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This study extends research on hospital-initiated smoking cessation by establishing the feasibility of a novel text-messaging approach for post-discharge follow up. Text messaging is a low-cost alternative to proactive telephone counseling that could help overcome resource barriers in middle and lower income countries. This hybrid texting/counseling intervention identified smokers in hospitals, established rapport through a single telephone follow-up, and expanded acceptability and reach of later support by using text-messaging, which is free of charge in this and other low-income countries. The favorable cessation outcomes achieved by the hybrid intervention provide support for a fully powered effectiveness trial.

Costa PHA, Mota DCB, Cruvinel E, Paiva FS, Ronzani TM. Metodologia de implementação de prá-ticas preventivas ao uso de drogas na atenção primária latino-americana. Rev Panam Salud Publica. 2013;33(5):325-31. Como citarRev Panam Salud Publica 33 (5) Atenção primária à saúde; pesquisa participativa baseada na comunidade; detecção do abuso de substâncias; América Latina. resumo Palavras-chaveEm todo o mundo, o uso de álcool e de outras drogas contribui para configurar um novo perfil no quadro dos problemas de saúde. Segundo a Organização PanAmericana da Saúde (OPAS), em torno de 4,5 milhões de homens e 1,2 milhão de mulheres na América Latina e Caribe, em algum momento de suas vidas, sofreram transtornos causados pelo uso de drogas (1). De acordo com a literatura, os mecanismos mais efetivos na redução da vulnerabilidade da população a essas novas epidemias são aqueles que operam na prevenção das doenças e na promoção da saúde (2). Contudo, as experiências preventivas ao uso de álcool e outras drogas ainda são limitadas, apesar da importância de tais ações para mudar os indicadores de saúde geral da população.Nessa perspectiva, diversos autores (3-5) apontam o enfoque denominado

Objective A clinical trial carried out in patients hospitalized for clinical and surgical conditions. This study evaluated the effectiveness of text messaging interventions (TM) versus telephone counseling (TC) to promote smoking cessation among hospitalized smokers in a middle-income country. Seven-day abstinence was measured during follow-up phone calls one month after discharge. The comparative cost of the two interventions considered the cost of calls, time spent on phone calls and sending SMS and cost of the professional involved in the approaches. Results Past 7-day tobacco abstinence was not statistically different between groups (30.5% in TM group and 26% in TC, p = 0.318). Costs were significantly lower in the TM group (U$9.28 × U$19.45- p < 0,001). Continuous abstinence was reported by 26% of TM participants and 24.5% of TC participants (p = 0.730). In the 3-month follow-up, 7-day abstinence was 23% in the TMI and 27% in the TC (p = 0.356) group. Continuous abstinence was reported by 20% of TM participants and 24% of TC participants (p = 0.334). Trial registration: ClinicalTrials.gov ID: NCT03237949 Registred on: 30th May 2017.

El objetivo del presente estudio consistió en evaluar la literatura sobre Intervenciones Breves (IBs) en América Latina. Métodos: se realizó una búsqueda en nueve bases de datos acerca de estudios empíricos publicados en el periodo de 2005 a 2016. Resultados: luego de eliminar los duplicados y aplicar criterios de exclusión, 29 estudios fueron evaluados. El número de sesiones, la duración, la definición de IB, los instrumentos para evaluar el uso de sustancias y las características de los participantes variaron en cada estudio. Conclusiones: Aunque se han adoptado IBs en varios países de Latinoamérica, esta investigación encontró estudios únicamente de cinco países, caracterizados por una gran heterogeneidad en métodos de investigación, instrumentos y tipos de IBs.

