Relación entre la autoeficacia para dejar de fumar, la voluntad propia y quién envía a los pacientes / Relationship between self-efficacy to quit smoking, own will and who referred patients

Objetivo: Comprobar si el grado de autoeficacia (AE) para dejar de fumar es diferente según quién remita al fumador a la consulta de tabaquismo y evaluar si el grado de AE medida según procedencia tiene impacto en el resultado (éxito o fracaso). Método: Estudio observacional, longitudinal (cohorte prospectiva), multicéntrico, en consultas para dejar de fumar de España y Argentina. Para valorar la motivación, fueron utilizados test cuantitativos (Richmond, Henry Mondor de Paris y Khimji Watts) y una escala semicuantitativa. La AE se midió con una pregunta de dos cuestionarios distintos (pregunta 4 del cuestionario de Richmond y pregunta 3 del cuestionario de Khimji-Watts). El análisis estadístico incluyó modelos descriptivos, de asociación y de regresión. Resultados: Muestra de 182 sujetos (90 [49,5%] mujeres, edad media 51,4 años [DE: 11; IC 26-77]). Con la pregunta 3 de AE del test Khimji-Watts se encontró asociación con la procedencia en los varones: acudir por voluntad propia incrementa la AE frente a los que acuden enviados desde atención primaria o desde otras especialidades. Ninguna de las variables de AE presentó asociación con el resultado en dejar de fumar, pero las mujeres que acudieron por voluntad propia o enviadas desde atención primaria tienen más probabilidades de dejar de fumar. Los varones procedentes de otras especialidades y con edades medias tienen más probabilidades de fracaso. Conclusiones: Los varones que acuden a dejar de fumar por voluntad propia presentan puntuaciones más altas de AE que aquellos que acuden enviados por atención primaria y otras especialidades. No hemos encontrado una mayor abstinencia final según la puntuación de AE y la procedencia.(AU)

Objective: To check whether the degree of self-efficacy to quit smoking is different depending on who refers the smoker to the smoking cessation clinics, considering as origin: primary care, from another medical specialist or by the patient’s own volition, and to assess whether the degree of self-efficacy measured by who refers the patient has an impact on the ­outcome (success or failure). Methods: Observational, longitudinal (prospective cohort), multicentre study in smoking cessation clinics in Spain and Argentina (daily clinical practice). Quantitative tests (Richmond, Henry Mondor de Paris and Khimji Watts) and one semiquantitative test were used to assess motivation. Self-efficacy was measured with one question from two different questionnaires (question 4 of the Richmond questionnaire and question 3 of the Khimji-Watts questionnaire). Statistical analysis included descriptive, association, and regression models. Results: 182 subjects [90 (49.5%) women, mean age 51.4 years (11; 25-77)]. With question three of the auto-efficacy of the Khimji-Watts test an association was found with the origin in men: attending of their own free will increases self-efficacy compared to those who attend sent from primary care or from other specialties. None of the self-efficacy variables was associated with the outcome of quitting smoking, but women who attended of their own free will or referred from primary care are more likely to quit smoking. Men from other specialties and with middle ages are more likely to fail. Conclusions: Men referred for QS by his OV have higher SE scores (KWT3 question) than those referred by PC and OS. We did not find a higher final abstinence according to SE score and source.(AU)

Is the motivation to quit smoking a predictor of abstinence maintenance?

INTRODUCTION: The aim of this study was to explore the utility of measuring motivation to quit smoking as a predictor of abstinence maintenance among smokers who wanted to quit and who were included in a multicenter study conducted in daily clinical practice. METHODS: This observational, longitudinal (prospective cohort), multicenter study was conducted in smoking clinics in Spain and the Argentine Republic in daily clinical practice. Motivation was assessed using three quantitative motivation tests and a Visual Analogue Scale. Statistical analysis included descriptive, association measures and logistic regression models. RESULTS: Of a total of 404 subjects, 273 were ultimately included for analysis (147 women; 53.8%), mean age 51±11 years). In one year, 53.5% (36.13% by intention to treat) of subjects (146) were successful in quitting smoking [men: 45.2% (66) and women: 54.8% (80)], with no differences between sexes. None of the scales utilized was associated, in an unquestionable or direct way, with long-term abstinence, although three of them, in a very complex model, with additional variables and added interactions, were associated with the 'result' variable, when other variables intervened in certain circumstances. CONCLUSIONS: None of the analyzed motivational scales alone demonstrated an association with success or failure in quitting smoking; thus, their use in isolation is of no value. Some of the scales analyzed might be related to the maintenance of abstinence but in complex models where other variables intervene, which makes interpretation considerably difficult. Therefore, the predictive capacity of the tests analyzed, based on the models, was low.

