ABSTRACT
Los tratamientos para dejar de fumar son eficaces en hombres y mujeres. Sin embargo, las posibles diferencias encontradas en los resultados del tratamiento aún son objeto de controversia. Este estudio analiza si existen diferencias entre hombres y mujeres en el éxito al dejar de fumar a corto y largo plazo (> 1 año) con un programa de tratamiento que incluye la perspectiva de género. Se realizó una encuesta telefónica en fumadores atendidos en una unidad de tabaquismo. Los pacientes que completaron con éxito el tratamiento (3 meses), fueron encuestados telefónicamente para determinar su abstinencia a largo plazo; se validó la abstinencia mediante cooximetría (CO espirado ≤10 ppm) en los que se mantenían abstinentes. La probabilidad de permanecer abstinentes a largo plazo se calculó utilizando un análisis de supervivencia de Kaplan-Meier. La tasa de éxito del tratamiento fue de 41,3% (538/1302), sin diferencias por sexo. El 89% (479/538) fue localizado por teléfono y el 47,6% (256/479) se mantenía abstinente sin diferencias por sexo (p = ,519); la abstinencia fue validada en 191 de 256 (53,9% hombres y 46,1% mujeres). En el análisis de supervivencia, la probabilidad de que los hombres y las mujeres mantuvieran la abstinencia a largo plazo no fue significativa. No hay diferencias por sexo en el resultado del tratamiento para dejar de fumar, que incluyan aspectos de género, a corto y largo plazo (> 1 año)
Smoking cessation treatments are effective in men and women. However, possible sex-related differences in the outcome of these treatments remain a controversial topic. This study evaluated whether there were differences between men and women in the success of smoking cessation treatment, including gender-tailored components, in the short and long term (> 1 year). A telephone survey was carried out between September 2008 and June 2009 in smokers attended in a Smoking Cessation Clinic. All patients who have successfully completed treatment (3 months) were surveyed by telephone to determine their long-term abstinence. Those who remained abstinent were requested to attend the Smoking Cessation Clinic for biochemical validation (expired CO ≤10 ppm). The probability of remaining abstinent in the long-term was calculated using a Kaplan- Meier survival analysis. The treatment success rate at 3-months was 41.3% (538/1302) with no differences by sex 89% (479/538) among those located in the telephonic follow-up study and 47.6% (256/479) were abstinent without differences by sex (p = .519); abstinence was validated with CO less than 10 ppm in 191 of the 256 (53.9% men and 46.1% women). In the survival analysis, the probability of men and women remaining abstinent in the long-term was not significant. There are no differences by sex in the outcome of smoking cessation treatment that included gender-tailored components in the short and long term (> 1 year)
Subject(s)
Humans , Smoking/therapy , Tobacco Use Cessation/statistics & numerical data , Sex Distribution , Treatment Outcome , Gender and Health , Surveys and QuestionnairesABSTRACT
Smoking cessation treatments are effective in men and women. However, possible sex-related differences in the outcome of these treatments remain a controversial topic. This study evaluated whether there were differences between men and women in the success of smoking cessation treatment, including gender-tailored components, in the short and long term (> 1 year). A telephone survey was carried out between September 2008 and June 2009 in smokers attended in a Smoking Cessation Clinic. All patients who have successfully completed treatment (3 months) were surveyed by telephone to determine their long-term abstinence. Those who remained abstinent were requested to attend the Smoking Cessation Clinic for biochemical validation (expired CO ≤10 ppm). The probability of remaining abstinent in the long-term was calculated using a Kaplan-Meier survival analysis. The treatment success rate at 3-months was 41.3% (538/1302) with no differences by sex 89% (479/538) among those located in the telephonic follow-up study and 47.6% (256/479) were abstinent without differences by sex (p = .519); abstinence was validated with CO less than 10 ppm in 191 of the 256 (53.9% men and 46.1% women). In the survival analysis, the probability of men and women remaining abstinent in the long-term was not significant. There are no differences by sex in the outcome of smoking cessation treatment that included gender-tailored components in the short and long term (> 1 year).
