Factors relating to failure to quit smoking: a prospective cohort study

Abstract

CONTEXT AND OBJECTIVE: Considering the difficulties in stopping smoking, this article aimed to identify factors relating to failure of attempts to quit smoking among smokers who sought care at an outpatient clinic in a general university hospital. DESIGN AND SETTING: Prospective cohort study evaluating 100 smokers who sought treatment at the Psychoactive Substances Outpatient Clinic. METHODS:The variables gathered were sociodemographic factors; degree of dependence (Fagerström questionnaire); stage of motivation for change (University of Rhode Island Change Assessment Scale); and presence of depression and anxiety (Hospital Anxiety and Depression Scale). The patients were followed up after 4, 8, 12 and 24 weeks to identify factors relating to failure to quit smoking. RESULTS:The patients were mostly women (75%), between 40 and 59 years of age (67%); with incomplete elementary education (60%); with leisure activities (57%); suffering from tobacco-related disease (53%); with previous attempts to quit smoking (70%); with a medical recommendation to stop (51%); with encouragement to stop (66%); and with a high degree of dependence (78%). The main motivational stage was contemplation/action (43%); the anxiety rate was 64% and the depression rate was 39%. The quitting rate was 66% among adherents and 17% among non-adherents (P < 0.001). Lack of success was correlated with absence of leisure, higher education and absence of tobacco-related disease. CONCLUSION:The variables of lack of leisure activities, higher education and/or lack of tobacco-related disease correlated with failure to quit smoking among smokers who sought treatment at an outpatient clinic in a tertiary general hospital.reSUMO CONTEXTO E OBJETIVO: Considerando as dificuldades na cessação do tabagismo, este artigo objetiva identificar fatores relacionados ao insucesso na tentativa de cessação tabágica de fumantes que procuraram atendimento em ambulatório de um hospital geral universitário. TIPO DE ESTUDO E LOCAL: Estudo de coorte prospectivo, que avaliou 100 fumantes que procuraram tratamento no Ambulatório de Substâncias Psicoativas. MÉTODOS: Avaliaram-se variáveis sociodemográficas, grau de dependência (Questionário de Fagerström), estágio de motivação para a mudança (University of Rhode Island Change Assessment), presença de depressão e ansiedade (Hospital Anxiety and Depression Scale). Os pacientes foram acompanhados em 4, 8, 12 e 24 semanas para identificar fatores relacionados ao insucesso na cessação do tabagismo. RESULTADOS: Os pacientes eram, na maioria, mulheres (75%), entre 40 e 59 anos de idade (67%), com ensino fundamental incompleto (60%), com atividades de lazer (57%), portadores de doença tabaco-relacionada (DTR) (53%), com tentativas anteriores de parar de fumar (70%), que receberam recomendação médica (51%) e incentivo para a cessação (66%) e com elevado grau de dependência (78%). O estágio de motivação principal foi contemplação/ação (43%), a taxa de ansiedade foi de 64% e de depressão, 39%. A taxa de cessação foi de 66% entre ...

Determinants of smoking cessation and abstinence in a Russian smoking-cessation center

“…The level of motivation to quit should be considered as a fundamental factor and predictor for the success of any kind of SC aid. The level of motivation to quit can determine the SCC result association with other factors, such as age, experience of SC, adherence to SCC recommendations and TA treatment 15,28 . It is known that the level of motivation to quit in the population of smokers can significantly differ 10,11 .…”

Ansiedade e baixo nível motivacional associados ao fracasso na cessação do tabagismo

“…Possivelmente, com o passar do tempo essa taxa será ainda maior, pois existe a tendência de aumentarem as recaídas quanto maior for o tempo de acompanhamento dos pacientes analisados com determinada terapêutica empregada 21 . Outros autores relataram taxas de fracasso semelhantes às aqui encontradas, em torno de 66,6% a 69%, e concluíram que aqueles com dificuldades de adesão ao tratamento e que não pararam de fumar nas primeiras semanas têm mais chances de fracassar [22][23][24] . Diversos fatores dificultadores da cessação devem estar interagindo com esses pacientes estudados.…”

“…14,15 : consiste de uma lista com 21 itens que são afirmações descritivas de sintomas de ansiedade e mede a intensidade deles (alfa de Cronbach = 0,92). A pontuação dos sintomas varia entre 0 e 63, e os resultados podem ser: mínimo (0-10), leve (11)(12)(13)(14)(15)(16)(17)(18)(19), moderado (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) e grave (31-63). Para fins de análise, a amostra foi dicotomizada, estabelecendo que a pontuação de 0 a 19 fosse caracterizada como mínima e/ou leve e a acima de 20 foi considerada como moderada a grave, assim como estudo prévio 16 .…”

Outcome predictors of smoking cessation treatment provided by an addiction care unit between 2007 and 2010

“…Using the Enter method, the authors decided to include 20 variables in the logistic regression model, following two criteria: (i) a low p-value (p f 0.15) on the chi-square test (age, time to first cigarette [TTFC], most difficult cigarette to quit, nicotine patch, educational attainment, hypertension, heart palpitations, currently undergoing medical care, number of years smoking, problems with drugs other than alcohol, and smoking cessation recommended by a doctor); and clinical relevance, which was previously studied by other authors (sociodemographic, 23 Fargestrom Test for Nicotine Dependence, 23 psychiatric/ addiction profile 5 and type of treatment 8 variables: gender, income, cigarettes per day, difficulty being in non-smoking areas, tendency to smoke most of the day during sick leave, previous attempts to quit, currently undergoing psychiatric treatment, problems with alcohol, and bupropion or nortriptyline). We analyzed the linear correlations between the 20 selected variables.…”