Vaping, Perceptions of Vaping, and Plans to Quit Among E-cigarette Users in the United States and the United Kingdom.

INTRODUCTION: Government and health organizations in the United States and the United Kingdom have taken different stances on e-cigarettes policy. To explore the potential effects of these policies, we describe e-cigarette user characteristics, intentions to quit, and perceived attitudes toward vaping. METHODS: We used the online crowdsourcing platform Prolific to conduct a cross-sectional survey of current vapers in both countries. Measures were drawn from international surveys. RESULTS: The sample included 1044 vapers (524 United Kingdom; 520 United States) with a mean age of 34. Samples differed by gender (United States: 57% male vs 45% in United Kingdom), race (United States: 79% White vs 90% in United Kingdom) and employment (United States: 73% employed vs 79% in United Kingdom). UK respondents were more likely than US respondents to be ever smokers (89% vs 71%, p < .0001); be daily vapers (69% vs 53%, p < .0001) and to use e-cigarettes to quit smoking (75% vs 65%, p < .0007). Most vapers in the United Kingdom and the United States want to stop vaping (62% vs 61%; p < .9493), but US respondents plan to quit significantly sooner (odds ratio 0.47, p < .0004). Attitudes differed as well. Over half (56%) of UK respondents reported their government-approved e-cigarette use, and 24% felt health care providers had positive views on e-cigarettes versus 29% and 13% from the United States, respectively (p < .0004 for both). CONCLUSIONS: Plans for quitting and perceptions regarding e-cigarettes differ markedly between demographically similar groups of vapers in the two countries. Future research should determine whether e-cigarette cessation for adults should be a public health goal, and if so, identify effective ways to stop. IMPLICATIONS: The contribution of this study is that it describes differences in behaviors and attitudes of vapers recruited through the same research platform and adjusted to account for minor demographic differences across country samples. For clinicians, these findings suggest that most vapers would welcome assistance in quitting. For researchers and policymakers, findings suggest that government policy regarding nicotine devices might influence behaviors and attitudes related to use and also that future research is needed to determine effective ways to quit.

An Experimental Feasibility Study of a Hybrid Telephone Counseling/Text Messaging Intervention for Post-Discharge Cessation Support Among Hospitalized Smokers in Brazil.

OBJECTIVE: Text messaging interventions are effective. Despite high utilization of smartphones, few studies evaluate text messaging for cessation in middle-/lower-income countries. Initiating tobacco treatment in hospitals is an effective but underutilized approach for reaching smokers. We evaluated a hybrid phone counseling/text messaging intervention for supporting cessation among hospitalized smokers in Brazil. METHODS: We used an experimental design to assess the feasibility and potential effect size of the intervention. Participants (N = 66) were recruited from a university hospital and randomized in a 2:1 ratio into TXT (one session of telephone counseling plus 2 weeks of text messaging; N = 44) or Standard Care control group (N = 22). Participants lost to follow-up were counted as smokers. RESULTS: Counselors sent 1186 texts, of which 924 (77.9%) were received by study participants. Participants rated the TXT content as "helpful" (80.4%) and the phone counseling length to be "just right" (95.1%). Although the study was not powered to evaluate abstinence rates, we did observe a higher prevalence of abstinence in the TXT compared to control group at both 1-month follow-up (25.0% vs. 9.1%) and 3-month follow-up (31.8% vs. 9.1%). Carbon monoxide-verified abstinence at month 3 was also higher in TXT (20.5% vs. 4.5%). CONCLUSIONS: This hybrid telephone/text intervention should progress to full-scale effectiveness testing as it achieved favorable outcomes, was acceptable to participants, and was readily implemented. This type of intervention has strong potential for expanding the reach of hospital-initiated tobacco treatment in middle-/lower-income countries. IMPLICATIONS: This study extends research on hospital-initiated smoking cessation by establishing the feasibility of a novel text-messaging approach for post-discharge follow-up. Text messaging is a low-cost alternative to proactive telephone counseling that could help overcome resource barriers in middle- and lower-income countries. This hybrid texting/counseling intervention identified smokers in hospitals, established rapport through a single telephone follow-up, and expanded acceptability and reach of later support by using text-messaging, which is free of charge in this and other low-income countries. The favorable cessation outcomes achieved by the hybrid intervention provide support for a fully powered effectiveness trial.

[A methodology to implement preventive actions against harmful drug use in the context of primary health care in Latin America]. / Metodologia de implementação de práticas preventivas ao uso de drogas na atenção primária latino-americana.

