Degree Of Nicotine Dependence Research Articles

The influence of occupational stress factors on nicotine dependence among students of health and nonhealth care professional colleges.

Objectives:To study the relationship between perceived job stress measured using Effort-Reward Imbalance (ERI) scale and nicotine dependence using Fagerström Test for Nicotine Dependence (FTND) scale among students of health and nonhealth care professional colleges.Materials and Methods:A descriptive cross-sectional study was carried on convenient sample of 408 health and nonhealth care professional who were current smokers. Nicotine dependence was measured using the FTND. The extent of the stress factors experienced at work was assessed using the ERI. Chi-square test and logistic regression were used for the statistical analysis.Results:Occupational stress factors are actually associated with higher levels of nicotine dependence (odds ratio = 4.523). The degree of nicotine dependence and stress imbalance was found to be more among health care professional students as compared to nonhealth care professional students (P < 0.05). Being religious was found to have a significant effect in reducing nicotine dependence.Conclusion:Being religious, having low occupational stress and being nonhealth care professional have a significant effect on the prevention of nicotine dependence.

Smoking is Unrelated to Female Sexual Function

Background. Previous research shows that smoking status is unrelated to female sexual difficulties. However, degree of nicotine dependence has not been measured, and the assessment of sexual functioning has not specified penile–vaginal intercourse (henceforth, intercourse), which is more clearly impaired by sexual difficulties than other sexual behaviors. Objectives. To test if smoking status is associated with poorer female sexual function during intercourse, and if nicotine dependence rather than smoking status is related to poorer female sexual function. Methods. During 2012, 129 Portuguese community women reported their smoking status, and completed the Fagerström Test for Nicotine Dependence, the Female Sexual Function Index (FSFI), and an adaptation of the FSFI to assess sexual functioning specifically during intercourse, as well as the desire thereof. Results. Smokers reported higher desire for intercourse and were more likely to have actually engaged in it in the past 4 weeks. Among the coitally active women in the preceding 4 weeks, nicotine dependence correlated with lower desire for intercourse. Smoking status and nicotine dependence were unrelated to arousal, lubrication, orgasm, satisfaction, pain. Conclusions. The findings are consistent with many studies that fail to demonstrate an increased risk of sexual difficulties among female smokers. However, nicotine dependence, rather than smoking status per se, might be associated with lower libido. The results suggest the possibility of an inverse U-shaped relationship between smoking and libido with a moderate use of tobacco being associated with higher sexual desire.

Investiagation of the status of quitting smoking in the hospitalized patients with smoking in the department of respiratory in Grade III Class A hospital

Objective To investigate the status of quitting smoking in the hospitalized patients with smoking in the department of respiratory to provide the basis for the individualized education on quitting smoking in patients .Methods The nicotine dependence scale , the self-designed questionnaire about the intention of quitting smoking , the cognitive questionnaire about the tobacco harm and the questionnaire about the misunderstanding of tobacco were used to investigate the degree of nicotine dependence , the cognition of tobacco harm and quitting smoking , the history of smoking in 68 cases patients in the department of respiratory . Results The average score of the intention of quitting smoking was （18.9 ±8.92） in 68 cases patients; the cases of patient who thought that smoking had relation to their disease were 43 cases, and the average score was （20.91 ±8.57）;the cases of patient who thought that smoking had no relation to their disease were 21 cases, and the average score was （14.62 ±7.68）, and the difference was statistically significant （t =2.848,P =0.006）.The score of the degree of nicotine dependence in 68 patients was 0-9, and the average score was （3.99 ±2.68）.The correlation analysis showed that there was no correlation between the total score of the cognition about quitting smoking and the intention of quitting smoking （r=-0.024,P〉0.05）.The percent of patients who thought that many people was smoking for years and had not health problems was 52.9%.There was no correlation between the smoking history and quit intention （r=-0.117,P〉0.05）.Conclusions The wrong cognition about smoking is nonnegligible factor on forming the intention of quitting smoking , and the health education mode should be changed .The individualized smoking guidance should be carried out according to the wrong cognition about quitting smoking in patients .The knowledge on the benefits of quitting smoking should be heavy promotion to help patients to overcome the obstacles and establish self -confidence . Key words: Department of respiratory; Inpatient; Smoking; Quit smoking; Intention

