Influence of the COVID-19 pandemic on contact lens wear in Spain.

PURPOSE: To investigate the behaviour of contact lens (CL) wearers in Spain during the COVID-19 pandemic. METHODS: An anonymized web-based questionnaire was used to assess demographics, CL history, and activity, CL wear habits and perceived risk of infection due to CL wear during the COVID-19 pandemic. RESULTS: A total of 737 participants with an average age of 27.4 (±9.3) years completed the online questionnaire. The vast majority of respondents were soft CL wearers and reported at least two years of CL wear. Patients concerns about the increased risk of SARS-CoV-2 infection due to CL wear (40.6 % of participants) were significantly related (χ2(1) = 11.195, p < 0.05) to CL discontinuation (46 % of participants) during the COVID-19 pandemic. This fact joins the significant changes in the frequency of CL wear during the COVID-19 pandemic (χ2(4) = 31.982, p < 0.05), with a tendency to increase occasional CL wear from 29.1 % to 61.8 %. Interestingly, the majority of respondent (87.9 %) indicated that no professional had offered them information related to CL wear and COVID-19, and that they had not sought it on their own (82.2 %). CONCLUSION: There is a relationship between the perceived risk of infection and CL dropout during the COVID-19 pandemic, and a tendency to change the CL frequency of wear, with an increase in occasional CL wear. During the ongoing pandemic, eye care practitioners should reinforce CL patient education to minimize the risk of SARS-CoV-2 infection and CL-related complications requiring clinical care.

The role of gender in a smoking cessation intervention: a cluster randomized clinical trial.

BACKGROUND: The prevalence of smoking in Spain is high in both men and women. The aim of our study was to evaluate the role of gender in the effectiveness of a specific smoking cessation intervention conducted in Spain. METHODS: This study was a secondary analysis of a cluster randomized clinical trial in which the randomization unit was the Basic Care Unit (family physician and nurse who care for the same group of patients). The intervention consisted of a six-month period of implementing the recommendations of a Clinical Practice Guideline. A total of 2,937 current smokers at 82 Primary Care Centers in 13 different regions of Spain were included (2003-2005). The success rate was measured by a six-month continued abstinence rate at the one-year follow-up. A logistic mixed-effects regression model, taking Basic Care Units as random-effect parameter, was performed in order to analyze gender as a predictor of smoking cessation. RESULTS: At the one-year follow-up, the six-month continuous abstinence quit rate was 9.4% in men and 8.5% in women (p = 0.400). The logistic mixed-effects regression model showed that women did not have a higher odds of being an ex-smoker than men after the analysis was adjusted for confounders (OR adjusted = 0.9, 95% CI = 0.7-1.2). CONCLUSIONS: Gender does not appear to be a predictor of smoking cessation at the one-year follow-up in individuals presenting at Primary Care Centers. CLINICALTRIALS.GOV IDENTIFIER: NCT00125905.

[Benefit of brief interventions and pharmacotherapies for smoking cessation in teenagers]. / Valor de la intervención breve y los tratamientos farmacológicos para dejar de fumar en adolescentes.

Management of smoking includes approaches such as health advice against smoking, brief or intensive interventions, and pharmacotherapy. However, we do not have enough information on the use of such approaches in teenagers. School programs aimed at children and adolescents are perhaps the most widely used intervention and the one for which we have the most experience. Such programs should meet a series of well-defined criteria, but in recent years their effectiveness has been questioned. Currently, information is lacking on how effective these interventions are in young smokers who wish to stop. Several clinical guidelines recommend advice and a brief intervention in adolescents but are less specific regarding pharmacotherapy. By integrating advice and a brief intervention into existing smoking prevention and control programs in schools, such approaches could be used to combat smoking in children and adolescents. However, the information available on the use of such interventions in children and adolescents is insufficient and more research needs to be done, particularly by health care professionals specialized in the identification of susceptible individuals and treatment of smoking.

