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OBJECTIVES: The aim of this study is to analyse Global Youth Tobacco Survey (GYTS) data on a prevalence of tobacco use, indicators of tobacco control and pro-tobacco activities in Czechia and Slovakia between 2002 and 2016. METHODS: GYTS is a school-based survey of students aged 13-15 years carried out in Czechia and Slovakia in 2002/2003, 2007, 2011 and 2016. Standardized uniform questionnaires provided representative data. RESULTS: Between 2002 and 2016 the current cigarette smoking declined both in Czechia and Slovakia (from 34.6% and 26.4% to 15.2% and 17.1%, respectively). Indicators of tobacco control activities either did not change (access to buy cigarettes by minors) or decreased (school-based and mass media interventions). Indicators of pro-tobacco activities declined (being ever offered by a free tobacco product and having something with a tobacco product brand logo on it). CONCLUSIONS: Tobacco use is on decline and the situation becomes similar to the most of European countries. Preventive activities are only partially responsible for the process. Rather effect of global trends accelerated by widespread use of social media can play a role.

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OBJECTIVE: Smoking significantly affects morbidity and mortality of the population. The incidence of smoking is determined by gender and socioeconomic status (SES) of an individual. The aim of this study is to analyse the relationship between gender and SES indicators and smoking. METHODS: The analysis is based on data from the Czech National Tobacco Surveys from 2012 to 2015 (N∼1,800 per year). The prevalence of smoking, average daily consumption of cigarettes, initiation ratio and quit ratio were monitored. Smoking habits of the respondents were surveyed using the Czech version of the standard Tobacco Questions for Surveys (TQS) questionnaire. SES was measured by a composite index comprising three variables (level of education, income and job prestige); it had four categories: low, lower-middle, upper-middle, and high. RESULTS: In comparison with women, men had a higher smoking prevalence (OR=1.41, 95% CI=1.09-1.84), higher consumption of cigarettes (B=4.11, 95% CI=1.97-6.26), and higher rate of smoking initiation (OR=1.38, 95% CI=1.10-1.74), but they did not differ in the quit rate (OR=0.85, 95% CI=0.60-1.21). Persons in the low SES category had higher prevalence of smoking and higher initiation ratio compared with those in the high SES category (OR=2.59, 95% CI=1.36-4.97; OR=2.23, 95% CI=1.26-3.95). Cigarette consumption and quit ratio did not differ according to SES. The prevalence of smoking in the years 2012-2014 did not differ; in 2015, it was lower compared to the previous three years. CONCLUSIONS: Inequalities in socioeconomic status affect smoking, which significantly contributes to morbidity and mortality. Measures aimed at reducing inequalities in health must take into account both smoking as a risk factor and socioeconomic status, which affects its occurrence. Programmes to reduce tobacco use should reflect the different needs of individuals with different SES levels. It is especially necessary to seek effective approaches for smokers with low socioeconomic status.

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AIMS: To document the attitudes of general practitioners (GPs) from eight European countries to alcohol and alcohol problems and how these attitudes are associated with self-reported activity in managing patients with alcohol and alcohol problems. METHODS: A total of 2345 GPs were surveyed. The questionnaire included questions on the GP's demographics, reported education and training on alcohol, attitudes towards managing alcohol problems and self-reported estimates of numbers of patients managed for alcohol and alcohol problems during the previous year. RESULTS: The estimated mean number of patients managed for alcohol and alcohol problems during the previous year ranged from 5 to 21 across the eight countries. GPs who reported higher levels of education for alcohol problems and GPs who felt more secure in managing patients with such problems reported managing a higher number of patients. GPs who reported that doctors tended to have a disease model of alcohol problems and those who felt that drinking was a personal rather than a medical responsibility reported managing a lower number of patients. CONCLUSION: The extent of alcohol education and GPs' attitudes towards alcohol were associated with the reported number of patients managed. Thus, it is worth exploring the extent to which improved education, using pharmacotherapy in primary health care and a shift to personalized health care in which individual patients are facilitated to undertake their own assessment and management (individual responsibility) might increase the number of heavy drinkers who receive feedback on their drinking and support to reduce their drinking.

