Main Article Content
seafarers, smoking habits, nicotine addiction, lifestyles, prevention, public health
Background: populations living in stressful environments experience higher mortality from lung cancer and chronic diseases. Work-related stress was identified as important determinant of smoking together to health problems caused by a incorrect lifestyles. Aim of the work was to analyze tobacco smoking addiction in seafarers working on merchant ships. Only a few studies are available on this topic.
Methods: the survey was conducted using an anonymous questionnaire. The total number of questionnaires filled-in was 1478, out of 2000 distributed (response rate 73.9 %).
Results: about half of the sample (55.07%) has never smoked, the 28.96% is currently a smoker, while 15.97% of responders belong to the category of ex-smokers. Analysis of the number of cigarettes smoked every day based on the rank shows that captains and officers smoke more cigarettes than the crew members who smoke 10 cigarettes maximum per day. Analysis of the level of dependence among the smokers group by the Fagerström Test for Nicotine Dependence (FTND) revealed that a 89.0% of sample has a low/very low dependence level, and only the 10.98% of the sample show a high/very high dependence. A further analysis of the results of FTND in the different age groups has shown that the 41-50 and 51-60 age groups have high dependence levels.
Conclusions: working on board is associated to a high risk for chronic, lifestyle-related diseases, due also to lifestyle behaviours. This study suggests to further investigate the presence of other risk factors such as diet, physical exercise, combined with tobacco smoking, obesity.
2. Signorelli C, Odone A, Gozzini A, Petrelli F, Tirani M, Zangrandi A, Zoni R, Florindo N. The missed Constitutional Reform and its possible impact on the sustainability of the Italian National Health Service. Acta Biomed. 2017 Apr 28;88(1):91-94.
3. Petrelli F, Contratti CM, Tanzi E, Grappasonni I. Vaccine hesitancy, a public health problem. Ann Ig. 2018 Mar-Apr;30(2):86-103.
4. Martìnez-Sànchez JM, Fernàndez E, Fu M, Gallus S, Martìnez C, Sureda X, La Vecchia C, Clancy L. Smoking Behaviour, Involuntary Smoking, Attitudes towards Smoke-Free Legislations, and Tobacco Control Activities in the European Union. PLoS ONE 2010; 5(11): e13881.
5. Osservatorio Fumo Alcol e Droga – OSSFAD - Istituto Superiore di Sanità (2012). Rapporto sul fumo in Italia 2012. Roma, Italia
6. Bernstein SL, Boudreaux ED, Cabral L, Cydulka RK, Schwegman D, Larkin GL, Adams AL, McCullough LB, Rhodes KV. Nicotine dependence, motivation to quit, and diagnosis among adult emergency department patients who smoke: a national survey. Nicotine & Tobacco Research. 2008; 10 (8): 1277-82.
7. Fagerström K. The epidemiology of smoking: health consequences and benefits of cessation. Drugs 2002; 62 (Suppl 2): 1-9
8. Tizabi Y, Overstreet D H, Rezvani AH, Louis VA, Clark Jr E, Janowsky DS, Kling MA. Antidepressant effects of nicotine in an animal model of depression. Psychopharmacology 1999; 142(2), 193-99
9. Invernizzi G, Nardini S, Bettoncelli G, Codifava A, Corti F, Guerra G, La Vecchia C, Lazzaro C, Sabato E, Zuccaro P. The role of general practitioner in tobacco control: reccomendations for a proper management of the smoking patient. Rassegna di Patologia dell’Apparato Respiratorio 2002; 17: 55-70
10. Jarvis MJ. ABC of smoking cessation: Why people smoke. BMJ: British Medical Journal 2004; Jan 31; 328(7434): 277–79
11. Frantzeskou E, Kastania A N, Riza E, Jensen OC, Linos A. Risk factors for fishermen’s health and safety in Greece. Int Marit Health 2012; 63(3): 155-61
12. Jeżewska M, Iversen R. Stress and fatigue at sea versus quality of life. Int Marit Health 2012; 63(3): 106-15
13. Grappasonni I, Petrelli F, Scuri S, Mahdi SS, Sibilio F, Amenta F. Knowledge and Attitudes on Food Hygiene among Food Services Staff on Board Ships. Ann Ig. 2018 Mar-Apr;30(2):162-172.