Valor de la intervención breve y los tratamientos farmacológicos para dejar de fumar en adolescentes / Benefit of brief interventions and pharmacotherapies for smoking cessation in teenagers

El tratamiento del tabaquismo incluye conceptos como el consejo sanitario antitabáquico, la intervención breve o la intervención intensiva y el tratamiento farmacológico, pero carecemos de información suficiente acerca de su empleo en adolescentes. Los programas escolares destinados a niños y jóvenes, que son quizá los más ampliamente utilizados y los que cuentan con mayor experiencia, deben cumplir una serie de características muy bien definidas y en los últimos años se ha cuestionado su eficacia. En la actualidad no se dispone de información suficiente acerca de la eficacia de los tratamientos en niños y jóvenes fumadores que desean dejar el tabaco. Diversas guías clínicas recomiendan el consejo y la intervención mínima en adolescentes, pero se muestran menos categóricas en lo que respecta a la utilización de los tratamientos farmacológicos. La integración del consejo y de la intervención breve en los programas de prevención y control del tabaquismo que se realizan en los centros escolares posibilitaría la utilización de este instrumento de tratamiento del tabaquismo en niños y jóvenes, aunque la información disponible acerca de este tipo de tratamientos en niños y adolescentes es insuficiente y debería ser objeto de investigación, especialmente por parte de los profesionales especializados en diagnóstico y tratamiento del tabaquismo

Management of smoking includes approaches such as health advice against smoking, brief or intensive interventions, and pharmacotherapy. However, we do not have enough information on the use of such approaches in teenagers. School programs aimed at children and adolescents are perhaps the most widely used intervention and the one for which we have the most experience. Such programs should meet a series of well-defined criteria, but in recent years their effectiveness has been questioned. Currently, information is lacking on how effective these interventions are in young smokers who wish to stop. Several clinical guidelines recommend advice and a brief intervention in adolescents but are less specific regarding pharmacotherapy. By integrating advice and a brief intervention into existing smoking prevention and control programs in schools, such approaches could be used to combat smoking in children and adolescents. However, the information available on the use of such interventions in children and adolescents is insufficient and more research needs to be done, particularly by health care professionals specialized in the identification of susceptible individuals and treatment of smoking

Adverse effects of pharmacological therapy for nicotine addiction in smokers following a smoking cessation program.

This multicenter, community-based, prospective, longitudinal study evaluated the safety of nicotine replacement therapy (NRT), bupropion, and combined therapy of NRT and bupropion for smokers seeking to quit, when these therapies were used under real-world conditions following a smoking cessation program. Participants were smokers aged 18 years or older who attended five smoking cessation clinics. Evaluations were made at 15, 30, 60, and 90 days. We investigated the possible existence of adverse effects as well as the severity of each adverse effect and its influence on the treatment course. The study included 904 smokers: 370 received NRT, 413 received bupropion, and 121 received combined therapy. At 15, 30, 60, and 90 days, adverse effects were reported by 43.8%, 33.1%, 22.3%, and 5.7% of subjects, respectively. Adverse effects were significantly more frequent in subjects receiving combined therapy or bupropion alone than in NRT-treated subjects at the 15-, 30-, and 60-day follow-ups. A total of 83 smokers (9.3%) withdrew from treatment and 116 (12.8%) stopped temporarily because of adverse effects. No differences were found in the percentages of discontinuation among the different treatment options. Adverse effects rarely were severe (n=10). Nevertheless, 41 subjects (4.5%) discontinued drug therapy indefinitely and 55 (6.1%) discontinued it temporarily because of mild adverse effects. Pharmacological therapies for smoking cessation are safe as long as they are appropriately prescribed and supervised by clinicians according to clinical practice guidelines. Adverse effects are primarily mild. Nonetheless, mild adverse effects may be perceived by patients as a serious enough problem to cause them to discontinue treatment.

Harm reduction--a treatment approach for resistant smokers with tobacco-related symptoms.

Smokers with chronic obstructive pulmonary disease (COPD) appear to represent a hard-core group, and this presents a dilemma for chest physicians. A reduction in cigarette smoking benefits health, and nicotine replacement therapy (NRT) can aid smoking reduction. Hence we studied the efficacy of nicotine gum in helping hard-core smokers with severe COPD to quit. Seventeen smokers with severe COPD (FEV(1) 38-47% of predicted normal) who smoked >30 cigarettes/day but were unable to quit were encouraged to reduce their smoking as much as possible by using 4-mg nicotine gum. Five gradually reduced their daily tobacco consumption and, 18 months after starting NRT, were smoking an average of 6 cigarettes/day while still using nicotine gum. Compared to baseline, their respiratory symptoms had improved, and both FEV(1) and FVC had increased. There was no improvement in pulmonary function in the group of smokers who did not reduce their cigarette consumption. No adverse events relating to nicotine occurred among the patients who used NRT to reduce their smoking. We propose that this reduction approach should be considered for patients with respiratory disease who are unable or unwilling to stop smoking.