Effects of Smoking on Chest Expansion, Lung Function, and Respiratory Muscle Strength of Youths

[Purpose] Smoking has a direct effect on the respiratory system. The rate of cigarette smoking among young people has continued to increase steadily. The present study quantified and compared the respiratory function of smoking and non-smoking youths. [Subjects] Smoking and non-smoking male participants aged between 15 to 18 years were recruited (n=34 per group). [Methods] Participants were asked to complete a questionnaire relating to smoking habits and the Fagerström test for nicotine dependence questionnaire, and their respiratory function was tested (measurement of chest expansion, lung function test with a spirometer, and assessment of respiratory muscle strength). [Results] All respiratory function tests demonstrated significant differences between the smoking and non-smoking groups. Smokers initiated cigarette smoking between the ages of 15 to 18 years. The most common duration of cigarette smoking was 1-3 years and the degree of nicotine dependence among the youths was at a low level. [Conclusion] This study’s findings show that the early effects of cigarette smoking found in youths can lead to problems with the respiratory system. Such information can be used to illustrate the harm of smoking and should be used to encourage young people to quit or avoid cigarette smoking.

Controle do tabagismo em instituição de longa permanência para idosos: relato de experiência

Studies on institutionalized elderly smokers are important for developing appropriate preventive measures. This was a cross-sectional population-based study of individuals over 60 admitted to a Home for the Elderly in the Federal District. The following aspects were investigated: smoking prevalence, socio-demographic and clinical profile, gender, education, probable depression, degree of motivation to stop smoking, prior use of medication to stop smoking and perception of the harm of smoking to health. Spirometry, the measurement of exhaled carbon monoxide and classification according to severity of nicotine dependence were conducted. The program followed guidelines for stopping smoking, and was evaluated one year later. Results revealed that 25.7% were smokers, 22.8% men and 2.9% women, mean age 68.3 ± 8.5 years. A significant decrease in smoking among the more elderly was detected. Significant associations emerged between the degree of nicotine dependence and education, probable depression, degree of motivation for stopping smoking and perception of the harm of smoking to health. Higher indices of carbon monoxide were identified in individuals with severe obstruction. Initially, 37.9% of smokers agreed to participate in the campaign, and after a year 9% of them succeeded in stopping smoking.

Tobacco Smoking in Adolescent Psychiatric Outpatients

Three main aims of this study were to ascertain the prevalence rate of smoking among adolescent psychiatric outpatients; estimate smokers' degree of nicotine dependence; and investigate the relationship between smoking and common mental health disorders. Face-to-face interviews were conducted on 93 patients ages 13–18 presenting to an adolescent outpatient mental health service. At the time of the interview, 37.6% were smokers according to the study definition, with 25.8% scoring high or very high on the Fagerstrom Test for Nicotine Dependence. Smoking was more likely if patients had conduct disorder or cannabis/alcohol dependence or abuse, but no difference was detected between smokers and nonsmokers in relation to attention-deficit/hyperactivity disorder, depression, or anxiety disorders. Only 15.1% of patients were given a chart diagnosis of nicotine dependence.

Stress coping mechanisms in smoking psoriatics

The link between emotional stress and smoking has previously been investigated and results have suggested that smoking is used as a way of dealing with stress. There are many studies indicating the relationship between smoking and psoriasis or emotional stress and psoriasis. However, to our knowledge, the link between smoking associated with emotional stress and psoriasis has not been shown before. Our aim was to investigate psoriatic patients' abilities to cope with stress, the relationship between coping strategies and smoking habit. Ninety-nine individuals with psoriasis (57 females, and 42 males, mean age: 37.4 years) were included in this study. Sociodemographic information including age, sex, smoking habit, etc., was obtained; Psoriasis Area Severity Index (PASI) scores were recorded. The Fagerstrom Test for Nicotine Dependence was used on smoking patients to evaluate smoking habit or the degree of nicotine dependence. The Ways of Coping Questionnaire and Dermatology Life Quality Index were filled out by all patients. Data were assessed by comparing psoriatic smokers with nonsmokers and statistically analysis was carried out with the SPSS 11.5 program. Forty patients (40.4%) were smokers. When comparing the two groups' mechanisms of coping with stress, smokers and nonsmokers coped with stress in similar ways. The seeking social support scores from the Ways of Coping Questionnaire were significantly lower in smokers than nonsmokers ( p < 0.05), while the Fagerstrom Test for Nicotine Dependence scores were correlated with distrustful approach sub-scores, and PASI only correlated with smokers. The Dermatology Life Quality Index scores were correlated with the PASI and distrustful approach scores in all patients. Smoking and nonsmoking psoriatic patients had similar stress coping strategies, except the subgroup seeking social support, and usually used positive ways of coping with stress. Psoriatic patients who smoke might employ smoking to avoid stressful situations. They would benefit from education on adopting healthy stress management and, in turn, developing mature stress coping mechanisms. Future prospective studies are required to address the exact causal link between smoking, psoriasis and psychiatric comorbidity, including stress coping mechanisms.

