Características do processo de cessação do tabagismo na abstinência prolongada

Abstract

Resumo. O tabagismo é um comportamento refratário, pois, apesar de seus conhecidos efeitos negativos, poucos fumantes conseguem parar de fumar. Caracterizou-se o processo de cessação do tabagismo de 62 ex-fumantes (m = 50 anos, dp = 11), de ambos os sexos, com oitos anos de abstinência em média. Eles responderam um questionário do comportamento de fumar retrospectivo, com 16 questões sobre histórico prévio de consumo do cigarro, processo de cessação do tabagismo e manutenção da abstinência. Os dados foram analisados através de estatística descritiva de categorias defi nidas. A maior parte dos participantes havia feito pelo menos três tentativas prévias para parar de fumar, motivados por questões de saúde, e referiu não sentir mais fi ssura. Os fatores mais relacionados à recaída foram fi ssura, stress, sintomas de abstinência e ganho de peso. Festas, uso de álcool e café, solidão e stress foram considerados gatilhos para fi ssura. Diversas estratégias cognitivas e comportamentais para a manutenção da abstinência foram utilizadas. Identifi car variáveis associadas à abstinência prolongada de nicotina pode contribuir para aumentar a efi cácia do auxílio ao fumante, a adesão ao tratamento e as taxas de remissão do tabagismo.Palavras-chave: dependência de nicotina, recaída, uso de cigarro. Abstract.Smoking is a refractory behavior, despite its well-known negative eff ects; few quitt ers are successful. The smoking cessation process of 62 ex-smokers (m = 50, SD = 11) of both genders, with eight years of abstinence on average, was characterized. Most of them had already done at least three previous att empts to quit smoking, motivated by health issues, and said they no longer feel craving. Craving, stress, withdrawal symptoms and weight gain were related by them to relapse. Parties, alcohol and coff ee use, loneliness and stress were considered triggers for craving. The use of cognitive and behavioral strategies for the maintenance of abstinence was highly reported by them. Identifying variables associated with prolonged nicotine abstinence may contribute to increase the eff ectiveness of aid to smoking, treatment adherence and remission rates of smoking.Keywords: nicotine addiction, relapse, cigarett e consumption. Características do processo de cessação do tabagismo na abstinência prolongadaCharacteristics of the smoking cessation process in prolonged nicotine abstinence

Manutenção da abstinência do tabaco por ex-fumantes: estudo fenomenológico

“…A Brazilian study with 62 former smokers showed that 64.5% no longer had the urge to smoke, whereas 35% still felt it (29% with low intensity and 6.5% moderately). According to those 35.5% (n=22) who reported still having the urge to smoke, the situations that triggered this desire were social meetings/parties, stress, loneliness, and consumption of alcoholic beverages and coffee (3) . It should be stressed that the biographical situation and the pool of knowledge may or may not contribute to abstinence, especially if the person is included in a social context that favors the smoking habit.…”

“…Suffice it to say that existential reasons are drawn from intersubjective relations experienced by people and, as a result, they are common threads of social action (8) . A study conducted in the state of Rio Grande do Sul, Brazil with 62 former smokers, with an average abstinence time of eight years showed the concern about health, the unpleasant cigarette smell, pregnancy, advice from family/friends and physicians, promises, the death of a relative, and concern with their appearance were the main reasons to remain smoke-free (3) . Another Brazilian research study with former smokers showed that, among the reasons for not smoking again, there were the desire of not having the physical symptoms anymore (shortness of breath, cough, circulatory disease, fatigue, yellowish skin and teeth), hygiene (odor/ bad smell caused by cigarette smoke), and financial loss (12) .…”

“…The attempt to avoid smoking demands continuing efforts, such as persistence in carrying out self-regulatory strategies, in the sense of effectively handling situations that could trigger the urge to return to the smoking habit. Therefore, smokers face negative withdrawal symptoms, which quite often cause them to relapse into tobacco use (3) . Self-motivation is a crucial issue in the context of maintaining tobacco withdrawal.…”

“…Quitting smoking is beneficial for health at any age; however, the maintenance of tobacco withdrawal is an arduous task, because of the physical, psychological, and behavioral addiction caused by the nicotine. Studies have shown that, on average, smokers make three to five attempts before quitting smoking, while relapse is a frequent problem (3)(4) . Most people succeed in quitting smoking in the short term; however, relapse over a period of 12 months is quite common (5) .…”

“…Self-motivation is a crucial issue in the context of maintaining tobacco withdrawal. International studies have shown that self-motivation is perceived as one of the most important determinants for preventing relapses in both the short and the long term (3,(6)(7) . Despite extensive literature on this topic, the negative consequences of tobacco use on health and the difficulties observed in smokers of maintaining cigarette withdrawal have motivated this study.…”