OBJECTIVE: To develop a methodology to implement practices of prevention against the use of alcohol and other drugs in the context of primary health care (PHC) that will contribute to the debate about policies and actions in Latin American countries. METHODS: This intervention research project was carried out in a small/medium-sized Brazilian city. The development process was assessed through participant observation with the aim of adapting the methodology to local needs and identifying existing weaknesses and strengths with impact on implementation. RESULTS: A model was developed with six stages: initial contact and planning, diagnosis and mapping, sensitization, training, follow-up, and communication of results to participants. The following weaknesses were identified: limitation of resources (human, financial, infrastructural), limitations in the coverage and comprehensiveness of the assistance network, poor participation from physicians, training based on medicalized care, insufficient participation of health care management, insufficient involvement and participation of civil society, and few opportunities for participation of the population in the planning and execution of public policies. Strengths included the participation of community health agents and nurses in applying, organizing, and planning initiatives, in addition to the organization of educative and preventive actions in schools and communities by health care teams, suggesting that it is possible to implement screening, brief intervention, and referral to treatment (SBIRT) initiatives in the context of PHC in Latin America. CONCLUSIONS: The methodology developed in this study can be useful for Latin American countries if local needs are taken into consideration. It should be noted, however, that results will only be observed in the mid- to long term, rather than strictly in the short term.

Internet-Based Intervention Compared to Brief Intervention for Smoking Cessation in Brazil: Pilot Study.

BACKGROUND: Smoking is still the leading cause of preventable death. Governments and health care providers should make available more accessible resources to help tobacco users stop. OBJECTIVE: This study describes a pilot longitudinal study that evaluated the efficacy of an internet-based intervention compared to the brief intervention for smoking cessation among Brazilians. METHODS: Eligible participants were recruited and randomly allocated to one of the two interventions. Measures were drawn by comparing cessation rates, motivation scores, and sought treatment between groups, assessed 1 and 3 months after the intervention. Inferential analysis was performed to compare the participants' characteristics, and the intention to treat was calculated. RESULTS: A total of 49 smokers were enrolled in this study (n=25, 51% in the brief intervention group; n=24, 49% in the internet-based intervention group). Mean age was 44.5 (SD 13.3) years; most were male (n=29, 59.2%), had elementary school (n=22, 44.9%), smoked 14.5 cigarettes per day on average (SD 8.6), and had a mean score of 4.65 for nicotine dependence and 5.7 for motivation to quit. Moreover, 35 (71%) participants answered follow-up 1, and 19 (39%) answered follow-up 2. The results showed similar rates of cessation and reduction for both intervention groups. CONCLUSIONS: The internet-based intervention was slightly more effective for smoking cessation, while the brief intervention was more effective in reducing the number of cigarettes smoked per day. This difference was small and had no statistical significance even after adjusting for intention-to-treat analysis. These results should be interpreted with caution, especially due to the small sample size.

Text messaging interventions to support smoking cessation among hospitalized patients in Brazil: a randomized comparative effectiveness clinical trial.

OBJECTIVE: A clinical trial carried out in patients hospitalized for clinical and surgical conditions. This study evaluated the effectiveness of text messaging interventions (TM) versus telephone counseling (TC) to promote smoking cessation among hospitalized smokers in a middle-income country. Seven-day abstinence was measured during follow-up phone calls one month after discharge. The comparative cost of the two interventions considered the cost of calls, time spent on phone calls and sending SMS and cost of the professional involved in the approaches. RESULTS: Past 7-day tobacco abstinence was not statistically different between groups (30.5% in TM group and 26% in TC, p = 0.318). Costs were significantly lower in the TM group (U$9.28 × U$19.45- p < 0,001). Continuous abstinence was reported by 26% of TM participants and 24.5% of TC participants (p = 0.730). In the 3-month follow-up, 7-day abstinence was 23% in the TMI and 27% in the TC (p = 0.356) group. Continuous abstinence was reported by 20% of TM participants and 24% of TC participants (p = 0.334). TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT03237949 Registred on: 30th May 2017.

Regional Reference Centers: analysis of the national implementation of training processes on alcohol and other drugs. / Centros Regionais de Referência: análise da implementação nacional de processos formativos sobre álcool e outras drogas.

An analysis of the national implementation of Regional Reference Centers (RRCs) was carried out. A survey with 97 open-ended and closed-ended questions was answered by the coordinators of 51 RRCs from the five Brazilian regions. A multi-case ex-post-facto study was facilitated by the triangulation of descriptive statistical analysis of closed-ended questions and thematic analysis of open-ended ones. The effective national scope of the RRCs was based on the increased capillarity of public education institutions. Methodological flexibility was highlighted as a convenient feature in the course design, allowing content relevant to the local reality, with proposed intervention projects in the territory, affecting the coordination of the intersectoral network on drugs. Worth highlighting was the need for higher administrative and financial autonomy and the relevance of continuity of the training processes due to the critical role of RRCs in local and regional drug policies. The analysis flags axes that can support the construction of indicators for the evaluation of alcohol and other drugs educational processes, as well as the elaboration of training principles and guidelines for this area.

