This article is a literature review of the psychological aspects of smoking behavior, highlighting personality characteristics of the smoker as an obstacle to smoking cessation. It describes the relationship between smoking behavior and personality, and between smoking and the principal psychiatric disorders. Studies reveal that smokers tend to be more extroverted, anxious, tense, and impulsive, and show more traits of neuroticism and psychoticism than do ex-smokers or nonsmokers. The literature also reveals a strong association between smoking and mental disorders, such as schizophrenia and depression. Understanding the psychological factors associated with tobacco smoking and dependence can further the development and improvement of therapeutic strategies to be used in smoking-cessation programs, as well as of programs aimed at prevention and education. return to levels similar to those observed in controls. Excessive weight gain generally follows alterations in behavior and personality patterns, frequently manifested as depression, abstention, self-punishment, irritability, and aggression. Weight gain, together with increased stress, intensifies the impulse to eat, perpetuating the vicious cycle. At the moment, the three most widely accepted theories to explain the relationship between smoking and body weight are as follows: a) increased metabolic rate, with greater energy expenditure by smokers; b) differences in quality and quantity of food intake by smokers; c) appetite loss, via nicotine. (4,5) In this review article, emphasizing the personality profile of the smoker as an important obstacle to cessation, we describe the relationship between smoking and personality and, subsequently, the relationship between smoking and the principal psychiatric disorders. Smoking and personalityMost studies on the relationship between smoking and personality characteristics, in recent decades, were carried out according to the theoretical model proposed in 1967. (6) According to this approach, there are three predominant dimensions of character or personality supposedly related to smoking: extroversion, neuroticism, and psychoticism.The extroversion dimension comprises factors such as sociability, assertiveness, positive emotions, vivacity, and activity level. (7) It has been hypothesized that there is a relationship between extroversion and smoking. (6) In line with this interpretation, extroverts and introverts differ as to the level of necessary stimulation for their well-being. At equivalent stimulation levels, extroverts will be characterized by low cortical excitation, and introverts by high cortical excitation. At a medium level of stimulation, at which most daily activities occur, extroverts will more likely feel little stimulated, whereas introverts will feel highly stimulated. Since they operate below their ideal level of cortical excitation, extroverts might try to change their external environment through increased activity, or might try to change their internal environment by ingesting substances, su...

RESUMOEste artigo apresenta uma revisão não sistemática da literatura sobre a relação entre tabagismo e doenças mentais, destacando algumas perspectivas recentes sobre o assunto. Buscou-se identificar e descrever as hipóteses levantadas por estudiosos nas últimas décadas acerca da natureza da associação entre o tabagismo e as perturbações psiquiátricas como depressão maior, esquizofrenia e transtornos de ansiedade. Discutem-se, também, as reflexões sobre as abordagens utilizadas nas pesquisas, bem como as possíveis contribuições desse conhecimento para os programas de intervenção e assistência a pacientes psiquiátricos fumantes. Unitermos: Tabagismo; Transtornos psiquiátricos. ABSTRACT Relationship between smoking behavior and psychiatric disordersThis paper presents a non systematic literature review on the relationship between smoking behavior and psychiatric disorders, pointing out the new perspectives on the matter. The aim was to identify and describe the hypotheses on the nature of the association between smoking and major depression, schizophrenia and anxiety disorders, in the last decades. The different research approaches, as well as the possible contributions of this knowledge to intervention programs to assist smokers psychiatric patients are discussed. Keywords: Smoking behavior; Psychiatric disorders.