Los tratamientos para dejar de fumar son eficaces en hombres y mujeres. Sin embargo, las posibles diferencias encontradas en los resultados del tratamiento aún son objeto de controversia. Este estudio analiza si existen diferencias entre hombres y mujeres en el éxito al dejar de fumar a corto y largo plazo (> 1 año) con un programa de tratamiento que incluye la perspectiva de género. Se realizó una encuesta telefónica en fumadores atendidos en una unidad de tabaquismo. Los pacientes que completaron con éxito el tratamiento (3 meses), fueron encuestados telefónicamente para determinar su abstinencia a largo plazo; se validó la abstinencia mediante cooximetría (CO espirado ≤10 ppm) en los que se mantenían abstinentes. La probabilidad de permanecer abstinentes a largo plazo se calculó utilizando un análisis de supervivencia de Kaplan-Meier. La tasa de éxito del tratamiento fue de 41,3% (538/1302), sin diferencias por sexo. El 89% (479/538) fue localizado por teléfono y el 47,6% (256/479) se mantenía abstinente sin diferencias por sexo (p = ,519); la abstinencia fue validada en 191 de 256 (53,9% hombres y 46,1% mujeres). En el análisis de supervivencia, la probabilidad de que los hombres y las mujeres mantuvieran la abstinencia a largo plazo no fue significativa. No hay diferencias por sexo en el resultado del tratamiento para dejar de fumar, que incluyan aspectos de género, a corto y largo plazo (> 1 año).
Subject(s)
Sex Factors , Smoking Cessation/statistics & numerical data , Adult , Female , Follow-Up Studies , Humans , Male , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVE: it is known that very few women who continue to smoke at the time of delivery stop smoking during the postpartum period. Discovering strategies that can be incorporated during pregnancy to help improve women's participation in postpartum interventions could increase the number of women non-smokers. The aim of this study is to identify the predictors of participation by pregnant women smokers in a postpartum smoking cessation intervention. DESIGN: a cross-sectional study was carried out amongst women smokers who had attended to give birth. SETTING: women attended the University Clinical Hospital 'Lozano Blesa' of Zaragoza (Spain) who were smokers before pregnancy and reported at delivery to have continued smoking during pregnancy were eligible and were invited to participate in the study. FINDINGS: 2044 women completed the questionnaire 24 hours after giving birth. The smoking prevalence during pregnancy was 18.2% (n=372) and 62.9% of them (n=234) participated. The logistic regression model provided five significant predictors for women who participated: intention to breast feed, having less of an urge to smoke the first cigarette of the day before pregnancy, having reduced consumption during pregnancy by 50% or more, having received advice and being willing to get help. CONCLUSIONS AND IMPLICATIONS FOR THE PRACTICE: the factors associated with participation show aspects that can be modified by maternal and child health professionals. Advice to stop smoking, received during pregnancy, encourages participation in a postpartum intervention. From the point of view of public health, the huge increase in the prevalence of smoking women poses the need to take advantage of the pregnancy as an opportunity for giving up smoking definitely. It would be necessary to identify what programmes of smoking cessation have better results in pregnant women and to know how to motivate health professionals to implement them.