Realizou-se a análise da implementação em nível nacional dos Centros Regionais de Referência (CRRs). Um questionário com 97 questões abertas e fechadas foi respondido por coordenadores de 51 CRRs das cinco regiões brasileiras. Um estudo de casos múltiplos ex-post-facto foi viabilizado, recorrendo à triangulação entre a análise estatística descritiva das questões fechadas e a análise temática das questões abertas. A abrangência efetivamente nacional dos CRRs sustentou-se na ampliação da capilaridade das instituições públicas de ensino. A flexibilidade metodológica foi considerada oportuna no desenho dos cursos, viabilizando conteúdos atinentes à realidade local, com a proposição de projetos de intervenção no território que buscam impactar a articulação da rede intersetorial. Salientou-se a necessidade de maior autonomia administrativa e financeira e a relevância da continuidade dos processos formativos, devido ao protagonismo dos CRRs nas políticas de drogas locorregionais. A análise sinaliza para eixos que podem subsidiar a construção de indicadores de avaliação de processos formativos para o campo de álcool e outras drogas, bem como a elaboração de princípios e diretrizes para a formação na área.

[Consumption of psychoactive substances: from punishment to care]. / Consumos de sustancias psicoactivas: del castigo al cuidado.

Although the consumption of psychoactive substances is a practice that dates back to the earliest days of humanity, in the last century it has become an issue that has gained attention from the scientific community, State agencies of control, professionals in a number of diverse settings, and society at large. Despite being a complex issue with multiple manifestations, there has been a tendency to reduce it to a question of disease or of crime; nonetheless, not all forms of consumption constitute problematic substance use, nor do they produce substance use disorders. Bearing this in mind, the call for papers on "the consumption of psychoactive substances: from punishment to care" brings together research that contributes both knowledge and actions that are contrary to punitive responses, which unfortunately remain prevalent in society.

Si bien los consumos de sustancias psicoactivas son una práctica que se remonta a los albores de la humanidad, en el último siglo se han constituido en un problema que interpela a la comunidad científica, a las agencias estatales de control, a los profesionales que actúan en los más diversos ámbitos, a la comunidad toda. Siendo una cuestión compleja que se expresa en múltiples manifestaciones, se ha tendido a circunscribirla como enfermedad y/o como delito; sin embargo, no todas las formas de consumo representan un uso problemático, ni producen trastornos por el uso de sustancias. En este sentido, la convocatoria abierta "Consumos de sustancias psicoactivas: del castigo al cuidado" reunió investigaciones que aportan conocimientos y acciones contrarias al punitivismo, que desgraciadamente insiste en permanecer en la sociedad.

Facebook recruitment of smokers: comparing gain- and loss-framed ads for the purposes of an Internet-based smoking cessation intervention.

Gain- and loss-framed messages about smoking behavior have commonly been used to promote cessation. However, there are still no clear conclusions as to what kind of message is more effective for motivating smokers to quit. This study compared the effectiveness of loss- and gain-framed messages in the online recruitment of smokers via Facebook Advertising. Loss- and gain-framed messages about smoking were created and released as Facebook ads. Users who clicked on the ads were automatically redirected to the "Live Without Tobacco" intervention (http://www.vivasemtabaco.com.br). The amount spent on the ads was BRL 647.64. Data were collected from the Facebook Ads platform and from a relational database. Analyses were performed on the 6,350 users who clicked on one of the ads and 1,731 who were successfully redirected to the intervention. Gain-framed ads reached 174,029 people and loss-framed ads reached 180,527. The former received 2,688 clicks, while the latter received 3,662. The cost of the click was BRL 0.12 per gain-framed ad and BRL 0.09 per loss-framed ad. Loss-framed ads reached more users, got more clicks (and website accesses), and led to more accounts and quit plans being created. Loss-framed messages about smoking appear to be more cost-effective for both initial recruitment and intervention engagement. Facebook has proven to be a good outreach and recruitment tool and can be a solution for the difficulty in reaching smokers for cessation interventions.

Estimating Service Needs for Alcohol and Other Drug Users According to a Tiered Framework: The Case of the São Paulo, Brazil, Metropolitan Area.