Prevalencia, conocimiento y actitudes acerca del consumo de tabaco en los miembros de SEPAR / Prevalence, knowledge and attitudes towards smoking among SEPAR members

Los objetivos del estudio son estimar la prevalencia del hábito tabáquico entre los socios y las actitudes e intervenciones sobre tabaquismo que realizan los miembros SEPAR ante sus pacientes. Se realizó una encuesta on line, a la que respondieron 640 socios (496 neumólogos, 45 enfermeras, 34 cirujanos torácicos, 37 fisioterapeutas y 28 profesionales de otras especialidades). El 5% de los socios encuestados confiesan ser fumadores: neumólogos 3,4%; enfermería 8,9%; cirujanos torácicos 8,8%; fisioterapeutas 13,5%. El 96% de los socios dan mucha o bastante importancia a la función modélica. El 98% de los socios preguntan siempre o a menudo a sus pacientes sobre el consumo de tabaco. La intervención más eficaz para tratar el tabaquismo para un 77% de los socios es el uso de fármacos, combinado con soporte psicológico. Estos resultados son un exponente de la firme sensibilización e implicación que los miembros SEPAR tienen frente al tabaquismo

The aims of this study were to estimate the prevalence of smoking among SEPAR members, and their approach to smoking cessation in their patients. An online survey was completed by 640 members (496 pulmonologists, 45 nurses, 34 thoracic surgeons, 37 physiotherapists, and 28 other specialists). Of the members interviewed, 5% confessed that they were smokers: 3.5% pulmonologists; 8.9% nurses; 8.8% thoracic surgeons, and 13.5% physiotherapists. A total of 96% of members assign a lot or quite a lot of importance to setting an example; 98% of members always or often ask their patients about their smoking habit. The most effective anti-smoking intervention, according to 77% of members, is a combination of drugs and psychological support. These results are an indicator of the awareness and commitment of SEPAR members to smoking and its cessation

Prevalence, Knowledge and Attitudes Towards Smoking Among SEPAR Members. / Prevalencia, conocimiento y actitudes acerca del consumo de tabaco en los miembros de SEPAR.

The aims of this study were to estimate the prevalence of smoking among SEPAR members, and their approach to smoking cessation in their patients. An online survey was completed by 640 members (496 pulmonologists, 45 nurses, 34 thoracic surgeons, 37 physiotherapists, and 28 other specialists). Of the members interviewed, 5% confessed that they were smokers: 3.5% pulmonologists; 8.9% nurses; 8.8% thoracic surgeons, and 13.5% physiotherapists. A total of 96% of members assign a lot or quite a lot of importance to setting an example; 98% of members always or often ask their patients about their smoking habit. The most effective anti-smoking intervention, according to 77% of members, is a combination of drugs and psychological support. These results are an indicator of the awareness and commitment of SEPAR members to smoking and its cessation.

Budgetary impact analysis on funding smoking-cessation drugs in patients with COPD in Spain.

The aim of the study was to assess the budgetary impact of funding smoking-cessation drugs in COPD patients in Spain. A hybrid model (cohort and Markov) was developed for a 5-year time horizon. Only approved cessation drugs (varenicline, bupropion, and nicotine replacement therapy) were considered. Irrespective of the drug, the model allowed for an initial cessation attempt, and up to three additional attempts in case of failure or smoking relapse during a 5-year period. Drug effectiveness was based on controlled clinical trials. National Health System perspective was applied; therefore, only medical resources were included. The pharmaceutical costs for smoking-cessation drugs, extra medical follow-up as a consequence of public reimbursement, and annual savings for health costs avoided due to stopping smoking were considered. The model estimated that 17,756 COPD patients would stop smoking if public funding was available, compared with 1,303 without reimbursement. In the reimbursement scenario, the savings accounted for a total of €48.0 million, compensating for expenditures on drugs and medical visits (€40.4 million). Accumulated total additional savings in 5 years (€4.3 million) compared with the scenario without reimbursement was shown. Sensitivity analyses supported the results robustness. Funding smoking-cessation drugs in COPD patients seems to be an efficient option and a National Health System drug reimbursement scheme would represent a cost-saving policy in Spain.

Consumo y abandono del tabaco en el embarazo: la importancia de la intervención mínima sistematizada / No disponible

No disponible