• George Rachiotis, Anastasia Barbouni, Antonis Katsioulis, Eleni Antoniadou, Konstantinos Kostikas, Kyriakoula Merakou, Kallirrhoe Kourea, Rula N Khoury, Agis Tsouros, Jenny Kremastinou, and Christos Hadjichristodoulou.
• Faculty of Medicine, Department of Hygiene and Epidemiology, University of Thessaly, Larissa, Greece.
• BMJ Open. 2017 Jan 19; 7 (1): e013150.

ObjectivesGreece is one of the leading tobacco-producing countries in European Union, and every year over 19 000 Greeks die from tobacco-attributable diseases. The aim of the present study was to provide nationally representative estimates on current and secondhand smoking prevalence in Greece and their determinants.DesignCross-sectional.SettingGreece.ParticipantsA total of 4359 individuals participated in the Global Adult Tobacco Survey (GATS), a household survey of adults ≥15 years old (overall response rate 69%). They were selected through a multistage geographically clustered sampling design with face-to-face interview.Primary And Secondary Outcome MeasuresIn 2013, we investigated the prevalence of current and secondhand smoking and their determinants. Univariate and logistic regression analysis was used in order to identify possible risk factors associated with the prevalence of current and secondhand smoking.ResultsThe prevalence of current smoking was 38.2% (95% CI 35.7% to 40.8%), and the mean number of cigarettes smoked per day was 19.8. Multivariate analysis confirmed that male gender (OR=3.24; 95% CI 2.62 to 4.00), age groups (25-39, OR=4.49; 95% CI 3.09 to 8.46 and 40-54, OR=3.51; 95% CI 1.88 to 5.87) and high school education (OR=1.97; 95% CI 1.41 to 2.74) were independently associated with the current smoking. Remarkably, responders with primary or less education had the lowest prevalence of current smoking (p<0.001). The prevalence of exposure to secondhand smoke at work, home and restaurants, was 52.3%, 65.7% and 72.2%. In total, 90.0% (95% CI 87.8% to 91.9%) of Greek population is exposed to tobacco smoke (current smoking and secondhand smoke).ConclusionsOur results revealed an extremely high prevalence of current smoking and exposure to secondhand smoke among the adult population and a positive gradient between education and current smoking. These findings are alarming and implementation of comprehensive tobacco control and prevention strategies could be impactful in fighting the tobacco epidemic in Greece.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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