IntroduçãoO uso de álcool e outras drogas tem sido problematizado em várias esferas da sociedade brasileira. As consequências do abuso destas substâncias são múltiplas e percebidas em vários setores. Por afetar tanto a saúde individual quanto a coletiva, este fenômeno exige uma abordagem que agregue prevenção, tratamento, organização de práticas e serviços assistenciais e formulação de políticas públicas específicas 1 . Entretanto, no setor da saúde, a formação profissional para atuação com os problemas relacionados ao uso de drogas é deficitária, baseada no saber médico, enfocando a dependência e não priorizando a prevenção [2][3][4][5] . Esse descompasso entre a relevância da temática e a qualificação insuficiente denota a importância de propostas de formação profissional, fornecendo, aos usuários e familiares, cuidados adequados.Além do campo da saúde, o abuso de drogas está entre os principais problemas identificados pelos profissionais do Sistema Único de Assistência Social (SUAS) 6 . Em função do avanço das políticas de assistência social e suas capacidades institucionais, os serviços do SUAS oportunizam a realização de abordagens preventivas, encaminhamentos de usuários para tratamento, bem como a assistência e o suporte a familiares 6 . Nesse sentido, é importante que os profissionais dos dispositivos socioassistenciais também estejam capacitados para atender às demandas relacionadas ao uso indevido de drogas.

ObjectivesDetermine the national prevalence of smoking and factors related to smoking among adults with mental illness (PLWMI; people living with mental illness) in Brazil.DesignCross-sectional study.SettingWe used data from the nationally representative general health survey Pesquisa Nacional de Saude of 2013, which included the Global Adult Tobacco Survey (GATS) module.ParticipantsThe survey used a complex probabilistic sample to collect data from 60 202 Brazilians 18 years or older. Primary and secondary outcomes: smoking prevalence and access to smoking cessation treatment. We also assessed past tobacco use, quit attempts and quit ratio among people with and without mental illness. Analyses were conducted in R and were weighted to account for the survey design and generate national estimates.ResultsIn Brazil, the 2013 smoking prevalence among PLWMI was 28.4% and among people with no mental illness was 12.8%. Both groups had high rates of past-year quit attempts (51.6% vs 55.3%) but the lifetime quit ratio among PLWMI was much lower than those with no mental illness (37% vs 54%). Adjusted odds showed PLWMI were more likely to be current smokers (OR (95% CI)=2.60 (2.40 to 2.82), less likely to be former smokers (OR (95% CI)=0.62 (0.55 to 0.70)) and as likely to have tried to quit in the past year (OR (95% CI)=0.90 (0.78 to 1.02)). Very few (3.7%) PLWMI and fewer with no mental illness (2.6%) received cessation treatment.ConclusionSmoking rates among PLWMI are roughly double the rate in the general population. Compared with Brazilian smokers without mental illness, those with mental illness were significantly less likely to quit even though as many tried to. Few Brazilians appear to be using publicly available cessation services. Expanding utilisation of treatment might be a good place to start for Brazil to further decrease the prevalence of smoking among PLWMI.

BackgroundNumerous studies have demonstrated that positive organizational climates contribute to better work performance. Screening and brief intervention (SBI) for alcohol, tobacco, and other drug use has the potential to reach a broad population of hazardous drug users but has not yet been widely adopted in Brazil’s health care system. We surveyed 149 primary health care professionals in 30 clinics in Brazil who were trained to conduct SBI among their patients. We prospectively measured how often they delivered SBI to evaluate the association between organizational climate and adoption/performance of SBI.MethodsOrganizational climate was measured by the 2009 Organizational Climate Scale for Health Organizations, a scale validated in Brazil that assesses leadership, professional development, team spirit, relationship with the community, safety, strategy, and remuneration. Performance of SBI was measured prospectively by weekly assessments during the three months following training. We also assessed self-reported SBI and self-efficacy for performing SBI at three months post-training. We used inferential statistics to depict and test for the significance of associations.ResultsTeams with better organizational climates implemented SBI more frequently. Organizational climate factors most closely associated with SBI implementation included professional development and relationship with the community. The dimensions of leadership and remuneration were also significantly associated with SBI.ConclusionsOrganizational climate may influence implementation of SBI and ultimately may affect the ability of organizations to identify and address drug use.