Nicotine Dependence and Cost-Effectiveness of Individualized Support for Smoking Cessation: Evidence from Practice at a Worksite in Japan

Given the lack of economic studies evaluating the outcomes of smoking cessation programs from the viewpoint of program sponsors, we conducted a case study to provide relevant information for worksites. The present study was carried out between 2006 and 2008 at a manufacturing factory in the Toyama Prefecture of Japan and included subjects who voluntarily entered a smoking cessation program. The program included face-to-face counselling followed by weekly contact to provide encouragement over six months using e-mail or inter-office mail. Nicotine patches were available if required. All 151 participants stopped smoking immediately. Over the 24-month study period, self-report showed 49.7% abstained continuously from smoking. The rate of 24-month consecutive abstinence was higher in participants with lower Fagerström Test scores for Nicotine Dependence at baseline than in those with higher scores (63.6% for 0–2 points vs. 46.5% for 3–6 points vs. 43.8% for 7–10 points; chi-square test p = 0.19). A logistic regression model showed a significant linear trend for the association between the score and abstinence status after adjustment for possible confounding factors (p = 0.03). The crude incremental cost for one individual to successfully quit smoking due to the support program was ¥46,379 (i.e., ¥100 = $1.28, £0.83, or €1.03 at foreign exchange rates). The corresponding costs for the three categories of the Fagerström Test score for Nicotine Dependence were ¥31,953, ¥47,450 and ¥64,956, respectively. When a sensitivity analysis was conducted based on the 95% confidence interval of the success rate, the variance in the corresponding costs was ¥25,514–45,034 for 0–2 points, ¥38,344–61,824 for 3–6 points, and ¥45,698–108,260 for 7–10 points. The degree of nicotine dependence may therefore be an important determinant of the cost-effectiveness of smoking cessation programs.

Possible Association of Nicotinic Acetylcholine Receptor Gene (CHRNA4 and CHRNB2) Polymorphisms with Nicotine Dependence in Japanese Males: An Exploratory Study

Smoking is a leading global cause of avoidable mortality. It has been reported that the nicotinic acetylcholine receptor (CHRNA4 and CHRNB2) genes might be associated with smoking behavior in several ethnic populations. However, no study between the 2 genes and nicotine dependence (ND) using a Japanese population has been reported. We examined the association between ND and 5 single nucleotide polymorphisms (SNPs) within the CHRNA4 and 3 SNPs within the CHRNB2 using a well characterized sample of 558 Japanese healthy male workers with a relatively homogeneous background. The Fagerström test for nicotine dependence (FTND) was used to quantify the degree of ND. Additionally, we explored the effect of gene-gene interactions of the 2 genes on ND. We found CHRNB2 rs4845652 genotypes to be associated with FTND scores under an additive genetic model: rs4845652 T-allele carriers had lower ND levels (p=0.038; when adjusted for smoking duration: p=0.052). Furthermore, we demonstrated a possible gene-gene interaction of CHRNA4 and CHRNB2 on ND in a dose-dependent manner: those smokers with CHRNA4 rs1044397 GG or GA genotypes along with CHRNB2 rs4845652 CC genotype are likely to demonstrate higher ND scores. These findings suggest that CHRNB2 rs4845652 T-allele carriers may be associated with lower levels of ND, and that certain allelic combinations of CHRNA4 and CHRNB2 might be correlated with higher ND levels. This preliminary study has certain limitations (issues such as sample size/power and multiple testing) that need to be taken into account, and the present work thus has an experimental nature.

