Tobacco Dependence Clinical Trial
Official title:
European Regulatory Science on Tobacco: Policy Implementation to Reduce Lung Diseases (EUREST-PLUS)
The main objective of EUREST-PLUS is to monitor and evaluate the impact of the Tobacco
Products Directive (TPD) within the context of FCTC ratification at an EU level. The
investigators specific objectives, within WorkPackage 2 and Workpackage 3 are: To evaluate
the psychosocial and behavioral impact of TPD implementation and FCTC implementation, through
the creation of a cohort study of adult smokers in 6 European Member States (EU MS), Germany,
Greece, Hungary, Poland, Romania, Spain; (total n=6000) in a pre- vs. post-TPD study design.
EUREST-PLUS is funded through the European Union's Horizon 2020 research and innovation
programme under grant agreement No 681109
Smoking and other forms of tobacco consumption are considered the single most important cause
of preventable morbidity and premature mortality worldwide, with tobacco the major single
cause for premature deaths in the European Union (EU).Efforts to reduce the devastation of
tobacco-related deaths and illness in the EU consist of its newly adopted binding
legislation, the Tobacco Products Directive (TPD), and the ongoing implementation of the WHO
Framework Convention on Tobacco Control (FCTC).
Objective:
The main objective of EUREST-PLUS is to monitor and evaluate the psychosocial and behavioral
impact of the TPD within the context of FCTC ratification at a European level, through the
creation of a cohort study of adult smokers in 6 EU MS (Germany, Greece, Hungary, Poland,
Romania, Spain; total n=6000) in a pre- vs. post-TPD study design. The baseline recruitment
will take place in WP2 and the follow up in WP3.
Sampling frames:
- The sampling frame will be determined through a national probability sampling design
within each country.
- Sample stratification will be geographic and comprise the major regions of each country
(Nomenclature of Territorial Units for Statistics - NUTS) NUTS2 (Basic regions for the
application of regional policies) will be used for all countries except Germany - where
NUTS1 (Major socio-economic regions) will be used, as well as degrees of urbanization
(city/town/rural.)
- Geographic areas excluded from the sampling design will be: In Greece, the islands in
the Ionian Sea, the northern Aegean Sea and the southern Aegean Sea. In Spain the
Canaries, Ceuta and Melilla
- Overall the design will be multistage within strata. The strata will be conceptually
divided into clusters, each the size of an enumeration area, with the objective of
sampling a total of 250 clusters - 4 adult smokers per cluster in every country.
- Clusters will be allocated based on population size and sampled via random sampling.
Sampling households within clusters:
- Interviewers will employ a random walk procedure within a particular cluster
- Once interviewers have arrived at an address, the household will be approached four
times at different times of the day and week before being designated as "unable to be
contacted."
- If an address corresponds to multiple households, a single household will be chosen at
random.
- Households are approached until a total of 4 adult smokers have been reached within the
cluster. A maximum of one male smoker and one female smoker will be selected for
interview in each household.
- One male and one female from within the household that meet the criteria will be
selected using the last birthday method
Respondents:
- The respondents for the Survey will be smokers aged 18 and older. The first part of the
survey, which is the household screener, contains the questions that are used to
determine whether the household has members that meet the criteria for inclusion.
- The household screener is asked of the most knowledgeable individual (MKI) within
the household.
- One male and one female from within the household that meet the criteria will be
selected using the last birthday method.
- The Individual screener follows the Household screener and confirms the information from
the MKI is accurate. If the selected individual meets the eligibility criteria and
consents to participate, they will be included in the sample
Survey (questionnaire):
The questionnaire will include questions not only about tobacco use, history of use, history
of quitting, quit method(s) used, measures of dependence, and demographics (age, gender,
education, income) but also extensive, theory-based measures of responsiveness to each policy
domain of the FCTC. The survey questionnaire will consist of:
1. multiple measures of policy-specific variables for each of the domains of the TPD and
FCTC (e.g., health warnings, additives, e-cigarettes for TPD, illicit trade; additional
domains of the FCTC, including smoke-free laws, tax/price policies, cessation services,
additional product regulation domains);
2. psychosocial mediators, identified by past research and theory to predict future health
behaviours, including beliefs and attitudes, perceived risk, intentions to quit;
3. moderators such as demographic variables (sex, gender), and other variables that will
allow analyses of whether TPD and FCTC policies vary in their impact as a function of
socioeconomical status.
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