Valor predictivo de la abstinencia tabáquica a los 2 meses de tratamiento / Two-month results are predictors of outcome in a smoking cesation program

FUNDAMENTO: La intervención mínima sistematizada y la terapia sustitutiva con nicotina han demostrado ser efectivas en el tratamiento del tabaquismo. El objetivo de nuestro estudio ha sido determinar si los resultados obtenidos a los 2 meses con un programa de tratamiento del tabaquismo, con ambos procedimientos, desarrollado en la asistencia habitual pueden ser considerados predictores de los resultados al año. SUJETOS Y MÉTODO: Hemos realizado un estudio longitudinal y prospectivo en el que se ha incluido a todos los fumadores (n = 357) que acudieron a una consulta de atención primaria o especializada durante un período de 6 meses. La intervención mínima fue utilizada en los fumadores con baja dependencia a la nicotina (Fagerström < 7) o que aún no se encontraban en fase de preparación. La terapia sustitutiva con nicotina se aplicó a los fumadores con alta dependencia (Fagerström 7).RESULTADOS: Un total de 32 pacientes (9 por ciento) de los 357 no acudieron a los controles establecidos y se consideraron casos perdidos. El estudio anual fue completado por 177 pacientes en el grupo de intervención mínima y 148 en el de la terapia sustitutiva. La abstinencia al año fue conseguida por el 39,2 por ciento de los sujetos del grupo de la intervención mínima y por el 36,2 por ciento de los tratados con terapia sustitutiva con nicotina. Previamente, a los 2 meses, la abstinencia observada había sido del 34 por ciento (27,4-40,7) y 52,1 por ciento (44,5-59,8), respectivamente. Los pacientes que habían conseguido la abstinencia a los dos meses del inicio del programa tenían 19 veces más probabilidades de éxito al cabo de un año (odds ratio, 19,4), presentando en el grupo de la intervención mínima una sensibilidad del 72,4 por ciento y una especificidad del 90,7 por ciento, y en el grupo de la terapia sustitutiva del 93,2 por ciento y el 71,2 por ciento, respectivamente. CONCLUSIONES: Los resultados observados a los 2 meses del inicio del programa se comportan como predictores de éxito y pueden ser de utilidad para modificar la actitud terapéutica con el fin de mejorar las tasas de abstinencia al año del inicio del programa (AU)

Grado de cumplimiento de la legislación e impartición de enseñanzas anti-tabaco en los centros escolares españoles / Anti-tobacco laws compliance and health education in the Spanish schools

Fundamento: No se dispone de estudios que analicen el cumplimiento de la legislación antitabaco en los centros escolares españoles, por lo que nos propusimos conocer el grado de cumplimiento de la legislación oficial anti-tabaco en dichos centros y la influencia que ello tiene sobre el porcentaje de alumnos fumadores. Método: Se realizó una encuesta entre 3.050 directores de centros educativos españoles, a los que se les preguntó sobre diversos aspectos del cumplimiento de la legislación oficial anti-tabaco en los centros y sobre las principales características del consumo de tabaco en los mismos. Resultados: El 80,9 por ciento de los directores afirman que en sus centros se exige el cumplimiento de la legislación y el 64,9 por ciento disponen de carteles que advierten de la prohibición de fumar. Afirman impartir enseñanzas anti-tabaco el 82,2 por ciento de los centros en los que se exige la legislación y en el 64,8 por ciento de los centros en los que esta legislación no se exige. Creen que el porcentaje de profesores que fuman ante los alumnos es del 5,9 por ciento en los centros en que se exige la legislación y del 12,9 por ciento en los que no se cumple. En los centros donde se imparten enseñanzas anti-tabaco creen que han probado el tabaco el 29 por ciento de los alumnos, frente al 31 por ciento que creen lo han hecho en los centros donde no se imparten estas enseñanzas (p<0,001). Conclusiones: El cumplimiento de la legislación es insuficiente. Los directores de los centros educativos, como encargados de velar por el cumplimiento de la legislación oficial anti-tabaco en sus centros, deben exigir el cumplimiento de esta legislación, ya que esta medida es eficaz para mejorar el funcionamiento global de los centros y para reducir los porcentajes de alumnos y profesores fumadores (AU)