Grupo terapêutico para tabagistas: resultados após seguimento de dois anos

Abstract

Objective. To assess immediate and two-year treatment results in smokers seen at the outpatient clinic of a university hospital. MethOds. One hundred seventy one smokers were assessed for inclusion in a Treatment Group at the Outpatient Clinic for Psychoactive Substance Use at Hospital das Clínicas da Universidade Estadual de Campinas. Sociodemographic variables, history of smoking, presence of comorbidities and psychiatric symptoms, immediate and long-term outcomes (median: 25 months) were evaluated by telephone contact. Frequency analyses and multiple logistic regression analysis were carried out, at a significance level of 5%. Results. Most patients were female (73.4%), married (48%), had elementary education (74.6%), and were working (57%); 65.2% started to smoke before the age of 15; 63.8% had been smoking for more than 30 years; 76% had already tried to stop smoking; 46.2% presented severe dependence; 72.1% presented medical comorbidities; and 36% presented psychiatric symptoms. The service was sought spontaneously by 51% of the patients, who were mainly concerned with their own health. Of the total number of patients, 79.1% stopped smoking during treatment; after 25 months, 62% remained abstinent. Presence of psychiatric symptoms was the variable associated with failure in smoking cessation. Variables related to relapse were psychiatric symptoms and low attendance to motivation sessions. There was an association between presence of clinical comorbidities, years of smoking, and professional inactivity. cOnclusiOn. This study reinforces the importance of understanding the profile of subjects attending smoking treatment groups in order to evaluate the strategies employed and the adequacy of treatment regimens for smokers, with the aims of improving smoking cessation rates and reducing relapse rates. The life expectancy of a smoker is 25% lower than that of a non-smoker. When compared to people who continue smoking, those who stop smoking before the age of 50 show a 50% reduction in the risk of death for tobacco-related diseases. 4 Although 70% of smokers state they would like to stop smoking, less than 10% reach that objective on their own account. In addition, there has been a progressive increase in the demand for cessation support actions, which highlights the role of health Azevedo rCs et Al. Keywords 594Rev Assoc Med Bras 2009; 55(5): 593-6

Profile and motivation for smoking cessation in surgical inpatients

“…The sociodemographic and economic characteristics of the sample were similar to those described in other similar studies (4,5,7,(11)(12)(13)(14)(15) . Patients were, on average, 54 years old, and had therefore reached an age at which the comorbidities associated with lifestyle factors often begin to appear.…”

“…Most smokers in the present sample had made previous attempts to quit, as is often found in similar studies in the literature (12,(14)(15) . Nicotine is an addictive substance, which further complicates the process of quitting, so that although many people may wish to stop smoking, few succeed without assistance.…”

“…Studies performed in similar samples have identifi ed low to very high levels of nicotine dependence in diff erent patient profi les (12,14,17) . The scale used in the present study is easily administered and can be used by health care workers to plan tobacco control interventions or to evaluate nicotine dependence in inpatient settings.…”

Impacto Do Programa De Apoio Ao Tabagista De Um Município Do Sul De Minas Gerais, Brasil

“…Em um estudo realizado na China, verificouse que indivíduos com baixa escolaridade têm uma probabilidade cerca de sete vezes maior de serem fumantes do que indivíduos com nível superior e, no Brasil, essa probabilidade é cinco vezes maior (22). As estratégias para a expansão do mercado da indústria do tabaco que estimulam o consumo e facilitam o acesso ao cigarro contribuem para o seu maior consumo pelas populações de baixa renda e escolaridade (32).…”

“…Considera-se que culturas e hábitos são passíveis de mudança somente em longo prazo. A inclusão e a ampliação de estratégias motivacionais precisam ser consideradas no processo que antecede a tentativa de cessação de fumar, principalmente em serviços públi-cos (32).…”