Subject(s)
Patient Acceptance of Health Care/statistics & numerical data , Patient Selection , Postpartum Period , Smoking Cessation/methods , Smoking Prevention , Adult , Cross-Sectional Studies , Female , Humans , Maternal Behavior , Practice Guidelines as Topic , Pregnancy , Primary Prevention/methods , Smoking/epidemiology , Spain/epidemiology , Young AdultABSTRACT
Objetivo: Analizar los factores predictores de los resultados del tratamiento del tabaquismo según sexo,en personas fumadoras que solicitan tratamiento para dejar de fumar en una unidad de tabaquismo.Métodos: Estudio transversal en personas fumadoras que iniciaron tratamiento en una unidad de tabaquismo entre los anos 2002 y 2007. Se recogieron variables sociodemográficas, de patrón de consumo, del entorno del paciente respecto al tabaco y la presencia de comorbilidad psiquiátrica. Se realizó tratamiento multicomponente: psicológico y farmacológico. Se consideró éxito del tratamiento la abstinenciacontinua validada con CO ≤10 ppm, y se realizó el análisis mediante el criterio de intención de tratar.Para analizar los factores predictores se llevó a cabo un análisis de regresión logística.Resultados: Se analizaron 1302 personas, 52,1% (678) hombres y 47,9% (624) mujeres, con una media deedad de 43,4 (10,2) anos. El consumo medio de cigarrillos era de 25,3 (10,4) y la dependencia física de 6,2 (2,2) puntos. El 41,3% (538) logró el éxito, sin encontrar diferencias. Los factores predictores del éxitoen los hombres fueron la menor dependencia física y una pareja no fumadora, y en las mujeres fueron lamayor edad, el menor consumo de cigarrillos, la minoría de amigos fumadores y no padecer ansiedad odepresión durante el tratamiento.Conclusiones: Hombres y mujeres tienen un porcentaje de éxito similar en los tratamientos para dejar defumar, aunque hay factores predictores del éxito diferentes según el sexo que condicionan la abstinencia.Es necesario incorporar la perspectiva del sexo en el consumo de tabaco, tanto en la prevención como enel tratamiento (AU)
Objective: To identify factors predictive of the outcome of a smoking cessation program by gender.Methods: A cross-sectional study of smokers starting treatment in a smoking cessation clinic from 2002to 2007 was conducted. The variables consisted of data on sociodemographic factors, smoking habits,the social context of smoking and psychiatric comorbidity prior to or during the smoking cessationprocess. All patients received multicomponent treatment consisting of psychological and pharmacological interventions. Success was defined as self-reported continuous abstinence confirmed by cooximetry(CO ≤10 ppm). Logistic regression was used to analyze the factors predictive of success.Results: A total of 1302 persons (52.1% men and 47.9% women), with a mean age of 43.4 (10.2) years,were included. The mean number of cigarettes smoked per day was 25.3 (10.4) and the mean Fagerströmtest score was 6.2 (2.2) points. The success rate was 41.3% (538) with no differences by gender. Positivepredictors were lower nicotine dependence and having a non-smoking partner in men and older age,smoking fewer cigarettes per day, having fewer smoking friends and not experiencing depression oranxiety during the treatment in women.Conclusions: Men and women have similar tobacco abstinence outcomes although gender factors play arole in determining abstinence. The gender perspective should be incorporated in smoking preventionand cessation programs (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Smoking/therapy , /statistics & numerical data , Tobacco Use Cessation/statistics & numerical data , Smoking/epidemiology , Patient Compliance/statistics & numerical data , Tobacco Use Cessation/psychology , Gender and Health , Cross-Sectional Studies , Predictive Value of TestsABSTRACT
OBJECTIVE: to analyse the efficacy of a proactive intervention during the postpartum period to prevent a relapse in recent quitters and to promote progress in the behavioural process of change in smokers. DESIGN: randomised controlled trial designed for women at the end of the pregnancy using a proactive intervention. Motivational Interviewing (MI) and relapse prevention served as principles for the programme. In the intervention group, four telephone supporting sessions were performed in weeks 3, 6, 9 and 12. For the control group only two check calls in weeks 3 and 12. SETTING: women who attended the University Clinical Hospital 'Lozano Blesa' of Zaragoza (Spain) to give birth between January 2009 and March 2010. The intervention began after delivery, lasted for 3 months, and finished with a visit to validate abstinence biochemically. FINDINGS: a total of 2,044 women were studied, 30.6% (n=626) smoked before pregnancy; 65.8% (n=412) of them agreed to participate. The results for recent quitters by self-report showed that the probability of remaining abstinent after 12 weeks was 74% for the intervention group and 37% for the control group. Only the half of the sample attended the visit at 3 months to confirm the abstinence biochemically. For smokers, 90.7% of the intervention group said that they would be ready to try to quit in the following 6 months, vs. 18.3% for the control group. CONCLUSIONS AND IMPLICATIONS FOR THE PRACTICE: a proactive intervention in the postpartum period may reduce the probability of relapse in recent quitters and helps female smokers to make progress in the behavioural process of change. Such interventions should be included systematically in mother-child health services.