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BACKGROUND: This study compares dose-response injury risk estimates for two control periods defined as the same 6-hour period the week prior and the set of all non-sleeping 6-hour periods over the past year. METHOD: Dose-response injury risk estimates for the multiple match controls are generated via the application of a maximum-likelihood approach. RESULTS: Injury risk associated with any (i.e., 1 drink or more) drinking 6 hours prior to injury was similar for the two control choices (last week and usual frequency). For 1-4 drinks, risk estimates were similar across control period definitions; for 5+ drinks, risk using the week prior as the control was nearly double that using the past 12 months as the control. CONCLUSIONS: Although studies with smaller ns may benefit from the increase in precision from the use of the multiple control periods, results indicate that heavy drinking injury risk estimates should be used with caution.

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OBJECTIVES: The European project VINTAGE - Good Health Into Older Age aims at filling the knowledge gap and building capacity on alcohol and the elderly, encouraging evidence- and experience-based interventions. METHODS: Systematic review of scientific literature on the impact of alcohol on older people; ad hoc survey and review of grey literature to collect EU examples of good practices for prevention; dissemination of findings to stakeholders involved in the field of alcohol, aging or public health in general. RESULTS: Design and procedures of the VINTAGE project are described, providing also an outline of major results, with particular attention to those related to the dissemination activity. CONCLUSIONS: Much more information and research is needed. This issue should be part of both alcohol and healthy ageing policies.

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INTRODUCTION: There is a lack of information about initiatives aimed at preventing the harmful effects of alcohol amongst the elderly. OBJECTIVES: One of the objectives of the VINTAGE study was to collect the initiatives carried out in Europe and review the published grey literature about this topic. METHODS: Email-based survey addressed to researchers, professionals and policymakers, and internet search of grey literature. RESULTS: Three hundred nine contacts were finally made, and 21 of the 36 collected initiatives were considered as useful in preventing the harmful use of alcohol amongst the elderly. Out of the about 2900 references identified 96 were classified as relevant. CONCLUSIONS: Despite a growing interest, alcohol use in the elderly is not yet perceived as a major issue for prevention.

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OBJECTIVES: The main objective of the study is to explore associations between alcohol consumption and marijuana use in young adults and to discuss the opportunities for brief intervention. METHODS: Face to face structured interviews were carried out with 2,221 young adult Czechs (mean age 29.9, sd. 5.8 years). 51.4% were males. Alcohol consumption was calculated using beverage specific quantity frequency method. Alcohol-related problems were assessed using the Czech version of the AUDIT. Frequency of marijuana use in the last twelve months was asked as well. RESULTS: The overall alcohol consumption was 9.2 litres of pure alcohol per person and year. The last year prevalence of marijuana use was 21.8%. The use of marijuana positively correlated with the frequency of beer drinking (r = 0.27), frequency of heavy episodic drinking [HED] (r = 0.32) and with the summary score in AUDIT (r = 0.39). Harmful or problem drinkers (AUDIT score > or = 16) reported marijuana use more frequently than moderate drinkers (60% compared to 18.8%; OR = 6.54; 95% CI = 4.7; 9.1). OR for marihuana use in heavy episodic drinkers was 4.3 (95% CI = 3.3; 5.6). DISCUSSION: The results suggest that frequent HED and harmful drinking are closely associated with marijuana use in younger adults. Since marijuana use (including heavy use) is rather common in the Czech Republic, it would be recommendable to also extend screening and brief intervention to reduce the use of cannabis. The existing guidelines for brief intervention should be modified in order to cover marijuana consumption as well.

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AIM: The primary aim of the study is to examine the psychometric properties and the structure of the Czech version of the Alcohol Use Disorders Identification Test (AUDIT), and to estimate the rate of risky, harmful and problematic alcohol consumers. METHODS AND SAMPLE: Two large data sets were analyzed. The first was based on the application of the AUDIT as a part of a general population survey (N = 1.326; age range 18-64), the second represents data gathered by general practitioners (GPs) in the context of a pilot screening and brief advice (SBA) project in the area of Greater Prague (N = 2.589). RESULTS: Analyses of reliability showed satisfying internal consistency of the AUDIT (Cronbach's alpha = 0.83 for population survey and 0.77 for survey based on SBA). Principal component analyses suggest two factor solutions where one factor represents drinking patterns and the second alcohol-related problems or symptoms of dependence. The principal component analyses of both data sets led to similar factor formation. A total of 19% of the general population sample was classified as risky or harmful drinkers and 2% as problem drinkers. These figures were slightly lower in the sample of patients of general practitioners. CONCLUSIONS: The Czech version of the AUDIT seems to be a plausible screening instrument. The properties of the instrument suggest usefulness of the summary score for identification of the level of risk.