OBJECTIVE: The purpose of this study was to estimate the need for population-level services for alcohol and other drug abuse in support of local planning. METHOD: Data were drawn from a subsample of 2,942 interviewees from the São Paulo Megacity Study, which evaluated mental health in the general population (18 years and older) of residents in the São Paulo metropolitan area. This population was classified into five hierarchical categories of severity, making it possible to obtain estimates of need for services, combining evaluation criteria regarding drug and alcohol use and general and mental health comorbidities over the last 12 months. For the at-risk groups in this population, estimates from the Potential Demand for the Use of Services survey interviews over the last year were generated. RESULTS: Concerning the need for services, 86.5% of the population (Tier 1) had no problems related to drug and alcohol use, 8.9% (Tier 2) used heavily, 3.5% (Tiers 3, 4, and 5) met criteria for substance abuse disorders, among whom 1.3% (Tiers 4 and 5) require more specialized and intensive treatment and support. The following estimates for the Potential Demand for the Use of Services were found: 25.5% (Tier 3) and 51.1% (Tier 4), indicating that a significant number of individuals met criteria for substance abuse disorders but did not perceive any need for professional help or neglected the help available. CONCLUSIONS: In São Paulo there exists a large sector of the population that requires prevention strategies regarding the risks and harm resulting from alcohol and drug use, followed by a group requiring more specialized care. But a large number of substance users requiring specialized support did not use services and did not believe that they needed professional help.

[There was a CAPSad in the middle of the road: care logic and centrality of the care network for drug users]. / No meio do caminho tinha um CAPSAD: centralidade e lógica assistencial da rede de atenção aos usuários de drogas.

By applying Social Network Analysis (ARS), this study seeks to evaluate the role of the Center for Psychosocial Care - Alcohol and Other Drugs (CAPSad) in the care network for drug users. It involves an exploratory, cross-sectional and quantitative approach of the Juiz de Fora city network in the state of Minas Gerais. One hundred and eighty-seven care services were identified in the city. The data gathering was made from a questionnaire with professionals of these instruments. The analysis took the cohesion and centrality metrics of the ARS into account as well as the creation of network sociograms. One centrality of the network was found in the CAPSad, in accordance with the policies and the care model advocated in the area, referred to here as "CAPSolization," The centralization in this instrument, still in insufficient number and with structural and workflow dynamics problems, leads to low resilience power of the network indicating the need for care logic modifications, still based on specialized and emergency care, to the detriment of territorial/community and ongoing prospects.

O presente estudo objetiva avaliar, através da Análise de Redes Sociais (ARS), o papel do Centro de Atenção Psicossocial - Álcool e outras Drogas (CAPSad) sobre a rede de atenção aos usuários de drogas. Trata-se de uma pesquisa exploratória, de corte transversal e abordagem quantitativa na rede de Juiz de Fora, Minas Gerais. Nela, foram identificados 187 serviços assistenciais no município. A coleta de dados foi feita a partir de questionário com profissionais destes dispositivos. A análise levou em consideração métricas de coesão e centralidade da ARS, bem como a confecção de sociogramas da rede. Constatou-se uma centralidade da rede no CAPSad, em conformidade com as políticas e o modelo assistencial preconizado na área, nomeada de "CAPSolização". A centralização neste dispositivo, ainda em número insuficiente e com problemas estruturais e na dinâmica de trabalho, influi para um baixo poder de resiliência da rede e indica a necessidade de modificação da lógica assistencial, ainda pautada pelo cuidado especializado, de urgência, em detrimento de perspectivas territorializadas/comunitárias e contínuas.

Social Determinants and Drug Dependence: Systematic Review of Literature / Determinantes Sociais e Dependência de Drogas: Revisão Sistemática da Literatura

ABSTRACT A systematic literature review on social determinations and consumption of psychoactive substances was realized. The research was accomplished in some databases, in Portuguese, English and Spanish, using the descriptors "Social Determinants in Health" and the Boolean descriptor AND for the term "Disorders Related to Substance Use". Then, 78 articles were selected, in which a concentration of studies was observed in the northern hemisphere, emphasizing on micro social factors. The most studied drugs were multiple substances (44.9%), alcohol (21.8%) and tobacco (15.4%), highlighting the determinants of income (35.9%), sex, family and territory (26.9% each). It is important to consider drug use as a complex and multifaceted biopsychosocial phenomenon, requiring greater production of evidence in developing countries, using different epistemological and methodological perspectives.

RESUMO Realizou-se revisão sistemática da literatura sobre determinantes sociais e dependência de substâncias psicoativas. A pesquisa foi feita em algumas bases de dados utilizando-se, nos idiomas português, inglês e espanhol, os descritores "Determinantes Sociais em Saúde" e o descritor booleano AND para o termo "Transtornos Relacionados ao Uso de Substâncias". Selecionaram-se 78 artigos, nos quais observou-se uma concentração de estudos no hemisfério norte, com ênfase em fatores microssociais. As drogas mais estudadas foram múltiplas substâncias (44,9%), álcool (21,8%) e tabaco (15,4%), destacando-se os determinantes renda (35,9%), sexo, família e território (26,9% cada). É importante considerar o uso de drogas como fenômeno biopsicossocial complexo e multifacetado, sendo necessária maior produção de evidências em países em desenvolvimento, utilizando-se diferentes perspectivas epistemológicas e metodológicas.

