Background and Objectives: The aim of this study was to determine the role of physicians in the intensive intervention and education regarding the smoking cessation of patients undergoing elective surgery under general anaesthesia. Materials and Methods: A randomised prospective study was conducted in family physicians’ clinics in which smokers of both sexes, aged 21–65 years, without cognitive impairments, and who were not addicted to psychoactive substances voluntarily participated. Four weeks preoperatively, 120 smokers were randomised into two equal groups; the intervention group (IG) underwent an intervention for the purpose of smoking cessation and the control group (CG) underwent no intervention. Biochemical tests were performed in order to determine the smoking status of the participants in the phase of randomisation, one week preoperatively, as well as 40, 120, and 180 days and 12 months postoperatively. The examinees of the IG talked to the physician five times and received 140 telephone messages, leaflets, and motivational letters along with the pharmacotherapy, while the participants in the CG received little or no advice on smoking cessation. Results: The results of this study confirmed a significant influence of the intervention and education on the smoking abstinence in the IG compared to the CG (p < 0.001). The smokers in the IG had 7.31 (95% CI: 2.32–23.04) times greater odds of abstinence upon the 12-month follow-up than the smokers in the CG. The smokers in the IG who did not stop smoking had a lower degree of dependence and smoked fewer cigarettes (p < 0.0001) compared to those in the CG, as well as a multiple times higher prevalence of short- and long-term abstinence. Conclusions: It can be concluded that the intensive intervention and education can motivate patients preparing for elective surgery to stop smoking in the short- and long term.

Introduction. Combustible tobacco smoking accounts for nearly 30% of all cancer deaths in the United States of America and about 7 million deaths worldwide each year. Nowadays, e-cigarettes are increasingly used, especially among young people, but nicotine addiction that develops by such smoking easily converts to smoking combustible tobacco. Therefore, public health efforts must be directed to the prevention of initiation of smoking all nicotine-containing products. Role of Physicians. Medical doctors are very influential in smoking-related changes in local society, especially those who work in primary care, and they have an important role in both prevention and cessation of tobacco smoking. Tobacco smoking should be eliminated among medical doctors, yet many of them still smoke. The lowest percentage of smoking among physicians is in Oceania and North America (less than 11%) and the highest in Eurasia (25%). Smoking prevalence among medical students is higher than 35% in Georgia, Greece, Spain, and Italy, but less than 5% in the United States of America and Australia. In Serbia, 23% of physicians smoke. The age of physicians does not affect the number of smokers, but gender has a significant effect; women smoke less than men. Smoking Prevention and Cessation. Education about the effects of combustible tobacco smoking is a critical issue for successful smoking prevention and cessation; the best way is to provide educational programs on smoking at medical schools by introducing a mandatory course on combustible tobacco smoking at the beginning of the first year of study, especially in societies with a large percentage of smokers. Conclusion. In this paper, we showed how smoking can be eliminated among physicians and how they can affect the patients, public health policies, and antismoking campaigns.

Introduction/Objective. The objective of this paper was to determine the connection between the socioeconomic status (SES) of the respondents and cigarette smoking and the use of alcohol and marijuana. Is there a connection between the SES respondents and their gender and place of residence? Methods. A total of 4188 primary and secondary school respondents from Brcko District of Bosna and Herzegovina participated in a cross-sectional study based on the European School Survey Project on Alcohol and Other Drugs questionnaire, adapted to this research. The data was collected using the questionnaire prepared for each respondent. Data on gender, marital status, occupation, and professional qualifications of parents were used to determine a family?s SES according to the Hollingshead methodology. Results. Alcohol and marijuana use are in relation to SES respondents (p < 0.001 or p = 0.008): respondents living in low-SES families use alcohol or marijuana at a lower percentage than respondents from middle-SES or high-SES families. Smoking habits are not in relation to SES respondents (p = 0.678). The place of residence is connected to SES respondents (p < 0.001): more respondents from low-SES families live in rural areas, while those from medium-SES and high-SES families predominantly live in urban areas. Conclusion. The SES of the respondents is in relation to their place of residence, alcohol and marijuana use, but it is not related to cigarette smoking.