14. Grappasonni I, Marconi D, Mazzucchi F, Petrelli F, Scuri S, Amenta F. Survey on food hygiene knowledge on board ships. Int Marit Health. 2013;64(3):160-7.
15. Siracusa M, Petrelli F. Trade of food supplement: food or drug supplement? Recenti Prog Med. 2016 Sep;107(9):465-471.
16. Grappasonni I, Scuri S, Tanzi E, Kracmarova L, Petrelli F. The economic crisis and lifestyle changes: a survey on frequency of use of medications and of preventive and specialistic medical care, in the Marche Region (Italy). Acta Biomed. 2018 Mar 27;89(1):87-92.
17. Szymańska K, Jaremin B, Rosik E. Suicides among Polish seamen and fishermen during work at sea. Int Marit Health 2006; 57: 36-45
18. Scuri S, Tesauro M, Petrelli F, Peroni A, Kracmarova L, Grappasonni I. Implications of modified food choices and food-related lifestyles following the economic crisis in the Marche Region of Italy. Ann Ig. 2018 Mar-Apr;30(2):173-179.
19. Petrelli F, Grappasonni I, Peroni A, Kracmarova L, Scuri S. Survey about the potential effects of economic downturn on alcohol consumption, smoking and quality of life in a sample of Central Italy population. Acta Biomed. 2018 Mar 27;89(1):93-98.
20. Leone A. Smoking and hypertension: independent or additive effects to determining vascular damage? Curr Vasc Pharmacol 2011; 9(5): 585-93
21. Pittilo RM. Cigarette smoking, endothelial injury and cardiovascular disease. Int J Exp Pathol 2000; 81(4): 219-30
22. Bollettino sulle dipendenze (http://www.bollettinodipendenze.it/FLASH-NEWS/Rapporto-OMS-sul-fumo-di-tabacco.html) (consultato il 22 gennaio 2014)
23. Ministero Della Salute; http://www.salute.gov.it
24. Grappasonni I, Petrelli F, Amenta F. Deaths on board ships assisted by the Centro Internazionale Radio Medico in the last 25 years. Travel Med Infect Dis. 2012 Jul;10(4):186-91.
25. Fort E, Massardier-Pilonchery A, Bergeret A. Alcohol and nicotine dependence in French seafarers. International Maritime Health 2009; 60(1-2): 18–28
26. Fort E, Massardier-Pilonchéry A, Bergeret A. Psychoactive substances consumption in French fishermen and merchant seamen. International Archives of Occupational and Environmental Health 2010; 83(5): 497–509
27. Spacilova L, Klusonova H, Petrelli F, Signorelli C, Visnovsky P, Grappasonni I. Substance use and knowledge among Italian high school students. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2009 Jun;153(2):163-8
28. Kračmarová L, Klusoňová H, Petrelli F, Grappasonni I. Tobacco, alcohol and illegal substances: experiences and attitudes among Italian university students. Rev Assoc Med Bras (1992). 2011 Sep-Oct;57 (5):523-8.
29. Petrelli F, Scuri S, Tanzi E, Nguyễn TTC, Grappasonni I. Lifestyles and discomfort in a sample of young Romanian students. J Prev Med Hyg. 2018 Sep 28;59(3):E230-E235.
30. Oldenburg M, Harth V, Manuwald U. Non-cancer diseases requiring admission to hospital among German seafarers. International Maritime Health. 2015; 66(1): 6–10
31. Scuri S, Petrelli F, Tesauro M, Carrozzo F, Kracmarova L, Grappasonni I. Energy drink consumption: a survey in high school students and associated psychological effects. J Prev Med Hyg. 2018 Mar 30;59(1):E75-E79.
32. Petrelli F, Grappasonni I, Evangelista D, Pompei P, Broglia G, Cioffi P, Kracmarova L, Scuri S. Mental and physical effects of energy drinks consumption in an Italian young people group: a pilot study. J Prev Med Hyg. 2018 Mar 30;59(1):E80-E87.