Difference between the prevalence of symptoms of depression and anxiety in non-diabetic smokers and in patients with type 2 diabetes with and without nicotine dependence.

BackgroundIndividuals with diabetes who are smokers have higher risks of cardiovascular disease, premature death, and microvascular complications. The present study aims to determine the prevalence of symptoms of depression and anxiety in smokers with type 2 diabetes mellitus (T2D) and to evaluate if the prevalence of symptoms of depression and anxiety differ between the three groups studied (patients with T2D who smoke; patients with T2D who do not smoke; smokers without T2D), and finally determine if the degree of nicotine dependence is related to symptoms of anxiety and depression in smokers (with or without T2D).MethodsThree study groups were formed: 46 T2D smokers (DS), 46 T2D non-smokers (D), and 46 smokers without diabetes (S), totaling 138 participants. Hospital Anxiety and Depression (HAD) scale and Fagerström Test were applied.ResultsThe prevalence of symptoms of depression and anxiety in smokers with T2D was 30.4% and 50%, respectively. There was no significant difference in the proportion of individuals with symptoms of anxiety (p = 0.072) or depression (p = 0.657) in the DS group compared to group D or S. Among male patients with T2D, the smokers had a higher prevalence of anxiety symptoms (19.6%) than non-smokers (4,3%) (p = 0,025). The prevalence of high nicotine dependence among smokers with and without T2D was 39.1% and 37.1%, respectively (p = 0.999). Fagerström scores showed no significant correlation with the scores obtained on the subscale of anxiety (p = 0,735) or depression (p = 0,364).ConclusionsThe prevalence of depression and anxiety among smokers with and without diabetes and non-smokers T2D is similar. Among male individuals with T2D, the smokers have more symptoms of anxiety than the non-smokers. There is no difference in the prevalence of nicotine dependence among smokers with and without diabetes. The presence of symptoms of anxiety or depression is similar between patients who are dependent and not dependent on nicotine.

Illicit drug use in heavy smokers with and without schizophrenia

ObjectiveThe prevalence of cigarette smoking among people with schizophrenia is greater than that of the general population. Because smoking and use of other drugs covary, we examined illicit drug use in current smokers not trying to quit or reduce their tobacco use. We recruited outpatient participants who had a DSM-IV diagnosis of schizophrenia or schizoaffective disorder (schizophrenia, n=70) and a control group who had no Axis I psychiatric disorders (control, n=97). During a 2–3‐hour session, participants completed demographic and research questionnaires, including the Drug Use Survey (DUS). ResultsParticipants with schizophrenia were older than controls (p<0.001) and smoked more cigarettes per day (p=0.01), but did not differ in degree of nicotine dependence. Ever using a drug was similar between the groups, except that significantly more participants with schizophrenia reported ever using hallucinogens (p<0.001) and inhalants (p=0.001). For alcohol, cocaine, and marijuana, fewer participants with schizophrenia were current users, but more participants with schizophrenia were past users (ps<0.0001). Heavy smokers from the general population continued to use illicit drugs throughout their lives, while schizophrenia participants had the highest period of illicit drug use in their 20s. ConclusionsThese data suggest that illicit drug use tends to be high in heavy cigarette smokers, regardless of a schizophrenia diagnosis. However, while illicit drug use is high across the lifespan of heavy smokers in the general population, heavy smokers with schizophrenia use illicit drugs mostly in the first decade of their illness.

Tobacco chippers seeking assistance for smoking cessation: a case series.

To describe a series of cases of tobacco chippers (TCs) who sought assistance for smoking cessation. We describe the case of three TCs who participated in a free quit-smoking support group. Smokers answered self-administered questionnaires covering sociodemographic data, smoking history, nicotine dependence, perceived health status, and motivational stages. Of the 183 smokers enrolled in the program, three (1.6%) were considered TCs. All three were women and reported alcohol use, although at low frequencies. Two of them reported the presence of potentially tobacco-related disease. All TCs presented light nicotine dependence and reported difficulties quitting smoking. All dropped out after the first group meeting. This study describes a subgroup of smokers not extensively described in the literature: TCs seeking assistance for smoking cessation, with some degree of nicotine dependence, and who do not adhere to regular group therapy. Interventions aimed at this population may be an interesting strategy for smoking cessation.

