once per night" (84.8%). Smaller improvements were observed for the reported "dry mouth-throat upon awakening" (36.1%),"excessive fatigue"(54.5%), and "decreased energy" (55.3%). Conclusion We conclude that OSAS patients who adhere to nighttime CPAP therapy show significant improvement of their quality of life, daytime sleepiness, and other symptoms after 6 months of treatment with CPAP. © Springer-Verlag 2011.

Alpert H.R.,Center for Global Tobacco Control | Vardavas C.I.,Center for Global Tobacco Control | Vardavas C.I.,Smoking and Lung Cancer Research Center | Chaloupka F.J.,University of Illinois at Chicago | And 6 more authors.
Tobacco Control | Year: 2014

Objectives Greece is in an economic crisis compounded by the costs caused by smoking. The present investigation estimates the economic and public health benefits ensuing from the recent cigarette excise tax increase in 2011 and projects the potential benefits from an additional €2.00 per pack cigarette tax increase. Methods The effects of the recent cigarette excise tax increase were calculated on outcome measures: total price per pack, including specific excise, ad valorem tax, and value-added tax consumption; tax revenue; and per capita consumption of cigarettes. Additionally, smoking-attributable mortality, years of potential life lost, and productivity losses were estimated. Projected effects of an additional €2.00 per pack tax increase on consumption and tax revenue were also assessed. Results The cigarette excise tax increase in 2011 created €558 million in new tax revenue. Cigarette consumption reached a recent low of 24.9 billion sticks sold or 2197 sticks per person in 2011, indicating a 16% decrease in per capita cigarette consumption from the previous year. An additional €2.00 per pack increase in Greek cigarette taxes is projected to result in reduced cigarette sales by an additional 20% and lead to an increase in total cigarette tax revenues by nearly €1.2 billion and the prevention of 192 000 premature deaths. Conclusions Nations such as Greece, should employ taxation as a crucial measure to promote public health and economic development in such dire times. International economic organisations should aggressively pursue programmes and policies that champion the economic benefits of tobacco taxation.

Vardavas C.I.,Center for Global Tobacco Control | Vardavas C.I.,Smoking and Lung Cancer Research Center | Filippidis F.T.,National and Kapodistrian University of Athens | Agaku I.,Center for Global Tobacco Control | And 6 more authors.
Tobacco Induced Diseases | Year: 2012

Background: Increases in tobacco taxation are acknowledged to be one of the most effective tobacco control interventions. This study aimed at determining the mediating role of socioeconomical status (SES) and the earmarking of revenue to healthcare and tobacco control, in influencing population support for the adoption of a 2 Euro tobacco tax increase in Greece, amid the challenging economic environment and current austerity measures. Methods. Data was collected from two national household surveys, the "Hellas Health III" survey, conducted in October 2010 and the "Hellas Tobacco survey" conducted in September 2012. Data was analyzed from 694 and 1066 respondents aged 18 years or more, respectively. Logistic regression models were fitted to measure the adjusted relationship between socio-economic factors for the former, and support for increased taxation on tobacco products for the latter. Results: In 2012 amidst the Greek financial crisis, population support for a flat two euro tax increase reached 72.1%, if earmarked for health care and tobacco control, a percentage high both among non-smokers (76%) and smokers (64%) alike. On the contrary, when not earmarked, only 43.6% of the population was in support of the equivalent increase. Women were more likely to change their mind and support a flat two-euro increase if the revenue was earmarked for health care and tobacco control (aOR = 1.70; 95% C.I: 1.22-2.38, p = 0.002). Furthermore, support for an increase in tobacco taxation was not associated with SES and income. Conclusion: Despite dire austerity measures in Greece, support for an increase in tobacco taxation was high among both smokers and non-smokers, however, only when specifically earmarked towards health care and tobacco control. This should be taken into account not only in Greece, but within all countries facing social and economic reform. © 2012 Vardavas et al.; licensee BioMed Central Ltd.

Papadopoulos G.,National and Kapodistrian University of Athens | Papadopoulos G.,Smoking and Lung Cancer Research Center | Vardavas C.I.,Smoking and Lung Cancer Research Center | Limperi M.,National and Kapodistrian University of Athens | And 3 more authors.
BMC Pulmonary Medicine | Year: 2011

Background: Chronic obstructive pulmonary disease (COPD) remains a major public health problem that affects the quality of life of patients, however smoking cessation may emeliorate the functional effects of COPD and alter patient quality of life.Objective-design: The aim of this study was to validate the Clinical COPD Questionnaire (CCQ) into Greek and with such to evaluate the quality of life in patients with different stages of COPD, as also assess their quality of life before and after smoking cessation.Results: The internal validity of questionnaire was high (Cronbach's a = 0.92). The reliability of equivalent types in 16 stabilized patients also was high (ICC = 0.99). In general the domains within the CCQ were strongly correlated with each other, while each domain in separate was strongly correlated with the overall CCQ score (r2= 0.953, r2= 0.915 and r2= 0.842 in regards to the functional, symptomatic and mental domain, respectively). The CCQ scores were also correlated with FEV1,(r2= -0.252, p < 0.001), FEV1/FVC, (r2= -0.135, p < 0.001) as also with the quality of life questionnaire SF-12 (r2= -0.384, p < 0.001). Smoking cessation also lead to a significant reduction in CCQ score and increase in the SF-12 score.Conclusions: The self administered CCQ indicates satisfactory validity, reliability and responsiveness and may be used in clinical practice to assess patient quality of life. Moreover the CCQ indicated the health related quality of life gains attributable to smoking cessation among COPD patients, projecting smoking cessation as a key target in COPD patient management. © 2011 Papadopoulos et al; licensee BioMed Central Ltd.

Filippidis F.T.,National and Kapodistrian University of Athens | Schoretsaniti S.,National and Kapodistrian University of Athens | Dimitrakaki C.,National and Kapodistrian University of Athens | Vardavas C.I.,Center for Global Tobacco Control | And 5 more authors.
European Journal of Public Health | Year: 2014

Background: Economic crises may have a significant impact on public health. The objective of this study was to assess trends in health-related behaviours and cardiovascular risk factors within Greece before, at the beginning and during the current financial crisis by comparing data from three waves of the Greek cross-sectional household 'Hellas Health' surveys. Methods: Data from three waves were analysed. The first wave was conducted in 2006 (n = 1005), the second in 2008 (n = 1490) and the third in 2011 (n = 1008). Samples were representative of the Greek adult population in terms of age and residency. Smoking status, height, weight and fruit and vegetable consumption were self-reported. Physical activity levels were assessed with the International Physical Activity Questionnaire. Results: The prevalence of smoking in Greece decreased from 42.6 to 38.1% during the crisis period 2008-11 (P = 0.026), but not during 2006-8. The prevalence of high levels of physical activity increased among Greek adults (from 21.9 to 31.7%, P < 0.001) in all socio-economic and demographic groups, with the exception of the highest socio-economic status (SES) group. On the contrary, the consumption of at least five portions of fruit and vegetables per day significantly decreased during the crisis among those of lower SES (from 9.0 to 4.1%, P = 0.006). Prevalence of obesity did not show significant trends. Conclusions: During the economic crisis, fruit and vegetable consumption alarmingly decreased, especially among those of lower SES, whereas trends in smoking prevalence and physical activity levels seem favourable. These results indicate that the economic crisis may unequally impact cardiovascular risk factors among different socio-economic groups. © 2013 The Author.

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