Subject(s)
Behavior Control/methods , Postpartum Period/psychology , Smoking Cessation , Smoking , Adult , Female , Hotlines , Humans , Maternal Behavior , Maternal Health Services/methods , Maternal Health Services/statistics & numerical data , Monitoring, Physiologic/methods , Motivational Interviewing , Pregnancy , Secondary Prevention , Smoking/epidemiology , Smoking Cessation/methods , Smoking Cessation/psychology , Smoking Prevention , Spain/epidemiology , Treatment OutcomeABSTRACT
OBJECTIVE: To identify factors predictive of the outcome of a smoking cessation program by gender. METHODS: A cross-sectional study of smokers starting treatment in a smoking cessation clinic from 2002 to 2007 was conducted. The variables consisted of data on sociodemographic factors, smoking habits, the social context of smoking and psychiatric comorbidity prior to or during the smoking cessation process. All patients received multicomponent treatment consisting of psychological and pharmacological interventions. Success was defined as self-reported continuous abstinence confirmed by cooximetry (CO ≤10 ppm). Logistic regression was used to analyze the factors predictive of success. RESULTS: A total of 1302 persons (52.1% men and 47.9% women), with a mean age of 43.4 (10.2) years, were included. The mean number of cigarettes smoked per day was 25.3 (10.4) and the mean Fagerström test score was 6.2 (2.2) points. The success rate was 41.3% (538) with no differences by gender. Positive predictors were lower nicotine dependence and having a non-smoking partner in men and older age, smoking fewer cigarettes per day, having fewer smoking friends and not experiencing depression or anxiety during the treatment in women. CONCLUSIONS: Men and women have similar tobacco abstinence outcomes although gender factors play a role in determining abstinence. The gender perspective should be incorporated in smoking prevention and cessation programs.
Subject(s)
Smoking Cessation/statistics & numerical data , Smoking/therapy , Adult , Cross-Sectional Studies , Female , Humans , Male , Prognosis , Sex FactorsABSTRACT
BACKGROUND: The application of new technologies to the education of health professionals is both a challenge and a necessity. Virtual worlds are increasingly being explored as a support for education. AIM: The aim of this work is to study the suitability of Second Life (SL) as an educational tool for primary healthcare professionals. DESIGN: Qualitative study of accredited clinical sessions in SL included in a continuing professional development (CPD) programme for primary healthcare professionals. LOCATION: Zaragoza I Zone Family and Community Medicine Education Unit (EU) and 9 health centres operated by the Aragonese Health Service, Aragon, Spain. METHOD: The EU held two training workshops in SL for 16 healthcare professionals from 9 health centres by means of two workshops, and requested them to facilitate clinical sessions in SL. Attendance was open to all personnel from the EU and the 9 health centres. After a trail period of clinical sessions held at 5 health centres between May and November 2010, the CPD-accredited clinical sessions were held at 9 health centres between February and April 2011. PARTICIPANTS: 76 healthcare professionals attended the CPD-accredited clinical sessions in SL. MAIN MEASUREMENTS: Questionnaire on completion of the clinical sessions. RESULTS: Response rate: 42-100%. Questionnaire completed by each health centre on completion of the CPD-accredited clinical sessions: Access to SL: 2 centres were unable to gain access. Sound problems: 0% (0/9). Image problems: 0% (0/9). Voice/text chat: used in 100% (10/9); 0 incidents. Questionnaire completed by participants in the CPD-accredited clinical sessions: Preference for SL as a tool: 100% (76/76). Strengths of this method: 74% (56/76) considered it eliminated the need to travel; 68% (52/76) believed it made more effective use of educational resources; and 47% (36/76) considered it improved accessibility. Weaknesses: 91% (69/76) experienced technical problems, while; 9% (7/76) thought it was impersonal and with little interaction. 65.79% (50/76) believed it was better than other distance learning methods and 38.16% (29/76) believed it was better than face-to-face learning. CONCLUSIONS: SL is a tool that allows educational activities to be designed that involve a number of health centres in different geographical locations, consequently eliminating the need to travel and making more effective use of educational resources.