CONTEXT AND OBJECTIVE: Non-adherence to treatment is one of the hindering factors in the process of smoking cessation. This study aimed to compare sociodemographic characteristics, smoking status and motivation among smokers who maintained or abandoned treatment to stop smoking, and to analyze associations between sociodemographic factors and smoking. DESIGN AND SETTING: Cohort study on 216 smokers who were attended at healthcare units in Cuiabá, Mato Grosso. METHODS:The instruments used were the Fagerström, URICA and CAGE questionnaires. Data from the initial evaluation was analyzed using the two-proportion test (α < 0.05). The patients were monitored for six months and those who abandoned treatment were accounted for. Bivariate analysis was conducted, using crude prevalence ratios and 5% significance level (P < 0.05), with abandonment of treatment as the outcome variable. Associations with P < 0.20 were selected for multiple robust Poisson regression (RPa). RESULTS:The abandonment rate was 34.26%. Males and individuals in the 20-39 age group, in employment, with low motivation, with shorter time smoking and lower tobacco intake predominated in the dropout group. In the final model, gender (RPa 1.47; 95% CI: 1.03-2.10) and age group (RPa 3.77; 95% CI: 1.47-9.67) remained associated with abandonment. CONCLUSION: Males and individuals in the 20-39 age group, in employment, with low motivation, with shorter time smoking and lower tobacco intake more frequently abandoned the treatment. Male gender and younger age group were associated with abandonment of nicotine dependence treatment. RESUMO

RESUMO (ISSL). Os dados foram digitados duplamente em programa Epidata versão 3.1, e para análise dos dados foi utilizado um modelo de regressão de Poisson. Resultados: Foram encontradas associações do fracasso terapêutico com as seguintes variáveis: faixa etária jovem (RP = 1,68; IC 95% 1,11-2,56); menor tempo de tabagismo (RP = 1,32; IC 95% 1,09-1,61); maior consumo de cigarros/dia (RP = 1,24; IC 95% 1,01-1,52) e menor grau de motivação (RP = 1,55; IC 95% 1,04-2,30). No modelo final (RPa), ficaram associadas ao fracasso as variáveis: menor tempo de tabagismo (RPa 1,53; IC 95% 1,07-2,32), maior carga tabágica (RPa 1,48; IC 95% 1,12-1,95), baixo nível de motivação (RPa 1,58; IC 95% 1,07-2,32) e alto nível de ansiedade (RPa 1,22; IC 95% 1,01-1,48). Conclusão: Baixo nível motivacional (Contemplação e Pré-contemplação), alto nível de ansiedade (moderado/grave), menor tempo de tabagismo e alta carga tabágica estão associados ao fracasso terapêutico.

Objective: To evaluate changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Methods: This cohort study involved patients enrolled in a smoking cessation program in Cuiabá, Brazil. We selected patients who completed the program in six months or less (n = 142). Patient evaluations were conducted at enrollment (evaluation 1 [E1]); after 45 days of treatment with medication and cognitive-behavioral therapy (E2); and at the end of the six-month study period (E3). Patients were evaluated with a standardized questionnaire (to collect sociodemographic data and determine smoking status), as well as with the University of Rhode Island Change Assessment scale, Beck Anxiety Inventory, Beck Depression Inventory, and Lipp Inventory of Stress Symptoms for Adults. The data were analyzed with the nonparametric Wilcoxon test for paired comparisons. To compare treatment success (smoking cessation) with treatment failure, the test for two proportions was used. Results: Among the 142 patients evaluated, there were improvements, in terms of the levels of anxiety, depression, motivation, and stress, between E1 and E2, as well as between E1 and E3. In addition, treatment success correlated significantly with the levels of motivation and anxiety throughout the study period, whereas it correlated significantly with the level of depression only at E2 and E3. Conclusions: We conclude that there are in fact changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Those changes appear to be more pronounced in patients in whom the treatment succeeded.