Estigma de cortesia e condições de saúde: revisão sistemática de literatura / Estigma de cortesía y condiciones de salud: revisión sistemática de la literatura / Courtesy stigma and health conditions: systematic literature review

RESUMO A literatura científica aponta consistentemente que grupos historicamente alvos de estigma social experimentam efeitos deletérios, em diversas esferas da vida. A despeito da sua gravidade e pervasividade, ainda existem lacunas na investigação do tema, tais como aquela voltada para o Estigma de Cortesia, que é vivenciado por pessoas que possuem vínculos afetivos ou profissionais com o indivíduo estigmatizado. O presente artigo teve como objetivo apresentar o estado da arte sobre estigma de cortesia, por meio de uma revisão sistemática de estudos empíricos originais publicados em periódicos revisados por pares e indexados nas principais bases relacionadas ao campo de investigação (PsycNET (APA), Pubmed, Bvs Brasil, Periódicos CAPES, SciELO e Pepsic). Como palavras-chave, para a busca dos resumos, utilizou-se: estigma de cortesia, estigma de afiliação e estigma de associação. Ao todo, 94 textos completos atenderam aos critérios de inclusão e exclusão. Os estudos apontaram que o estigma de cortesia tem sido investigado predominantemente entre familiares de pessoas que possuem algum tipo de problema relacionado com sua saúde mental, além de pais de crianças com algum tipo de deficiência.

RESUMEN La literatura científica señala constantemente que los grupos históricamente afectados por el estigma social experimentan efectos nocivos en diferentes ámbitos de la vida. A pesar de su gravedad y omnipresencia, todavía hay vacíos en la investigación del tema, como el centrado en el estigma de cortesía, que experimentan las personas que tienen vínculos afectivos o profesionales con el individuo estigmatizado. Este artículo tuvo como objetivo presentar el estado del arte sobre el estigma de cortesía a través de una revisión sistemática de estudios empíricos originales publicados en revistas revisadas por pares e indexados en las principales bases de datos relacionadas con el campo de investigación (PsycNET (APA), Pubmed, Bvs Brasil, CAPES, SciELO y revistas Pepsic). Como palabras clave para la búsqueda de resúmenes, utilizamos: estigma de cortesía, estigma de afiliación y estigma de asociación. En total, 94 textos completos cumplieron con los criterios de inclusión y exclusión. Los estudios han demostrado que el estigma de cortesía se ha investigado principalmente entre miembros de la familia de personas que tienen algún tipo de problema relacionado con su salud mental, además de los padres de niños con algún tipo de discapacidad.

ABSTRACT The scientific literature consistently points out that groups historically targeted by social stigma experience deleterious effects in different spheres of life. Despite its gravity and pervasiveness, there are still gaps in the investigation of the topic, such as that focused on the Courtesy Stigma, which is experienced by people who have affective or professional ties with the stigmatized individual. This article aimed to present the state of the art on Courtesy Stigma through a systematic review of original empirical studies published in peer-reviewed journals and indexed in the main databases related to the research field (PsycNET (APA), Pubmed, Bvs Brasil, CAPES, SciELO, and Pepsic journals). As keywords for the search for abstracts, we used: courtesy stigma, affiliate stigma and associative stigma. Altogether, 94 complete texts met the inclusion and exclusion criteria. Studies have shown that the Courtesy Stigma has been investigated predominantly among family members of people who have some type of problem related to their mental health, in addition to parents of children with some type of disability.

Atitudes de profissionais sobre o uso de drogas por gestantes / Health professional attitudes towards drug use for pregnant women / Actitudes de profesionales sobre el consumo de drogas en mujeres embarazadas

O uso de drogas é um dos fatores associados a gestações de alto risco. As crenças e atitudes dos profissionais configuram possíveis dificultadores dos cuidados em saúde. O presente estudo buscou verificar as atitudes profissionais em relação a gestantes usuárias de drogas. Realizou-se a busca bibliográfica de publicações entre 2000 e junho de 2022, nas bases de dados Scielo, Lilacs, Medline/Pubmed, Scopus e PsycINFO. Ao final foram analisados 27 artigos, todos de língua inglesa. Foram identificadas atitudes negativas em 33,3% dos artigos, e atitudes positivas em 44,5%; também foram encontradas atitudes ambivalentes (22,2%). Além disso, alguns dos estudos apontaram algumas barreiras quanto às intervenções. Atitudes negativas e moralizantes denotam um cunho individualizante. Em relação às atitudes positivas, essas podem ter um papel fundamental na atuação profissional e na saúde materna e do feto.