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BACKGROUND: While the validity of self-reported consumption based on blood alcohol concentration (BAC) has been found to be high in emergency room (ER) samples, little research exists on the estimated number of drinks consumed given a BAC level. Such data would be useful in establishing a dose-response relationship between drinking and risk (e.g., of injury) in those studies for which the number of drinks consumed is not available but BAC is. METHODS: Several methods were used to estimate the number of drinks consumed in the 6 hours prior to injury based on BAC obtained at the time of ER admission of n = 1,953 patients who self-reported any drinking 6 hours prior to their injury and who arrived to the ER within 6 hours of the event, from the merged Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study on Alcohol and Injury across 16 countries. RESULTS: The relationship between self-reported consumption and averaged BAC within each consumption level appeared to be fairly linear up to about 7 drinks and a BAC of approximately 100 mg/dl. Above about 7 reported drinks, BAC appeared to have no relationship with drinking, possibly representing longer consumption periods than only the 6 hours before injury for those reporting higher quantities consumed. Both the volume estimate from the bivariate BAC to self-report relationship as well as from a Widmark calculation using BAC and time from last drink to arrival to the ER indicated a somewhat weak relationship to actual number of self-reported drinks. CONCLUSIONS: Future studies may benefit from investigating the factors suspected to be driving the weak relationships between these measures, including the actual time over which the reported alcohol was consumed and pattern of drinking over the consumption period.

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BACKGROUND: The Czech Republic is a member of the European Union (EU) and the World Health Organization (WHO). The EU has made tobacco use prevention a primary health issue and WHO European Region has adopted the European Strategy for Tobacco Control. The aim of the current study is to evaluate the status of tobacco use among adolescents in the Czech Republic and relate these findings to the tobacco control programme efforts supported by the EU and WHO. METHODS: Global Youth Tobacco Survey (GYTS) data were collected from representative samples of students in grades associated with ages 13-15 in the Czech Republic in 2002 and 2007. RESULTS: Current cigarette smoking decreased from 35% to 31% overall. Exposure to second-hand smoke (SHS) in public places remained unchanged over time (75% in 2007). Almost half of respondents reported having a parent who smokes and about one third had best friends who smoked. There were significant decreases in exposure to pro-tobacco advertisements on billboards in magazines. CONCLUSIONS: Efforts to reduce the current and projected harm caused by tobacco use in the Czech Republic are urgently needed. The Czech Republic needs to expand its national comprehensive tobacco prevention and control programmes and enforce those laws already passed. Without this effort little reduction can be expected in the burden of chronic diseases and tobacco-related mortality. What this paper adds. Results from the GYTS conducted in the Czech Republic indicate a number of serious challenges to prevent and control tobacco use in the region despite a range of ongoing tobacco control activities. GYTS data can enhance countries' capacity to monitor tobacco use among youth; guide development, implementation, and evaluation of their national tobacco prevention and control programme; and allow comparison of tobacco-related data at the national, regional, and global levels.

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OBJECTIVES: To present data on Environmental Tobacco Smoke (ETS), Global Youth Tobacco Survey (GYTS), Czech Republic, Hungary, Poland and Slovakia. METHODS: A questionnaire survey of a representative sample of 16 918 schoolchildren aged 13-15 years (2002-2003). RESULTS: Exposure to ETS was reported more frequently in public places than in homes and more frequently from current smokers (CS) than from never smokers (NS). ETS in homes was lower in Czech (57.6% in CS, 24.7% in NS) than in other countries (the highest in Poland: 93.0% in CS, 80.9% in NS). ETS in public places was highest in Hungary (96.9% in CS, 89.2% in NS), lowest in Czech (90.1% in CS, 57.3% in NS). Most students considered ETS as harmful and presented positive attitudes towards smoking ban. DISCUSSION: ETS in studied countries, save the Czech Republic, exceeded the global prevalence, while the situation is better than in numerous other Eastern European countries.