Cessação de tabagismo em pacientes de um hospital universitário em Curitiba

To determine the prevalence of smoking and the frequency of smoking cessation counseling among patients at a university hospital, as well as to compare smokers and former smokers in terms of smoking history. A cross-sectional study involving 629 patients at the Federal University of Paraná Hospital de Clínicas, located in the city of Curitiba, Brazil. Of the 629 patients, 206 (32.7%) were male, 76 (12.1%) were smokers, 179 (28.5%) were former smokers, and 374 (59.5%) were nonsmokers. The mean age of the patients was 49.9 ± 15.0 years (range, 18-84 years). Of the 76 smokers and 179 former smokers, 72 (94.7%) and 166 (92.7%), respectively, were questioned about tobacco use. Smoking history and degree of nicotine dependence were higher among the former smokers (p = 0.0292 and p = 0.0125, respectively). Gender, age at smoking initiation, physician inquiry about tobacco use, and smoking cessation counseling were comparable between the two groups. The smoking cessation rate was 0.70. The prevalence of heavy smoking varied by gender and by age bracket, being higher in males and in the 41-70 year age bracket. The smoking prevalence in this group of patients was lower than that reported for patients at another university hospital, for adults in Curitiba, and for adults in Brazil. The smoking cessation rate was higher in these patients than in the general population of Curitiba. Smokers and former smokers differed regarding age, smoking history, and degree of nicotine dependence. Heavy smoking and a moderate or high degree of nicotine dependence were not obstacles to smoking cessation.

P50 sensory gating and smoking in the general population

P50 gating is a major functional biomarker in research on schizophrenia and other psychiatric conditions with high smoking prevalence. It is used as endophenotype for studying nicotinic systems genetics and as surrogate endpoint measure for drug development of nicotinic agonists. Surprisingly, little is known about P50 gating in the general population and the relationship to smoking-related characteristics. In this multicenter study at six academic institutions throughout Germany, n=907 never-smokers (NS<20 cigarettes/lifetime), n=463 light smokers (LS) with Fagerström Test for Nicotine Dependence (FTND)≥4 and n=353 heavy smokers (HS, FTND<4) were randomly selected from the general population. As part of a standardized protocol for investigating the genetics of nicotine dependence (ND), an auditory P50 paradigm was applied. The main outcome measure was P50-amplitude difference followed by time-frequency analyses and functional imaging (sLORETA). Reduced P50 gating was found in HS compared to NS with LS taking an intermediate position-correlating with the degree of ND. sLORETA and time-frequency analyses indicate that high-frequency oscillations in frontal brain regions are particularly affected. With growing age, P50 gating increased in (heavy) smokers. This is the first large-scale study (normative sample data) on P50 sensory gating and smoking in the general population. Diminished gating of P50 and associated high-frequency oscillations in the frontal brain region are indications of a deficient inhibitory cortical function in nicotine-dependent smokers. The suitability and application of sensory P50 gating as functional biomarker with regard to genetic and pharmacological studies is discussed.

Smoking prevalance and the degree of nicotine dependence among healthcare workers at the ataturk university medical facility.

In this study, we aimed to investigate smoking prevalence and the degree of nicotine dependence in our hospital healthcare workers. This study was conducted between January 2008 and June 2008 in our hospital (Medical Facility of Atatürk University). A total of 691 (370 females, 321 males) subjects were included in this study. A questionnaire, including demographic findings, tobacco consumption information and the Fagerström nicotine dependence test, was distributed to healthcare workers and collected. The questionnaire was answered by 691 health workers, 46.5% of whom were male, and 53.5% of whom were female. Overall, the rate of smoking was 36.9%; 48% of males and 27.6% of females were current smokers. When classified according to clinic, the greatest rate of smoking was in the psychiatry clinic (60.0%), and the lowest rate of smoking was in the ear, nose and throat (ENT) Clinic (0.0%). Thirty-four percent of nurses, 18.7% of doctors, 45.5% of officers, and 50.4% of ancillary staff were smokers. According to education level, 50% of the cases (smokers) graduated from primary school, 45% of the cases graduated from high school and 26.9% of the cases graduated from university. The major reason for the initiation of smoking was attention-seeking behavior. The age at smoking initiation was 7 to 20 years in 83.9% of cases and 21 to 35 years in the remaining 16.1%. Thirty-five percent of smokers had very low levels of dependence, while 11.9% had very high levels dependence. Ninety-two percent of cases indicated they would prefer to work at a smoke-free hospital. Ninety-five percent of cases would support making this facility a smoke-free hospital. The smoking rate was 36.9% amongst our hospital health workers. Smoking prevalence was higher in males (48%) than females (27.6%). The greatest smoking rate was amongst ancillary staff. Ninety-five percent of healthcare workers were supportive of a law requiring hospitals to be smoke-free.