Subject(s)
Community Medicine/education , Computer-Assisted Instruction/methods , Education, Medical, Continuing/methods , Family Practice/education , User-Computer Interface , Accreditation , Attitude of Health Personnel , Attitude to Computers , Curriculum , Education , Humans , Software , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To assess the evolution of anxiety during the smoking cessation process (3 months) and early smoking relapse, in a group of smokers seeking treatment for giving up smoking. METHOD: Analytical, prospective and longitudinal study. STUDY VARIABLES: sex, age, marital status, educational level, anxiety and depression background, use of psychopharmacological drugs, cigarettes smoked per day, co-oximetry, nicotine dependence (Fagerström Test for Nicotine Dependence) and state and trait anxiety (State-Trait Anxiety Inventory). Trait anxiety was assessed at the same time as medical history and state anxiety over the following sessions: Medical history session, day prior to stopping smoking, the day after, and at one week, one month and three months. Continuous abstinence was assessed by self-report and confirmed by co-oximetry ≤ 10 ppm. RESULTS: 569 patients, 288 men (50.6%) and 281 women (49.4%), mean age 43 years, mean cigarettes per day 23, average score on Fagerström Test 6. State anxiety levels decreased during the smoking cessation process, and these levels were maintained three months later. Women scored higher on state and trait anxiety, and so did smokers who took psychopharmacological drugs. Relapsing patients had higher levels of state anxiety in the session prior to relapse. CONCLUSIONS: State anxiety decreases during the smoking cessation process, remaining at the same level after 3 months. There is a need to incorporate behavioural strategies in smoking cessation treatment.
Subject(s)
Anxiety/etiology , Smoking Cessation/psychology , Adult , Anxiety/epidemiology , Female , Humans , Male , Prospective StudiesABSTRACT
Objetivo: Conocer la evolución de la ansiedad a lo largo del proceso de cesación tabáquica (3 meses) en pacientes que solicitan tratamiento para dejar de fumar y su posible valor pronóstico en la recaída. Método: Estudio analítico prospectivo longitudinal. Variables de estudio: sexo, edad, estado civil, nivel de estudios, antecedentes de ansiedad y/o depresión, consumo de psicofármacos, cigarrillos diarios, cooximetría, dependencia a la nicotina (Test de Fagerström) y ansiedad estado/rasgo con el cuestionario STAI-E/R (State-Trait Anxiety Inventory). La ansiedad rasgo se evaluó el día de la historia clínica y la ansiedad estado en las siguientes sesiones: Hª clínica, día previo a dejar de fumar, día posterior, semana, mes y a los tres meses. Se midió la abstinencia continuada y validada con CO ≤10 ppm. Resultados: 569 pacientes, 288 hombres (50,6%) y 281 mujeres (49,4%), media de edad: 43 años; media cigarrillos/día: 23; media Test de Fagerström:6. La A/E disminuyó al dejar de fumar y se mantuvo a lo largo del tiempo (3 meses). Se encontraron mayores puntuaciones de A/R y A/E en el grupo de mujeres y en los sujetos que consumían psicofármacos. Los pacientes que recayeron tenían mayor grado de ansiedad estado en la sesión anterior a la recaída. Conclusiones: La ansiedad disminuye a lo largo del proceso de deshabituación y se mantiene en el tiempo (3 meses); los sujetos que recaen puntúan más alto en ansiedad estado. Es necesario incorporar estrategias conductuales en el tratamiento del tabaquismo (AU)