INTRODUÇÃO: O estudo da relação entre personalidade e tabagismo pode subsidiar o tratamento da dependência. OBJETIVOS: Identificar características de personalidade de fumantes, ex-fumantes e não-fumantes. MÉTODO: Foram selecionados 1.245 estudantes matriculados na Universidade Federal de Mato Grosso. Foi aplicado um questionário padronizado para levantamento do perfil sociodemográfico e padrão de consumo de tabaco dos estudantes, seguido pela versão revisada das Escalas Comrey de Personalidade (CPS). Utilizou-se a análise de variância ANOVA para comparação dos escores de fumantes, ex-fumantes e não-fumantes no CPS e duas análises de regressão logística múltipla para avaliar as associações entre os escores do CPS e tabagismo. RESULTADOS: Foi encontrada prevalência de 6,67% de fumantes, 6,58% de ex-fumantes e 86,73% de não-fumantes. A primeira análise de regressão logística detectou associação positiva entre a categoria fumante e os escores nas escalas de masculinidade (M) e tendenciosidade (R) e associação inversa com a escala de ordem x falta de compulsão (O) do CPS. A segunda detectou associação negativa da categoria ex-fumante com os escores obtidos em R e M e positiva com a escala de atividade x falta de energia (A) do CPS. DISCUSSÃO: Fumantes foram mais tendenciosos e adotaram mais o estereótipo social da masculinidade em relação a não-fumantes e ex-fumantes. Fumantes se descreveram mais como descuidados, relaxados, imprudentes, não-sistemáticos e pouco asseados em comparação aos não-fumantes. Ex-fumantes apresentaram mais vigor, energia e disposição em relação aos fumantes. Supõe-se que esses resultados possam subsidiar programas de tratamento da dependência nicotínica.

O objetivo deste trabalho foi comparar características do repertório de habilidades sociais em universitários fumantes e não fumantes. Avaliaram-se 1126 estudantes matriculados em uma universidade pública do oeste paulista por meio da aplicação de um questionário – o Teste de Fagerström para dependência nicotínica – e do Inventário de Habilidades Sociais – IHS (Del Prette & Del Prette, 2001). Fumantes obtiveram, em média, pontuações maiores no escore fatorial F1 do IHS em comparação a não fumantes. Os dados não confirmam a hipótese de associação entre déficits em habilidades sociais e tabagismo entre os participantes desta pesquisa. Universitários fumantes descreveram-se, em média, como mais assertivos em comparação a não fumantes. Ainda são necessários mais estudos no sentido de se confirmar esse dado. Pesquisas de natureza prospectiva e/ou transversal sobre os possíveis fatores subjacentes à associação entre tabagismo e assertividade também podem contribuir para compreensão do assunto.

Background: Depression and anxiety are psychiatric disorders that are related to tobacco use and associated with dependence, the process of cessation, lapses and relapses after quitting smoking. Objective: To analyze the association of nicotine dependence with the level of anxiety and depression in patients who are in the process of smoking cessation. Methods: Cross-sectional study conducted with patients who sought the smoking cessation program in Cuiabá/MT. All the smokers enrolled from May to August 2012, participated in this study. Four instruments were applied: Socio-demographic Questionnaire, Fagerström test, Beck Anxiety Inventory and Beck Depression Inventory. Following bivariate analysis, using the crude prevalence ratio, with level of significance lower than 5% (p < 0.05), having as variable outcome the nicotine dependence ≥ 5 (Fagerström). The associations with p < 0.20 were selected for robust Multiple Poisson Regression (RP a ). Results: Associations of Fagerström ≥ 5 with the male sex (RP = 1.15 CI 95% 1.03-1.28); number of cigarettes/day (RP = 1,33; CI 95% 1.19-1.48); and moderate/severe level of depression (RP = 1.15; CI 95% 1.04-1.28) were found. In the final model (RPa), the following variables remained associated: male gender (RPa 1.12; CI 95% 1.01-1.24), number of cigarettes/day (RPa 1.28; CI 95% 1.15-1.43) and high level of depression (RPa 1.12; CI 95% 1.01-1.23). Discussion: High level of nicotine dependence was associated significantly with the level of depression, emphasizing the association between smoking and psychiatric comorbidities.