33. Grappasonni I, Petrelli F, Traini E, Grifantini G, Mari M, Signorelli C. Psychological symptoms and quality of life among the population of L’Aquila’s “new towns” after the 2009 earthquake. Epidem Biostat Pub Health. 2017; 14(2): e11690-1-13.
34. Priebe S, Grappasonni I, Mari M, Dewey M, Petrelli F, Costa A. Posttraumatic stress disorder six months after an earthquake: findings from a community sample in a rural region in Italy. Soc Psychiatry Psychiatr Epidemiol. 2009 May;44(5):393-7.
35. Grappasonni I, Petrelli F, Klusoňová H, Kračmarová L. Level of understanding of medical terms among italian students. Ceska Slov Farm. Winter 2016;65(6):216-220
36. Cioffi P, Laudadio L, Nuzzo A, Belfiglio M, Petrelli F, Grappasonni I. Gemcitabine-induced posterior reversible encephalopathy syndrome: a case report. J Oncol Pharm Pract. 2012 Jun;18(2):299-302.
37. Mignini F, Sabbatini M, Pascucci C, Petrelli F, Grappasonni I, Vanacore N. Pharmaco-epidemiological description of the population of the Marche Region (central Italy) treated with the antipsychotic drug olanzapine. Ann Ist Super Sanita. 2013;49(1):42-9.
38. Cioffi P, Marotta V, Fanizza C, Giglioni A, Natoli C, Petrelli F, Grappasonni I. Effectiveness and response predictive factors of erlotinib in a non-small cell lung cancer unselected European population previously treated: a retrospective, observational, multicentric study. J Oncol Pharm Pract. 2013 Sep;19(3):246-53.
39. Cioffi P, Antonelli D, Belfiglio M, Melena S, Petrelli F, Grappasonni I. The impact of a pharmacist as a member of healthcare team on facilitating evidenced-based prescribing of innovative drugs in an Italian oncology department. J Oncol Pharm Pract. 2012 Jun;18(2):207-12.
40. Siracusa M, Grappasonni I, Petrelli F. [The criminal liability of the hospital pharmacist vs the liability of the hospit al]. Recenti Prog Med. 2016 Jan;107(1):19-24.
41. Oldenburg M, Jensen HJ, Latza U, Baur X. The risk of coronary heart disease of seafarers on vessels sailing under German flag. Int Marit Health. 2010; 61, 3: 123-28
42. Oldenburg, M. Risk of cardiovascular diseases in seafarers. International Maritime Health 2014; 65(2): 53–57
43. Carotenuto A, Molino I, Fasanaro A M, Amenta F. Psychological stress in seafarers: a review. International Maritime Health 2012; 63(4): 188–94
44. Jepsen JR, Zhao Z, Van Leeuwen WM. Seafarer fatigue: a review of risk factors, consequences for seafarers’ health and safety and options for mitigation. International Maritime Health 2015; 66(2): 106–17
45. Jeżewska M, Iversen R, Grubman M. (2012). Stress and fatigue at sea versus quality of life II International Congress on Maritime, Tropical, and Hyperbaric Medicine Venue: on board “Scandinavia” ferry, Gdansk – Nynashamn – Gdansk With supporting funding from the ITF Seafarers’ Trust REPORT 2012; 106–15
46. Cronan TA, Conway TL, Kaszas SL. Starting to smoke in the Navy: when, where and why. Social Science & Medicine 1991; 33(12): 1349-53
47. Lawrie T, Matheson C, Ritchie L, Murphy E, Bond C. The health and lifestyle of Scottish fishermen: a need for health promotion. Health Education Research 2004; 19(4): 373-79
48. Marco JL, Zubillaga GG. Smoking among maritime workers in the province of Guipúzcoa. An epidemiological study. Archivos de bronconeumologia 1995; 31(9): 443-47
49. Nogueroles A, Juan AS, Almenara BJ, Failde MI, Zafra MJ. (1992). The tobacco habit among fishermen of the Barbate coast (Cádiz). Revista de sanidad e higiene pública 1992; 66(5-6), 299-305
50. Novalbos J, Nogueroles P, Soriguer M, Piniella F. Occupational health in the Andalusian fisheries sector. Occupational medicine 2008; 58(2): 141-43
51. Hjarnoe L, Leppin A. Health promotion in the Danish maritime setting: challenges and possibilities for changing lifestyle behavior and health among seafarers. BMC public health 2013; 13(1): 1165.