Drug use is one of the factors related to high-risk pregnancy. The health professional beliefs and attitudes regarding this issue constitute possible difficulties in the health care. The present study sought to verify the health professional attitudes towards pregnant women who use drugs. A literature review for studies published between 2000 and june 2022 was carried out in the Scielo, Lilacs, Medline/Pubmed, Scopus, and PsycINFO databases. In the end, 27 articles were analyzed, all of them written in English. Negative attitudes were identified in 33,3% of the articles, and positive attitudes in 44,5%; ambivalent attitudes were also found in 22,2% of the studies. Additionally, some studies pointed out barriers to interventions. The negative and moralizing attitudes denote an individualizing nature. Concerning the positive attitudes, they can play a fundamental role on professional performance and, consequently, on the maternal and fetal health.

El uso de drogas es uno de los factores asociados a los embarazos de alto riesgo. Las creencias y actitudes de los profesionales se configuran como posibles obstáculos al cuidado en salud. El presente estudio buscó verificar las actitudes de los profesionales en relación a embarazadas usuarias de drogas. Se realizó una búsqueda bibliográfica de publicaciones entre 2000 y junio de 2022, en las bases de datos Scielo, Lilacs, Medline/Pubmed, Scopus y PsycINFO. Finalmente, fueron analizados 27 artículos, todos en idioma inglés. Se identificaron actitudes negativas en el 33,3% de los artículos, y actitudes positivas en el 44,5%; así también se encontraron actitudes ambivalentes (22,2%). Además, algunos de los estudios señalaron algunas barreras con respecto a las intervenciones. Las actitudes negativas y moralizantes denotan una impronta individualizadora. En relación con las actitudes positivas, estas pueden tener un papel fundamental en la actuación profesional y en la salud materna y del feto.

Implicações da Pandemia para a Psicologia nas Políticas Públicas / Implications of the Pandemic for Psychology in Public Policies / Implicaciones de la Pandemia para la Psicología en las Políticas Públicas

O artigo objetivou identificar e analisar desafios e potencialidades no trabalho de psicólogas(os) nas políticas públicas brasileiras na conjuntura pandêmica. É um estudo exploratório-descritivo de abordagem mista. A coleta de dados foi realizada por meio de questionário virtual com 123 psicólogas(os) que trabalhavam nas políticas públicas no país. A análise se deu a partir da extração de medidas de tendência central e pela Análise de Conteúdo temática, em um diálogo da psicologia com a tradição marxista. Os resultados apontaram para os efeitos deletérios objetivos e subjetivos do sucateamento das políticas às(aos) profissionais, bem como o tolhimento de suas práticas. Por outro lado, também apontaram algumas potencialidades que contradizem a si próprias(os) e à realidade. Fica a premência de responsabilização do Estado em fornecer melhores condições de trabalho e fortalecer as políticas públicas para o enfrentamento à pandemia, assim como a necessidade de reflexão e transformação da psicologia e sua práxis.

The article aimed to identify and analyze the challenges and potentialities of psychologists' work in Brazilian public policies in the pandemic context. It's an exploratory-descriptive study with a mixed approach. Data collection was carried out through a virtual questionnaire with 123 psychologists working in public policies around the country. The analysis was carried out from the extraction of central tendency measures and by Thematic Content Analysis, in a dialogue between psychology and the Marxist tradition. Results pointed to numerous deleterious effects (objective and subjective) on professionals resulting from the scrapping of public policies and the hampering of their practices. On the other hand, they also pointed out some potentialities that contradict themselves and reality. There is an urgent need for state responsibility to offer better working conditions and to strengthen public policies to fight the pandemic, together with the need for reflection and transformation of psychology and its own praxis.

El artículo objetivó identificar y analizar desafíos y potencialidades del trabajo de psicólogas/os en las políticas públicas brasileñas en el contexto de la pandemia. Es un estudio exploratorio-descriptivo con enfoque mixto. La recolección de datos se realizó a través de un cuestionario virtual con 123 psicólogos que trabajaban en políticas públicas en el país. El análisis se realizó a partir de la extracción de medidas de tendencia central, y por Análisis de Contenido temática, en un diálogo entre psicología y tradición marxista. Los resultados apuntaron los efectos deletéreos (objetivos y subjetivos) del desguace de políticas a los profesionales y la obstaculización de sus prácticas. Por otro lado, también señalaron potencialidades que contradicen a sí mismos y a la realidad. Existe una necesidad urgente de rendición de cuentas del Estado para mejorar las condiciones laborales y el fortalecimiento de las políticas para combatir la pandemia y la necesidad de reflexión y transformación de la psicología y de su praxis.

