A motivational profile for smoking among adolescents.

OBJECTIVES: To characterize a motivational profile of reasons for smoking among teenagers. To investigate the influence of clinical and social elements on observed scores. METHODS: High school students who smoked in the past month (n = 226; age, 16.4 ± 10 years; 46.5% male) answered a questionnaire during school time. The instrument included the University of São Paulo Reasons for Smoking Scale (USP-RSS), the Fagerström Test for Nicotine Dependence, and clinical and social information. The USP-RSS scores from 307 healthy adult smokers (67.5% male; age, 37.9 ± 11.2 years) were also used for comparisons. RESULTS: Most of the adolescents (90.2%) exhibited low or very low levels of nicotine addiction (median Fagerström Test for Nicotine Dependence score 0, range 0 to 8). The mean scores of the USP-RSS subscales were as follows: Addiction, 1.9 ± 1.1; Pleasure From Smoking, 3.0 ± 1.3; Tension Reduction, 2.4 ± 1.3; Stimulation, 1.9 ± 0.9; Automatism, 1.3 ± 0.6; Handling, 2.3 ± 1.1; Social Smoking, 1.9 ± 1.0; Weight Control, 1.4 ± 1.0; and Affiliative Attachment, 1.6 ± 0.9. In comparison with adults, teenagers exhibited lower scores for Addiction, Pleasure From Smoking, Tension Reduction, Automatism, Weight Control, and Affiliative Attachment and higher scores for Social Smoking (P < 0.05). Older age, past school failure, illicit drugs use, alcohol abuse, high levels of perceived stress, and the death of at least one parent were associated with high scores for all subscales. CONCLUSIONS: The USP-RSS subscales Addiction, Pleasure From Smoking, and Social Smoking were important factors for adolescent smoking. Comparisons with adult smokers stressed the importance of the component of Social Smoking. The identification of distinctive factors that drive teenagers to smoke might help in making decisions dealing with interventions aimed at smoking cessation and control.

Modified Reasons for Smoking Scale: translation to Portuguese, cross-cultural adaptation for use in Brazil and evaluation of test-retest reliability.

OBJECTIVE: To translate the Modified Reasons for Smoking Scale (MRSS) to Portuguese, to submit it to cross-cultural adaptation for use in Brazil and to evaluate the test-retest reliability of the translated version. METHODS: An English-language version of the MRSS was translated to Portuguese by Brazilian doctors who have thorough knowledge of the English language. A consensus version was produced by a multidisciplinary group including two pulmonologists, a psychiatrist and a psychologist. This version was back-translated to English by an American translator. Cross-cultural adaptation of the final version was evaluated in a sample of 20 healthy smokers. Test-retest reliability was evaluated by applying the translated version of the scale in 54 healthy smokers on two distinct occasions, 15 days apart. RESULTS: This translated version of the MRSS was well understood by 95% of the smokers, indicating excellent cross-cultural equivalence. The degree of reliability of the answers in two different occasions was almost perfect for two questions, substantial for ten questions, moderate for eight questions, and low for one question. The intraclass correlation coefficients of the motivational factors obtained on the two different occasions, calculated according to previously published theoretical models, were higher than 0.7 for six of the seven subscales. CONCLUSIONS: The Portuguese-language version of the MRSS shows satisfactory cross-cultural equivalence and test-retest reliability. It can be a useful tool in the evaluation and treatment of smokers in Brazil.

Prevalence of and the potential physiopathological mechanisms involved in dyspnea in individuals with class II or III obesity.

OBJECTIVE: To investigate dyspnea in individuals with Class II or III obesity and look for correlations among the respiratory data related to such individuals. METHODS: This study involved 49 subjects with a body mass index >35 kg/m(2), divided into two groups (those with dyspnea and those without). The baseline dyspnea index was evaluated, as were spirometry findings, maximal respiratory pressures and arterial blood gas analysis. RESULTS: Of the 49 subjects evaluated, 37 reported dyspnea and 12 reported no dyspnea. The baseline dyspnea index differed between the two groups. The mean values were within the range of normality for all subjects and all parameters, except for the following: ratio of residual volume to total lung capacity; expiratory reserve volume; and the alveolar-arterial oxygen gradient. The subjects with dyspnea presented significantly lower values for expiratory reserve volume, maximal expiratory pressure and arterial pH. In all subjects, body mass index correlated significantly with the following: baseline dyspnea index; the residual volume/total lung capacity ratio; the forced expiratory volume in one second/forced vital capacity ratio; forced expiratory flow between 25% and 75% of forced vital capacity; arterial oxygen tension; the alveolar-arterial oxygen gradient; and arterial carbon dioxide tension. The baseline dyspnea index was found to correlate significantly with the following parameters: residual volume/total lung capacity ratio; expiratory reserve volume; arterial oxygen tension; the alveolar-arterial oxygen gradient; and arterial carbon dioxide tension. CONCLUSION: Dyspnea is a common complaint in individuals with class II or III obesity. Such individuals present a pronounced reduction in expiratory reserve volume and an increase in the alveolar-arterial oxygen gradient. The correlations found suggest that obese individuals present dysfunction of the lower airways, and that obesity itself plays a role in the genesis of dyspnea.