Tabaquismo pasivo: importancia / Passive smoking: importance

RESUMEN. Objetivo. Se denomina tabaquismo pasivo al hecho involuntario de respirar aire contaminado por el humo de tabaco. A lo largo de los últimos años se ha ido acumulando evidencia científica acerca de las consecuencias sobre la salud de quienes se ven expuestos involuntariamente al humo ambiental del tabaco. Material y métodos. Se ha revisado la relación entre el tabaquismo pasivo y la morbimortalidad que se presenta en niños y adultos expuestos a este riesgo. Resultados. Actualmente se sabe que el tabaquismo pasivo es causa de morbilidad y de mortalidad prematura, tanto en niños como en adultos. En adultos la exposición al humo ambiental de tabaco aumenta el riesgo tanto de morbimortalidad coronaria, así como de padecer cáncer de pulmón. La exposición de niños al humo ambiental del tabaco es causa de muerte súbita del lactante, infecciones respiratorias agudas, y problemas del oído medio; así mismo, agrava el asma, ocasiona síntomas respiratorios y enlentece el desarrollo pulmonar. Conclusiones. No ha sido posible detectar la existencia de un umbral de exposición por debajo del cual no se aprecien riesgos para los fumadores pasivos. Los estudios muestran que la única manera real de proteger a la población de este riesgo es la restricción del consumo de tabaco en los espacios cerrados (AU)

Abstract. Objective. Involuntary exposure to environmental tobacco smoke (ETS), i.e., breathing other people’s smoke is called passive or secondhand smoking. Scientific evidence about the toxicity of ETS on the health of passive smokers is overwhelming. Material and methods. A bibliographic revision on the relationship between passive smoking and morbid- mortality in children and adults exposed was performed. Results. ETS exposure cause premature death and disease both in adults and in children who do not smoke. Adults exposed to ETS are at a higher risk of dying of coronary heart disease and lung cancer. In children, exposure to ETS increase the risk of sudden infant death syndrome (SIDS), acute respiratory infections, and middle ear problems; additionally, it aggravates asthma, causes respiratory symptoms and slows lung growth. Conclusions. The scientific evidence indicates that there is no risk-free level of exposure to ETS. It has not been possible to determine the presence of a threshold under which exposure to ETS does not cause any deleterious effect on passive smokers. Eliminating smoking in indoor spaces protects nonsmokers from exposure to ETS. In fact, it is the only way to fully protect them (AU)

[Nasal nicotine spray in smoking cessation. Results of a multicenter study]. / Tratamiento del tabaquismo con nebulizador nasal de nicotina. Resultados de un estudio multicéntrico.

We have carried out an open multicenter follow-up study of the efficacy of a smoking cessation therapy that combined psychological support with use of a nicotine nasal spray. Fifty-seven subjects (37 men, 20 women) with a mean age of 40.3 +/- 15.7 yr and smoking 37.4 +/- 4.7 cigarettes per day were enrolled. The mean Fagerström test score was 8.9 +/- 1.1. Patients received minimal psychological support and were prescribed a nicotine nasal spray at the recommended dose of 1 to mg/h for use while awake for a period of three months, with gradual reduction of dose. Subjects were seen on six occasions (on the first day of consultation; 1, 2 and 6 weeks after quitting; 3 and 6 months after quitting). After three months of follow-up, 22 patients (39%) were abstinent; six months after first trying to quit, only 20 of the 57 enrolled had succeeded (35%). Although most subjects (over 90% in the first 15 days, and over 50% at three months) used the treatment, only a small percentage (3%) followed the appropriate doses in the first 15 days and 31% reported doing so at the three-month check-up. The mean score reflecting withdrawal syndrome tripled over baseline level during the first six weeks of follow-up. Over three quarters of the subjects suffered side effects caused by the spray, the most common being nasal irritation, rhinorrhea and tearing. Five patients (87%) lef the study because of intolerance to medication. In conclusion, our study found a rate of success of 35% after six months of follow-up. Use of the prescribed medication was inadequate; withdrawal syndrome was more intense and the prevalence of side effects increased during the early treatment period.

[Bronchiolitis: conceptual review]. / Bronquiolitis: revisión conceptual.

Bronchiolitis is a term which brings together several processes which may confuse anyone who is not familiar with the subject. We will review these processes by focusing on the most common types.