Intervenciones efectivas para la deshabituación tabáquica en Atención Primaria

Abstract

Objective: to find the scientific evidence on effective interventions for smoking cessation in Primary Care. Method: a narrative review through a bibliographic search in different databases: PubMed, Cinahl, Cochrane Plus, Scielo, Clinical Key, Cuiden, Google Scholar and ScienceDirect. The MeSH and DeSH descriptors, or free terms used, depending on the database, were “Atención Primaria de Salud” (Primary Health Care) and “cese del uso de tabaco” (tobacco use cessation), combined with the boolean operator “Y” (AND). The search was conducted in Spanish and English, within the publication period from 2007 and 2017. The inclusion criteria were: original articles, reviews or expert panels, about interventions promoting smoking cessation for the adult population in the Primary Care setting. The exclusion criteria were: research protocols, editorials, letters, and opinion articles. Results: fourteen (14) articles were selected. Four types of intervention were identified: group, individual, pharmacological and mixed. Group interventions reported a 41.1% rate of abstinence per year. Within individual interventions, the 5 A’s model was used, with variability in its use; a reduction in smoking between 15 and 40% was reported. In the pharmacological interventions, it was observed that those patients using nicotine patches and/or inhaler presented higher adherence than those using chewing-gum, and that drug combination was more effective and caused fewer side effects. In mixed interventions, the abstinence was >50%.Conclusions: the combination of behavioural and pharmacological therapies offers encouraging results. No method of reference can be pointed at for the confirmation of abstinence applied from Primary Care.