OBJECTIVE The aim was to determine the prevalence of marijuana smoking among school-aged adolescents in the Brčko District of Bosnia and Herzegovina, with particular regard to their gender, age and residence, and the frequency of marijuana smoking in the past thirty days in relation to their peers in the rest of Bosnia and Herzegovina, the Republic of Croatia and the Republic of Serbia. SUBJECTS AND METHODS This research, designed as a cross-sectional study and based on the ESPAD (European School Survey Project on Alcohol and Other Drugs) questionnaire, adjusted to this research, encompassed 4,188 adolescents from elementary and secondary schools. The data were collected by means of questionnaires tailored to each respondent. RESULTS A significantly lower number of adolescents smoke marijuana in comparison to those who do not smoke, but male adolescents smoke more often than female adolescents (p<0.001), as well as urban youth in comparison to rural youth (p=0.04). Every fourth adolescent, regardless of gender, who smoked marijuana, used it before the age of thirteen (p<0.001), male adolescents more often than females (p=0.002). In the previous thirty days a higher percentage of all the respondents from the Brčko District had smoked marijuana than those from the Republika Srpska and the RS (p<0.001), and there is no difference between them and their peers from the Federation of Bosnia and Herzegovina and the RC (p=0.382 and p=0.608). CONCLUSION Smoking marijuana in the Brčko District is a major public health problem. Male adolescents smoke marijuana more often than female adolescents, and urban youth more in comparison to rural youth. In the previous thirty days adolescents from the Brčko District smoked more often than their peers from the Republic of Serbia and the Republika Srpska, and with the same intensity but less frequently compared to adolescents from the Republic of Croatia and the Federation of Bosnia and Herzegovina.

Objective The objective of the study was to determine the prevalence of cigarette smoking in adolescents in public schools of the Brčko District of B&H in relation to their gender, age and place of residence. Participants and ­Methods A cross-sectional study, based on the ESPAD (European School Survey Project on Alcohol and Other Drugs) questionnaire adapted to this research comprised 4,188 respondents who attended primary and secondary schools. Data were collected using a questionnaire prepared for each respondent. Results Significantly fewer respondents smoke cigarettes compared to those who do not (p < 0.001), while in relation to gender male adolescents smoke more often than female adolescents (p = 0.012). In relation to their place of residence it is established that a significantly higher number of respondents from rural areas smoke cigarettes compared to those from the city (p < 0.001). More than half of the respondents, who smoke regardless of their gender, had their first cigarette before the age of 13. Male adolescents often begin smoking before the age of thirteen compared to female adolescents (p < 0.001), while female adolescents often begin smoking between the ages of 15 and 16 in relation to male adolescents (p <0.001). Every second respondent who smokes cigarettes irrespective of his/her place of residence did so at the age of 13. However, the respondents from rural areas smoke more often (p < 0.0001). Out of 895 respondents who smoked during the last month, 259 of or 30.3 % smoked only one cigarette a week, 162 or 18.1 % smoked 1-5 cigarettes a day, 168 or 18.8 % of the respondents smoked 6-10 cigarettes a day, 146 or 16.3 % smoked 11 to 20 cigarettes a day, and 160 or 17.9 % of the respondents smoked every day. Conclusion Although 42.8 % of the respondents who had ever smoked cigarettes is significantly less compared to 57.2 % of the respondents who do not smoke, that number is disturbing since we talk about the vulnerable population group and the fact that every second adolescent started smoking at the age to 13.

www.paediatricstoday.com Introduction Adolescence is a period of dramatic biological change – occurring in the context of equally dynamic socio-environmental change with regard to the adolescent’s school, peer 1Government of Brčko District of Bosnia and Herzegovina, 2Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo Bosnia and Herzegovina, 3Institute for Biostatistics and Medical Informatics Faculty of Medicine, Ljubljana, Slovenia

Accomplishment of health needs of the pollution is challenge for all society sectors as also whole community. For complete health and wellbeing is needed to provide health and safe physical environment, appropriate social and economy conditions and health care, with multi-sectorial collaboration among health and other society sectors. Biological basis as a component which is difficult to be influenced, means significant part of morbidity and mortality, but some others components such as social, economy and physical means factors on which is possible to influence with multi-sectorial approach based on multi-disciplinary and intersectorial collaboration. Future health sector guided through health promotion and management should be guarantee to achieve better outcomes.