Tabagismo em idosos internados em instituições de longa permanência

To determine the prevalence of smoking among elderly patients admitted to long-term care facilities (LTCFs) and to determine whether the degree of nicotine dependence is associated with sociodemographic variables, affective ties, motivation for smoking cessation and depression. Cross-sectional, population-based study involving 573 individuals over the age of 60, admitted to 13 LTCFs in the Federal District of Brasília, Brazil. We analyzed the following variables: type of LTCF, gender, age, level of education, monthly income, marital status, retirement status, affective ties, probable depression, motivation for smoking cessation and degree of nicotine dependence. In order to collect these data, the following instruments were used: a sociodemographic questionnaire; the Flanagan Quality of Life Scale; the Mini-Mental State Examination; the Geriatric Depression Scale; the Richmond test; and the Fagerström Test for Nicotine Dependence. The prevalence of smokers in the study sample (573 individuals) was 23.0%. Of the 132 smokers, there were 90 males (25.8%) and 42 females (18.7%). Of these, 116 smokers were included in the study, 70 of whom (60.3%) presented with probable depression. The degree of nicotine dependence was found to be significantly associated with level of education, monthly income, affective ties, motivation for smoking cessation and probable depression, although not with the type of LTCF, gender, age, retirement status or marital status. Among elderly patients admitted to LTCFs in the Federal District of Brasília, the prevalence of smoking is high and the motivation for smoking cessation is low.

Abstract 981: Factors affecting success in smoking cessation for veteran smokers

Abstract Objective: Cigarette smoking is a serious, but preventable, risk factor for many types of cancer. U.S. veterans have a high rate of cigarette smoking, but there is paucity of data on smoking cessation issues in this population. We systematically examined factors associated with smoking cessation and six-month relapse in a smoking cessation program for veterans. Methods: Included in the analysis were 223 veteran smokers who participated in a group-based smoking cessation program at the Alvin C York Veterans Affair Medical Center between 1999 and 2002. Baseline data were collected from initial evaluation and medical chart abstraction, including socio-demographics, environmental factors, smoking behaviors, smoking history, and medical conditions. The Fagerstrom Test for Nicotine Dependence (FTND) was used to measure the degree of nicotine dependence. The Beck Depression Inventory (BDI) was used to assess depressive symptoms. A 5-point Likert scale was used to estimate patient confidence in the ability to quit smoking (“not at all sure”, “not too sure”, “fairly sure”, “quite sure”, and “extremely sure”). The intervention involved four group therapy sessions consisting of counseling and use of nicotine replacement and/or bupropion to aid quitting. Smoking status of the initial quitters was followed at six-months after cessation. Logistic regression was used to identify factors associated initial cessation. The Cox Proportional Hazards model was employed to identify risk factors associated with relapse within six months, and the Kaplan-Meier analysis was used to evaluate the effects of these risk factors on the relapse process. Results: Of 223 program participants, 189 (84.7%) reported having stopped smoking by the program completion, and the abstinence rate at the end of the six months was 31.8%. Factors positively associated with initial quit included educational level, currently employed, previous attempts at quitting, period of previous quitting, perceived confidence to quit, and number of sessions attended; while factors inversely associated with initial quit were age, amount of current smoking and heaviest smoking, BDI score, and FTND score. Six risk factors for six-month relapse after initial quit were identified and their effects on the relapse process can be categorized into two patterns. The influence of age, number of sessions attended, number of smoking coworkers, and a history of schizophrenia on the relapse curve occurred within several days after cessation, while household income and age at smoking initiation showed a delayed action that affected the relapse process after several weeks post quit. Conclusion: Age and number of sessions attended affected both initial cessation and the relapse process, while other factors influenced initial cessation and the relapse process differentially. The information will be useful in developing effective strategies to increase success in smoking cessation. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 981.

