[Analysis of quality of life in patients with Chronic Obstructive Pulmonary Disorder (COPD) who give up smoking]. / Análisis de la calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) que dejan de fumar.

OBJECTIVE: To analyse the impact in COPD patients' quality of life who stop smoking. PATIENTS AND METHODS: We studied a group of COPD patients who received smoking cessation treatment. All patients were treated with bronchodilators according to the severity of their disorder. This treatment was not changed during the process of smoking cessation. Patients received a smoking cessation programme that consisted of a combination of pharmacological treatment plus cognitive-behavioural treatment. All subjects fill in CAT questionnaire before starting smoking cessation programme and after 6 months of abstinence. All subjects included had stop smoking. RESULTS: The study included 59 patients, with 27 (45.8%) males, and a mean age of 61.8 (7.5) years. Mean CAT score before quitting was 18.9 (7.3) points, and after 6 months of abstinence was 8.1 (6.1) points, P=.038. Multiple regression analysis showed: a) the higher the baseline CAT score the greater is the difference after quitting, at 6 months, at same age, gender, and grade of severity of COPD, and b) the older the age, the lower is the difference between baseline CAT score and the 6 months CAT score. CONCLUSIONS: Smoking cessation is associated with improvement in the quality of life in COPD patients. Those with worse quality of life get the biggest benefit from quitting, although this difference can be diminished in ageing patients.

Effectiveness and safety of varenicline and nicotine replacement therapy among mental health patients: A retrospective cohort study.

OBJECTIVE: To analyse the effectiveness and safety of two smoking cessation medications (varenicline and nicotine patches) in patients with controlled psychiatric disorders in daily practice in a Smoking Cessation Service. METHODS: This is a retrospective cohort study. It was carried on at a smoking cessation clinic in Madrid and used a convenience sampling strategy. We reviewed medical records of patients diagnosed with psychiatric disorders who attended a Smoking Cessation Service. All patients received similar treatment programme: a combination of pharmacological treatment (varenicline or nicotine replacement therapy) and intensive cognitive-behavioural therapy. RESULTS: The group included 349 patients (38.4% men). Mean age (SD) 49.6 (10.5) years. 28.3 (12.8) cigarettes per day. 156 subjects achieved 9-24 weeks continuous abstinence (44.7%), in 39% of those who used nicotine patches and in 53.7% of those who used varenicline. OR: 1.64 (95% CI: 1.03-2.61; p=0.036). Success rates were higher in men; OR 1.85 (95% CI: 1.12-3.04; p=0.016). High levels of CO and high daily cigarette use were associated with poorer success rates (OR: 0.98, 95% CI: 0.96-0.99, p=0.007; and OR: 0.98, 95% CI: 0.96-1.00, p=0.045), respectively. Nausea and pruritus were the most common adverse events. No cases of suicidal ideation or behaviour were found. CONCLUSIONS: Varenicline and nicotine patches could be safe and effective smoking cessation treatments for patients with psychiatric disorders in daily clinical practice.

Searching for phenotypes in smoking cessation treatment.

BACKGROUND: It is important to define smoking phenotypes according to different variables, such as age, sex and degree of dependence, for which available treatments could have different efficacies. OBJECTIVE: The main objective of our study was aimed at defining different combinations of these variables to allow the best possible treatment to be chosen in routine clinical practice. METHODS: We reviewed the clinical records of smokers who had been treated in our Smoking Cessation Service. In all cases, the treatment programme consisted of a combination of behavioural therapy and optional drug treatment. RESULTS: The group consisted of 3622 subjects, specifically 1757 men (48.5%). The mean age of the participants in the group was 48.11 ± 11.19 years. The mean score of the FTCD-questionnaire was 6.66 ± 2.38. In addition, 78% of the subjects smoked their first cigarette within 30 min after waking. For the total sample, continuous abstinence rate from 9 to 24 weeks was 57.7%. A multivariate analysis using the logistic regression model was implemented, and it showed that: (i) Nicotine Replacement Therapy was less effective in patients with high tobacco dependence, (ii) young subjects can be highly resistant to all treatments and (iii) subjects with low tobacco dependence can be treated with any treatment, but bupropion and varenicline provided the best results. CONCLUSION: It was possible to identify several smoking phenotypes in which different treatments have different efficacies.

[Smoking in schools. A cross-sectional epidemiologic study of a population of 4,281 school children]. / Tabaquismo escolar. Estudio epidemiológico transversal en una población de 4.281 escolares.

Smokers begin to acquire their habit early. The objective of this study was therefore to determine real smoking habits among young people in Spain and create a profile of the adolescent smoker. A questionnaire was administered to a cross-section of the population. The results obtained coincide with reports by other authors in the Spanish and international literature. We found that the prevalence of smoking among young people between 9 and 19 years of age is approximately 25% and tobacco use increases with age. Young smokers participate less in sports and have a greater tendency to approve tobacco advertising. Young smokers' reasons for starting to smoke are diverse and the notion of "being grown-up" did not appear to apply to our cohort. We discuss, in the light of recent findings, the role of parents and social context in encouraging young people to smoke. The age of 14 is a key moment for taking up and establishing the habit of smoking.

[Pulmonary carcinoma associated with bullous emphysema]. / Carcinoma pulmonar asociado a enfisema bulloso.

Malignant complication of pulmonary bullous disease is rare but not negligible. Its importance lies in the young age when it appears. Eighty-nine cases in the literature, including four of our own cases, are included in this review. Etiopathogenic theories are discussed along with clinical, radiological, pathological, diagnostic, prognostic, and treatment characteristics. Smoking is a primary factor in this process, and quitting is key in terms of prevention. Surgical methods are usually necessary to perform the diagnosis, but that does not exclude the use of other techniques-particularly, fine-needle aspiration biopsy under radiological control-whose role should be validated. The prognosis is bad if there is no commitment to prevention. Even though the value of serial radiological controls is unknown, such controls may help in the early detection of neoplastic degeneration in bullous disease. The nature of the problem in handling these cases therapeutically is determined by the severity of bullous dystrophy: therefore, surgery should be considered on an individual basis.