Mensuração do Estigma de Cortesia: Revisão Sistemática de Literatura / Measurement of courtesy stigma: Systematic literature review / MEDICIÓN DEL ESTIGMA DE CORTESÍA: REVISIÓN SISTEMÁTICA DE LA LITERATURA

This article aimed to conduct a literature review regarding the instruments used to measure the stigma of courtesy, in the databases related to the field of investigation (PsychNET, PubMed, Virtual Health Library Brazil ­ Biblioteca Virtual em Saúde [BVS] Brasil, Capes Publications Portal, Scientific Electronic Library Online [SciELO], and Electronic Journals in Psychology ­ Periódicos Eletrônicos em Psicologia [PePSIC]), using the descriptors courtesy stigma, affiliate stigma, and associative stigma. Five hundred and six-ty-four articles were retrieved, and, after the exclusion criteria were evaluated, ten were selected. Positive correlations were noted between courtesy stigma and depression, anxiety, caregiver burden, burnout, awareness of public devaluation, and awareness of stigma. Quality of life, social support, self-esteem, quality of care, and social desirability presented negative correlations with the construct studied.

O presente artigo teve como objetivo realizar uma revisão de literatura a respeito dos instrumentos utili-zados para mensurar estigma de cortesia, nas bases de dados relacionadas ao campo de investigação (PsychNET, PubMed, Biblioteca Virtual em Saúde [BVS] Brasil, Periódicos Capes, Scientific Electronic Li-brary Online [SciELO] e Periódicos Eletrônicos em Psicologia [PePSIC]), utilizando-se os descritores cour-tesy stigma, affiliate stigma e associative stigma. Recuperaram-se 564 artigos e, após serem avaliados os critérios de exclusão, dez foram selecionados. Notaram-se correlações positivas entre estigma de cortesia e depressão, ansiedade, carga do cuidador, burnout, consciência da desvalorização pública e consciência do estigma. Qualidade de vida, suporte social, autoestima, qualidade do cuidado e desejabilidade social apre-sentaram correlações negativas com o constructo estudado.

Este artículo tuvo como objetivo realizar una revisión de la literatura sobre los instrumentos utilizados para medir el estigma de cortesía en las bases de datos relacionadas con el campo de investigación (Psy-chNET, PubMed, Biblioteca Virtual en Salud Brasil ­ Biblioteca Virtual em Saúde [BVS] Brasil, Periódicos Capes, Scientific Electronic Library Online [SciELO] y Periódicos Electrónicos en Psicología ­ Periódicos Eletrônicos em Psicologia [PePSIC]), utilizando los descriptores courtesy stigma, affiliate stigma y associative stigma. Se recuperaron 564 artículos y, una vez evaluados los criterios de exclusión, se seleccionaron diez. Se observaron correlaciones positivas entre el estigma de cortesía y la depresión, la ansiedad, la carga del cuidador, el agotamiento, la conciencia de la devaluación pública y la conciencia del estigma. Calidad de vida, apoyo social, autoestima, calidad de la atención y deseabilidad social mostraron correlaciones nega-tivas con el constructo estudiado.

A review of smartphone apps for smoking cessation available in Portuguese. / Revisão dos aplicativos de smartphones para cessação do tabagismo disponíveis em língua portuguesa.

Smartphone apps are being developed as a complement to smoking cessation treatment. The current study aimed to analyze the content of available apps in Portuguese in two operational systems, Android and iOS. Fifty-one apps were found in iTunes and 600 in Google Play. Content evaluation included apps that focused on smoking cessation, with a total of 12 apps in iOS and 3 in Android. Each app was categorized according to its approach to smoking cessation and scored according to level of adherence to the Treating Tobacco Use and Dependence smoking cessation treatment guideline. Nine apps were classified as calendars, 8 as information tools, 6 as calculators, 3 as cigarette trackers, and 1 as hypnosis. The apps showed low level of adherence to the guideline, with a mean score of 12.8. We recommend that the available apps be revised and that future apps be developed using evidence-based practices for smoking cessation.

Association between tobacco and alcohol use among hospital inpatients / Associação do uso de álcool e tabaco entre pacientes hospitalizados

We aimed to evaluate concurrent use of alcohol and tobacco among hospitalized patients as well as to compare the use of both substances among people living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome and those with other diagnoses. A cross-sectional study took place in a hospital in Minas Gerais (Brazil). Structured surveys were used to evaluate tobacco and alcohol use. Data analysis was conducted using descriptive statistics and chi-square test. We interviewed 972 patients, in which 20.3% were hazardous drinkers and 14.9% tobacco users. Almost half of the smokers (47.6%) were hazardous drinkers, while 15.5% of nonsmokers engaged in harmful consumption of alcohol (p < 0.001). Tobacco use was higher among people living with Human Immunodeficiency Virus when compared with patients that did not have an Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome diagnosis (32.1% vs 14.4%, p = 0.009). Our findings showed the association of tobacco use and hazardous drinking among hospitalized patients in Brazil and a higher prevalence of tobacco use among patients living with Human Immunodeficiency Virus. These findings can be used to develop smoking cessation interventions that address the comorbidities associated with substance use.