Influência do tabagismo atual na aderência e nas respostas à reabilitação pulmonar em pacientes com DPOC

To investigate the modulating effects of current smoking on adherence and responses to pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD). In a prospective study, 18 ex-smokers and 23 current smokers (GOLD stages II-III) were enrolled in a 12-week multidisciplinary, supervised PR program. The patients were assessed clinically and as to subjective variables (dyspnea and health-related quality of life) and objective variables (body composition, pulmonary function and 6-min walking distance). The degree of nicotine dependence in current smokers was assessed by the Fagerström test. Program completion defined PR 'adherence'. There was a significant association between current smoking and non-adherence to PR with 30.4% vs. 11.1% and odds ratio=2.9 (1.6-4.1; p<0.01). However, the current smokers who completed the program (n=16) had a similar absentee rate to the ex-smokers, as well as similar gains in the subjective (quality of life) and objective (walked distance) items. Additionally, there was a significant reduction in daily cigarette consumption and in the degree of nicotine dependence in current smokers (p<0.05). Although current smoking is negatively related to PR adherence, COPD smokers who complete the PR can have similar gains in functionality and quality of life compared to ex-smokers. Moreover, PR may be related to decreased nicotine dependence, even without a formal smoking withdrawal program.

Perfil de fumantes atendidos em serviço público para tratamento do tabagismo

To evaluate the characteristics of smokers seeking treatment in a public smoking cessation program. This was a retrospective evaluation of data collected during the interview for enrollment in the smoking cessation program of the Smoking Outpatient Clinic of the Paulista State University School of Medicine in the city of Botucatu, Brazil, between April of 2003 and April of 2007. Demographic variables; previous use of the behavioral approach, medications or alternative treatments for smoking cessation; degree of nicotine dependence; and history of comorbidities were evaluated in 387 smokers. In our sample, 63% of the smokers were female. The mean age of the subjects was 50 + or - 25 years. More than half of the subjects (61%) had up to eight years of schooling, and 66% had a monthly income of less than twice the national minimum wage. The degree of nicotine dependence was high/very high in 59%, medium in 17% and low/very low in 24% of the subjects. Although 95% of the patients presented comorbidities, only 35% had been referred to the program by a physician. More than half of the subjects (68%) had made at least one smoking-cessation attempt, 83% of whom did so without the help of a structured program. Smokers seeking assistance for smoking cessation were socially disadvantaged, presented a high degree of nicotine dependence and had previously made smoking-cessation attempts without the benefit of a structured program. Therefore, in order to be effective, smoking control interventions should take into consideration the general characteristics of the smokers treated via the public health care system.

Effect of Cancer Diagnosis on Smoking Behavior

Background: Smoking is universally recognized as the foremost preventable cause of cancer. And smoking behavior causes many negative effects in cancer patients. Based on the mounting evidence that smoking affects cancer treatment outcomes and survival, we studied whether the cancer diagnosis affects smoking behavior. Methods: During August 2007, 279 patients who were hospitalized with the diagnosis of cancer were surveyed by a questionnaire and a follow up survey was performed at 3 months and 7 months afterwards. Follow up survey was performed via telephone and finally 246 patients were enrolled. Questions in the survey included smoking history, nicotine dependence, stage of change and the reason for quit smoking or keep smoking. In the follow up survey at 7 month, we asked whether they needed smoking cessation interventions. Results: At the end of the study, the subjects who kept smoking were 27 patients, but the degree of nicotine dependence was decreased compared to the preceding 2 surveys and contemplation as well as preparation stage turned out to be the most prevalent stage of change. The main reasons to keep smoking were behavioral habits and stress. Regardless of their smoking history, almost all cancer patients wanted smoking cessation interventions. Conclusion: Smoking is a critical variable that affects cancer treatment and outcome. We surely found there is a smoking subgroup after cancer diagnosis and we should advise them to quit smoking.