Objective: To assess the evolution of anxiety during the smoking cessation process (3 months) and early smoking relapse, in a group of smokers seeking treatment for giving up smoking. Method: Analytical, prospective and longitudinal study. Study variables: sex, age, marital status, educational level, anxiety and depression background, use of psychopharmacological drugs, cigarettes smoked per day, co-oximetry, nicotine dependence (Fagerström Test for Nicotine Dependence) and state and trait anxiety (State-Trait Anxiety Inventory).Trait anxiety was assessed at the same time as medical history and state anxiety over the following sessions: Medical history session, day prior to stopping smoking, the day after, and at one week, one month and three months. Continuous abstinence was assessed by self-report and confirmed by co-oximetry ≤ 10 ppm. Results: 569 patients, 288 men (50.6%) and 281 women (49.4%), mean age 43 years, mean cigarettes per day 23, average score on Fagerström Test 6. State anxiety levels decreased during the smoking cessation process, and these levels were maintained three months later. Women scored higher on state and trait anxiety, and so did smokers who took psychopharmacological drugs. Relapsing patients had higher levels of state anxiety in the session prior to relapse. Conclusions: State anxiety decreases during the smoking cessation process, remaining at the same level after 3 months. There is a need to incorporate behavioural strategies in smoking cessation treatment (AU)
Subject(s)
Humans , Smoking Cessation/psychology , Anxiety Disorders/epidemiology , Smoking/psychology , Substance Withdrawal Syndrome/psychologyABSTRACT
OBJECTIVE: The aim of this study was to assess the results of smoking cessation therapy in a specialist unit by calculating the probability of continued abstinence at 6-month follow-up and analyzing differences according to the characteristics of the individuals. PATIENTS AND METHODS: A prospective longitudinal study was undertaken in smokers who received multicomponent smoking-cessation therapy over a period of 3 months. Continued abstinence was assessed on the basis of self-report by participants and confirmed by measurement of exhaled carbon monoxide levels. Kaplan-Meier survival analysis was performed to assess the probability of continued abstinence. Log-rank tests were used to analyze differences in continued abstinence according to different qualitative variables. RESULTS: The 1120 patients who participated in the study (56% men and 44% women) had a mean (SD) age of 44.1 (9.5) years. The mean score on the Fagerström test was 6.3 (2.1). Nicotine replacement therapy was provided in 70.8% of patients while 29.2% received bupropion. The probability of continued abstinence at 6 months was 62.2%. Individuals with a high dependence had a lower probability of continued abstinence at 6 months, as did those in whom treatment adherence was poor. No differences were observed in the probability of abstinence according to sex or type of pharmacological treatment. CONCLUSIONS: Individuals with a high nicotine dependence can benefit from intensive smoking-cessation treatment in a specialist unit to achieve continued abstinence.
Subject(s)
Patient Compliance/statistics & numerical data , Smoking Cessation , Adult , Female , Humans , Male , Prospective StudiesABSTRACT
Objetivo: Valorar los resultados del tratamiento del tabaquismo en una unidad especializada, mediante el cálculo de la probabilidad de permanecer abstinente a los 6 meses del seguimiento, y analizar las diferencias existentes según las características de los individuos. Pacientes y métodos: Se ha realizado un estudio analítico prospectivo y longitudinal entre los fumadores que recibieron tratamiento multicomponente durante 3 meses. Se consideró la abstinencia continuada mediante la declaración de los propios participantes, confirmada con cooximetría. Se realizó un análisis de supervivencia por el método de Kaplan-Meier. Se aplicaron contrastes de rangos logarítmicos para estudiar las diferencias en la abstinencia continuada de los pacientes para las distintas categorías de las variables cualitativas. Resultados: Se estudió a 1.120 pacientes (un 56% varones y el 44% mujeres), con una edad media (± desviación estándar de 44,1 ± 9,5 años. La puntuación del test de Fagerström fue de 6,3 ± 2,1 puntos. El 70,8% recibió tratamiento sustitutivo con nicotina y el 29,2% con bupropión. La probabilidad de mantenerse abstinente a los 6 meses fue del 62,2%. Los individuos con alta dependencia presentaron menos probabilidad de permanecer abstinentes a los 6 meses, así como aquéllos con mal cumplimiento terapéutico. No se encontraron diferencias en la probabilidad de abstinencia según el sexo y el tratamiento farmacológico utilizado. Conclusiones: Los individuos con dependencia alta a la nicotina pueden beneficiarse del tratamiento intensivo en una unidad especializada de tabaquismo para conseguir la abstinencia mantenida
