The two main determinants of oral and oesophageal cancer in Europe are alcohol and tobacco, and the two cancer sites show several similarities in their descriptive epidemiology. This study compares mortality from cancers of the oral cavity and oesophagus in European countries to evaluate similarities and differences. From official death certification numbers and population estimates, we obtained age-standardized rates for all ages and truncated (35-64 years). In most countries, rates for men tended to increase between 1955-59 and 1990-92 for both sites, although the increases were more marked for oral cancer. In the UK and Ireland, however, oral cancer decreased and oesophageal cancer increased, while in Finland and Iceland mortality for both sites decreased. The most striking increases were in Hungary, where the truncated rate in most recent calendar periods reached the highest levels in Europe. In France, rates for both cancers were extremely high: oral cancer increased from 1955-59 to the early 1980s, but started to decline afterwards. Mortality rates were much lower for women than men, and the correlation between the two sites was less marked. An age, period and cohort model, applied to the rates for men in selected European countries, suggested strong cohort effects for both cancers, generally more marked for oral cancer, with substantial increases in the cohorts born after 1920. The mortality rates of cancers of the oral cavity and oesophagus show several analogies, as expected from their relation to tobacco and alcohol; but some discrepancies suggest that other, less well-identified, factors may also influence their rates and trends in Europe.
Background We carried out a multicentric cohort study to evaluate the safety and efficacy as a tool of smoking cessation of electronic cigarettes (e-cigarettes), directly comparing users of e-cigarettes only, smokers of tobacco cigarettes only, and smokers of both. Although the final results are expected in 2019, given the urgency of data to support policies on electronic smoking, we are reporting the results of the 12-month follow-up. Methods Adults (30-75 years) were included if they were smokers of >1 tobacco cigarette/day (tobacco smokers), users of any type of e-cigarettes, inhaling >50 puffs weekly (e-smokers), or smokers of both tobacco and e-cigarettes (dual smokers). Data were collected through direct contact and structured questionnaires by phone or via internet. Carbon monoxide levels were tested in a sample of those declaring tobacco smoking abstinence. Results Follow-up data were available for 236 e-smokers, 491 tobacco smokers, and 232 dual smokers (overall response rate 70.8%). All e-smokers were tobacco ex-smokers. At 12 months, 61.9% of the e-smokers were still abstinent from tobacco smoking; 20.6% of the tobacco smokers and 22.0% of the dual smokers achieved tobacco abstinence. Adjusting for potential confounders, tobacco smoking abstinence or cessation remained significantly more likely among e-smokers (adjusted OR 5.19; 95% CI: 3.35-8.02), whereas adding e-cigarettes to tobacco smoking did not enhance the likelihood of quitting tobacco and did not reduce tobacco cigarette consumption. Esmokers showed a minimal but significantly higher increase in self-rated health than other smokers. Non significant differences were found in self-reported serious adverse events (eleven overall). Conclusions Adding e-cigarettes to tobacco smoking did not facilitate smoking cessation or reduction. If e-cigarette safety will be confirmed, however, the use of e-cigarettes alone may facilitate quitters remaining so. Key messages Adding e-cigarettes to tobacco smoking may not facilitate smoking cessation or reduction If e-cigarette safety will be confirmed, however, the use of e-cigarettes alone may facilitate quitters remaining so
Trends in death certification rates from all motor vehicle accidents and motor-cycle accidents in Italy over the period 1955-79 were analysed. For both sexes, age-standardised mortality rates per 100,000 population increased steadily up to the early 1970's, reaching 40.08/100,000 males in 1972 and 11.05/100,000 females in 1973. Marked downward trends followed, and the 1977-79 rates were comparable with 1955 for males (around 28/100,000), though the total number of motor vehicles increased almost six-fold (and the number of cars over 14-fold). When age-specific rates were considered, the largest increases between the late 1950's and the early 1970's were for younger (under 25) and older (55 and over) males and younger (under 35) females. The decreases from 1974 onwards applied to both sexes and all age groups. Motor-cycle death rates increased in males up to the mid 1960's, mostly in younger (15-25) and older (over 55) age groups. A sudden, marked inversion of trends followed, starting from the younger age groups and spreading to all age groups in the mid 1970's. This pattern corresponds roughly to a 50% decrease in male death certification rates per registered motor-cycle. In absolute terms, the decline in the second half of the 1970's corresponds to about 4,000 fewer deaths per year. This is one of the major changes observed in mortality from any cause during the 1970's in Italy. Provisional data for the period 1980-82 suggest that further downward trends, albeit moderate, have continued.