52. Hjarnoe L, Leppin A. A risky occupation? (Un)healthy lifestyle behaviors among Danish seafarers. Health Promot Int 2014; 29(4): 720-9.
53. Grappasonni I, Paci P, Mazzucchi F, De Longis S, Amenta F. Awareness of health risks at the workplace and of risks of contracting communicable diseases including those related to food hygiene, among seafarers. Int Marit Health 2012; 63 (1):24-31
54. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. (1991). The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. British Journal of Addiction 1991; 86(9), 1119–27
55. Du Plooy JL, Macharia M, Verster C. Cigarette smoking, nicotine dependence, and motivation ot quit smoking in South African male psychiatric inpatients. BMC Psychiatry 2016; 16; 16(1):403.
56. Smith F. Survey research: (2) Survey instruments, reliability and validity. Int J of Pharm Practice 1997; 5: 216-26
57. XLSTAT. Statistical software & data analysisi add-on for Excel. Addinsoft (2017)
58. Lemke MK, Apostolopoulos Y, Hege A, Wideman L, Sönmez S. Work, sleep, and cholesterol levels of U.S. long-haul truck drivers. Industrial Health 2017; 55: 149-61
59. Caruso CC, Hitchcock EM, Dick RB, Russo JM, Schmit JM. Overtime and extended work shifts: recent findings on illnesses, injuries, and health behaviors. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, OH. www.cdc.gov/niosh
60. Potvin L, Richard L, Alison CE. Knowledge of cardiovascular disease risk factors among the Canadian population: relationships with indicators of socioeconomic status. Canadian medical association journal. Supplement To CMAJ 2000;162(9 Suppl)
61. Hansen HL, Tüchsen F, Hannerz H. Hospitalisations among seafarers on merchant ships Occup Environ Med 2005; 62:145-50
62. Siahpush M, McNeill A, Hammond D, Fong GT. Socioeconomic and country variations in knowledge of health risks of tobacco smoking and toxic constituents of smoke: results from the 2002 International Tobacco Control (ITC) Four Country Survey. Tobacco Control 2006; 15 (Suppl III): 65-70.
63. Rachiotis G, Karydis I, Drivas S, Hadjichristodoulou C. Pattern of Smoking Habit among Greek Blue and White Collar Workers. Int. J. Environ. Res. Public Health 2009; 6: 1812-17
64. Memon A, Moody PM, Sugathan TN, el-Gerges N, al-Bustan M, al-Shatti A, al-Jazzaf H. Epidemiology of smoking among Kuwaiti adults: prevalence, characteristics, and attitudes. Bull World Health Organ 2000; 78(11): 1306-15
65. Sunday A, Mesbah FS. The effect of job stress on smoking and alcohol consumption. Health Economics Review 2011, 1:15.
66. Hassani S, Yazdanparast T, Seyedmehdi SM, Ghaffari M, Mirsaeed Attarchi M, Bahadori B. Relationship of Occupational and Non-Occupational Stress with Smoking in Automotive Industry Workers. Tanaffos. 2014; 13(2): 35-42
67. John U, Meyer C, Rumpf HJ, Hapke U. Probabilities of alcohol high-risk drinking, abuse or dependence estimated on grounds of tobacco smoking and nicotine dependence. Addiction 2003; 98: 805–14
68. Little HJ. Behavioral mechanism underlying the link between smoking and drinking. Alcohol Res Health 2000; 24: 215–24
69. Offen N, Arvey SR, Smith EA, Malone RE. Forcing the Navy to sell cigarettes on ships: how the tobacco industry and politicians torpedoed Navy tobacco control. American journal of public health 2011; Mar; 101 (3): 404-11
70. Geving IH, Jørgensen KU, Thi MS, Sandsund M. Physical activity levels among offshore fleet seafarers. Int Marit Health 2007; 58(1-4): 103-14
71. Filikowski J, Rzepiak M, Renke W, Winnicka A, Smolinska D. Selected risk factors of ischemic heart disease in Polish seafarers. Preliminary report. Int Marit Health 2003; 54 (1-4): 40-6.