Objective: The aim of this study was to assess the results of smoking cessation therapy in a specialist unit by calculating the probability of continued abstinence at 6-month follow-up and analyzing differences according to the characteristics of the individuals. Patients and Methods: A prospective longitudinal study was undertaken in smokers who received multicomponent smoking-cessation therapy over a period of 3 months. Continued abstinence was assessed on the basis of self-report by participants and confirmed by measurement of exhaled carbon monoxide levels. Kaplan-Meier survival analysis was performed to assess the probability of continued abstinence. Log-rank tests were used to analyze differences in continued abstinence according to different qualitative variables. Results: The 1120 patients who participated in the study (56% men and 44% women) had a mean (SD) age of 44.1 (9.5) years. The mean score on the Fagerström test was 6.3 (2.1). Nicotine replacement therapy was provided in 70.8% of patients while 29.2% received bupropion. The probability of continued abstinence at 6 months was 62.2%. Individuals with a high dependence had a lower probability of continued abstinence at 6 months, as did those in whom treatment adherence was poor. No differences were observed in the probability of abstinence according to sex or type of pharmacological treatment. Conclusions: Individuals with a high nicotine dependence can benefit from intensive smoking-cessation treatment in a specialist unit to achieve continued abstinence
Subject(s)
Male , Female , Adult , Humans , Tobacco Use Disorder/epidemiology , Tobacco Use Disorder/therapy , Nicotine/therapeutic use , Tobacco Use Disorder/epidemiology , Bupropion/therapeutic use , Prospective Studies , Longitudinal Studies , Substance Withdrawal Syndrome/epidemiology , Substance Withdrawal Syndrome/therapyABSTRACT
OBJECTIVE: To evaluate weight gain and its relation to anxiety in a group of smokers after 3 months of cessation treatment. PATIENTS AND METHODS: The target population for this prospective, analytical, longitudinal study was smokers being treated in a specialist smoking cessation clinic who were still abstinent at the conclusion of a 3-month treatment program. The following variables were analyzed: age, sex, nicotine dependence (Fagerström test), daily cigarette consumption, number of pack-years, pharmacological treatment (nicotine replacement/bupropion), use of nicotine gum (yes/no), weight gain, body mass index, and degree of state and trait anxiety. Successful cessation was defined as self-reported abstinence confirmed by measurement of expired carbon monoxide (CO) level (< or = 10 ppm). Anxiety was evaluated using the State-Trait Anxiety Inventory. The state anxiety and weight variables were measured on 5 occasions: before smoking cessation, and at the end of week 1, month 1, month 2, and month 3 after cessation. Results for the quantitative variables were expressed as means (SD), and results for the qualitative variables were expressed as percentages and absolute frequencies. RESULTS: The study population consisted of 122 individuals, 76 of whom were men (62%) and 46 of whom were women (38%). The mean age was 43.9 (9.9) years, and mean nicotine dependence according to the Fagerström scale was 6.2 (2.2) points. Average weight gain was 2.6 kg (3.6%), with no significant difference between the sexes. Weight gain in 25% of this population was greater than 4.2 kg, and maximum weight gain was 9.2 kg. Levels of state anxiety fell progressively as weight increased, although there was no evident relationship between the 2 variables. CONCLUSIONS: Weight gain is moderate as smokers quit. Anxiety levels, which are greater in the first few weeks after cessation, do not explain weight variation, which is more related to the metabolic effects of nicotine rather than to psychological variables.