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OBJECTIVES: The main objective of this work is to quantify the number of hospitalizations caused by smoking, estimate the costs of hospital treatment and to estimate contribution of smoking to mortality in the Czech Republic (CR) in 2002. METHODS: The estimate of the proportion by which smoking contributed to hospitalizations and to mortality in the CR was computed using the method of smoking-attributable fractions (SAF). The SAF was computed from relative risks established in the American study Cancer Prevention Study II and from estimates of the prevalence of smoking in the CR from a nationwide study conducted in 2002. RESULTS: In 2002, based on data provided by the General Health Insurance Company, there were 145,336 hospitalizations, and the total cost of hospital treatment was estimated as 4.727,612 (in thousands) CZK. The total number of deaths caused by smoking was 20,550 (95% CI: 18,851-22,262), 14,525 in men and 6,025 in women. Deaths caused by smoking represented 19% of the total nationwide mortality for 2002. Earlier estimates were published by Peto and Lopez for 1995 (22,300 deaths caused by smoking) and 2000 (17,746 deaths). The estimate arrived by authors using the SAF method for 2002 corresponds quite well with that by Peto and Lopez for 2000. CONCLUSIONS: The high morbidity and mortality rate related to smoking is directly connected to high prevalence of smoking in the Czech Republic. An effective tobacco control policy, including restrictive measures on availability of tobacco products combined with preventive programmes and smoking cessation programmes, could contribute to the reduction of smoking and save lives and treatment costs caused by smoking.

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OBJECTIVE: Self-reports of alcohol consumption among patients visiting an emergency department (ED) have been used extensively in the investigation of the relationship between drinking and injury. Little is known, however, about the associations between validity of self-reports with patient and injury characteristics and whether these relationships vary across regions or countries. Both of these issues are explored in this article. METHOD: In the construct of a multilevel logistical model, validity of self-reports was estimated as the probability of a positive self-report given a positive blood alcohol concentration (BAC). The setting included 44 EDs across 28 studies in 16 countries. Participants included 10,741 injury patients from the combined Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study of Alcohol and Injuries. Data were analyzed on self-reported drinking within 6 hours before injury compared with BAC results obtained from breath-analyzer readings in all but two studies, which used urine screens. Covariates included demographic, drinking, and injury characteristics and aggregate-level contextual variables. RESULTS: At the individual level, a higher BAC measurement was associated with a higher probability of reporting drinking, as was heavy drinking and sustaining injuries in traffic accidents or violence-related events. At the study level, neither aggregate BAC nor other sociocultural variables affected the validity of self-reported drinking. CONCLUSIONS: This study provides further evidence of the validity of self-reported drinking measures in crossnational ED studies based on the objective criterion of BAC estimates.

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OBJECTIVES: To show selected findings from the Global Youth Tobacco Survey (GYTS) conducted in Czech Republic, Hungary, Poland and Slovakia. METHODS: Representative sample of 16918 school children aged 13-15 years; data were obtained through uniform questionnaires. The fieldwork was conducted in 2002 and 2003. RESULTS: Age at initiation of smoking was particularly earlier in Czech Republic, Poland, and Slovakia than in Hungary. Over one third of the students reported current cigarette smoking in Czech Republic (34.9%) and Hungary (33.5%) compared to about one-fourth in Slovakia (24.3%) and Poland (23.3%). Among current smokers, about two thirds in Slovakia (64.0%) desired to stop smoking, while only one third in Hungary (36.7%). The prevalence of current cigarette smoking was similar between genders. DISCUSSION: Smoking prevalence in these countries is considerably higher than worldwide data. Women's smoking could be an important public health problem in the future. Repeated surveys could show trends and give a clearer picture of the epidemiological situation.

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OBJECTIVE: There are little data available on the performance of brief screening instruments for alcohol-use disorders cross-nationally; therefore, we analyzed the performance of one such instrument in a number of countries. METHOD: Performance of the RAPS4 for tolerance and the RAPS4-QF for heavy drinking are analyzed from emergency room data across 13 countries included in the combined Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study on Alcohol and Injuries. RESULTS: The RAPS4 showed good sensitivity and specificity for tolerance across most of the countries, but was higher in countries that were higher on societal-level detrimental drinking patterns. Prevalence of tolerance was also higher in those countries with high detrimental drinking pattern scores. Sensitivity of the RAPS4-QF for heavy drinking was uniformly high across countries, while maintaining good specificity, and did not vary by detrimental drinking patterns. CONCLUSIONS: Findings suggest the RAPS4 and RAPS4-QF may hold promise cross-nationally. Future research should more fully address the performance of brief screening instruments for alcohol-use disorders (using standard diagnostic criteria) cross-nationally, with consideration of the impact of societal drinking patterns.

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