Is there an association between home-tobacco outlet proximity and smoking status in Denmark?

Abstract

Background The economic stability and sustainability of National Health Care Systems is threatened by demographic and epidemiological changes and technology revolution. In such a situation, health promotion and disease prevention represents a strategic pillar for every system. The study intends to describe and compare different European models of prevention governance in order to support a potential reorganization of the Italian system. Methods The review of preventive service organization and financing in 4 European countries (United Kingdom UK, France, Germany, Spain) was conducted on Pubmed-NCBI, on major online search engines and on the institutional website of the major European and National Agencies (WHO, OECD, PHE, NHS England). A comparative analysis of the four models was performed through a template, which aims to investigate five sections: historical background and context of the national health system, organizational structures, financing, workforce, quality assurance and performance measurement of preventive services. Results The activities of health promotion and prevention, in the four analysed countries, are organised and distributed in different levels. The preventive services can be managed on a central level, by a national agency of public health (i.e. UK and France), or can be entrusted to local governmental or non-governmental agencies (i.e. Germany and Spain). The service delivery (i.e. vaccine and screening) can be provided by a public or private health professionals. The percentage of total health funds (GDP) reserved to the prevention in the four analysed countries ranges from 1,9% in France to 4.1% in UK. Conclusions Even if the variability of these organizational models doesn't allow a direct comparison, the study of different health care prevention systems is necessary to adopt models and good practices, which proved to be effective according to the available evidences, and could help to level out the prevention service in the European countries. Key messages: Considering the demographic and economic changes and importance of the prevention strategies, this work could act as the basis for the transformation of national health systems. The study of other national health systems could provide models that can be adopt to improve the governance and the efficiency of the preventive services. Background It is well established that exposure to point-of-sale tobacco promotion or impulse purchases and access to and distance to tobacco outlets are related to youth and adult smoking. The aim of the present study was to examine the association of distance from residence to the nearest alcohol and/or tobacco outlets on smoking habits for the first time in a population based survey in Denmark.