O presente estudo teve como objetivo avaliar a associação do uso de álcool e tabaco entre pacientes internados em um hospital geral e comparar o uso das duas substâncias entre pacientes que vivem com o Vírus da Imunodeficiência Humana/Síndrome de Imunodeficiência Adquirida e outros diagnósticos. Realizou-se um estudo observacional em um hospital público para avaliação do uso de tais substâncias. Entre 972 pacientes, 20,3% fizeram uso prejudicial de álcool e 14,9% de tabaco. Quase metade dos tabagistas (47,6%) fizeram uso prejudicial do álcool, enquanto 15,5% dos não tabagistas relataram uso excessivo da substância (p < 0,001). A porcentagem de fumantes foi significativamente mais alta no grupo de pacientes que vivem com o Virus da Imunodeficiência Humana do que nos demais diagnósticos (32,1% vs 14,4%, p = 0,009). Percebe-se a associação do uso de tabaco e uso prejudicial de álcool entre pacientes hospitalizados e alta prevalência do uso de tabaco entre pacientes que vivem com o Vírus da Imunodeficiência Humana/Síndrome de Imunodeficiência Adquirida. Esses dados podem direcionar o planejamento de intervenções para cessação do consumo de tabaco que consigam direcionar as comorbidades relacionadas ao uso da substância

Implementation of public policy on alcohol and other drugs in Brazilian municipalities: comparative studies.

One of the challenges with respect to public health and the abuse of alcohol and other drugs is to implement policies in support of greater co-ordination among various levels of government. In Brazil, policies are formulated by the Secretaria Nacional de Políticas sobre Drogas (SENAD - State Department for Policies on Drugs) and the Ministério da Saúde (MS - Ministry of Health). This study aims to compare implementation of policies adopted by SENAD and MS at the municipal level. Three municipalities were intentionally selected: Juiz de Fora having a larger network of treatment services for alcohol and drug users; Lima Duarte, a small municipality, which promotes the political participation of local actors (COMAD - Municipal Council on Alcohol and Drugs); and São João Nepomuceno, also a small municipality, chosen because it has neither public services specialised to assist alcohol and other drugs users, nor COMAD. Data collection was conducted through interviews with key informants (n = 19) and a review of key documents concerned with municipal policies. Data analysis was performed using content analysis. In Juiz de Fora, there are obstacles regarding the integration of the service network for alcohol and other drug users and also the articulation of local actors, who are predominant in the mental health sector. In Lima Duarte, while there is a link between local actors through COMAD, their actions within the local service network have not been effective. In São João Nepomuceno, there were no public actions in the area of alcohol and drugs, and consequently insufficient local debate. However, some voluntary, non-governmental work has been undertaken. There were weaknesses in the implementation of national-level policies by SENAD and the MS, due to the limited supply of available treatment, assistance and the lack of integration among local actors.

Consumo de drogas em contextos rurais: revisão sistemática na América Latina e Caribe / Drug use in rural contexts: systematic review in Latin America and Caribbean

Este estudo objetivou clarificar o cenário de consumo de drogas em contextos rurais na América Latina e Caribe. Trata-se de uma revisão sistemática seguindo o protocolo Prisma nas bases de dados Lilacs, PePSIC, PsycINFO/PsycNET, PubMed e SciELO. A amostra final foi composta por 20 artigos, os resultados indicam uma prevalência em enxergar o "problema das drogas" a partir de uma perspectiva epidemiológica, mas que existem críticas e outras construções com visões mais integrativas; os contextos rurais se mostraram heterogêneos e perpassados por questões socioeconômicas. Nesse sentido, discute-se um olhar em que a história, a cultura, a geografia, o território e a população são fundamentais para a percepção dos agentes nesses contextos.

This study aimed to clarify the drug use in rural contexts in Latin America and Caribbean. This is a systematic review following the Prisma protocol in the databases: Lilacs, PePSIC, PsycINFO/PsycNET, PubMed e SciELO. The final sample consisted of 20 articles; the results indicate a prevalence in considering the "drug problem" from an epidemiological perspective; however, criticism and other constructions with more integrative visions still exist; the rural contexts are heterogeneous and crossed by socioeconomic issues. In this sense, we discussed a view in which history, culture, geography, territory and population are essential for the perception of agents in these contexts.