Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2016-0041
Trends in Psychiatry and Psychotherapy
Original Article

Assessment of factors related to smokers' adherence to a short-term support group for smoking cessation: a longitudinal study in a developing country

Avaliação dos fatores associados à adesão de fumantes a um grupo de apoio de curta duração para a cessação de tabagismo: um estudo longitudinal em um país em desenvolvimento

Luciana Rizzieri Figueiró; Helena Maria Tannhauser Barros; Maristela Ferigolo; Denise Conceição Mesquita Dantas

http://dx.doi.org/10.1590/2237-6089-2016-0041 Trends Psychiatry Psychother, vol.39, n1, p.19-28, 2017
PDF
SciELO
Downloads: 0
Views: 587

Abstract

Abstract Objective: The aim of this study was to determine which individual characteristics of smokers are associated with their adherence to a support group for smoking cessation. Methods: Smokers from Porto Alegre, Brazil, were invited to participate in a support group for smoking cessation consisting of four weekly sessions. Demographic data, smoking history, presence of tobacco-related diseases, severity of nicotine dependence, stage of motivation, and symptoms of anxiety and depression were evaluated at baseline. Adherence was defined as attendance at group sessions and was measured at the second and fourth sessions of the program. Results: The study recruited 167 smokers who attended the first meeting and met criteria for admission to the study. One hundred and two of the participants returned to the second session and only 55 of those who attended the first meeting completed the four-week program. For immediate adherence (second session), adult smokers over the age of 35 were more likely to adhere to the treatment (p = 0.004), whereas smoking higher numbers of cigarettes per day was associated with lower adherence to attendance at group meetings (p = 0.031). For final adherence (fourth session), only minimal level symptoms of anxiety were associated with a higher likelihood of adherence (p = 0.02). Conclusions: Older smokers, those who smoked fewer cigarettes per day, and those with lower levels of anxiety exhibited higher rates of adherence to a smoking cessation support group.

Keywords

Adherence, smoking cessation, motivation, tobacco use disorder, comorbidity

Resumo

Resumo Objetivo: O objetivo deste estudo foi determinar quais características individuais de fumantes estão associadas à sua adesão a um grupo de apoio para a cessação do tabagismo. Métodos: Fumantes de Porto Alegre, Brasil, foram convidados a participar de um grupo de apoio para a cessação do tabagismo realizado em quatro reuniões semanais. Dados sociodemográficos, história tabagística, presença de doenças relacionadas ao tabaco, severidade da dependência de nicotina, estágio motivacional e sintomas de ansiedade e depressão foram avaliados no início do estudo. Adesão foi definida como estar presente nas reuniões do grupo, e foi medida na segunda e na quarta sessões do programa. Resultados: O estudo recrutou 167 fumantes que compareceram ao primeiro encontro e preencheram os critérios de inclusão. Desses participantes, 102 retornaram para a segunda sessão, e apenas 55 completaram as quatro semanas do programa. Com relação à adesão imediata (segunda sessão), adultos com idade superior a 35 anos mostraram maior probabilidade de aderir ao tratamento (p = 0.004), enquanto um maior número de cigarros por dia foi associado com menor adesão (p = 0.031). Para a adesão final (quarta sessão), apenas um nível mínimo de ansiedade foi associado com maior probabilidade de adesão (p = 0.02). Conclusões: Fumantes mais velhos, que fumavam menos cigarros por dia, e com menores níveis de ansiedade exibiram maiores taxas de adesão ao programa de apoio para a cessação do tabagismo.

Palavras-chave

Adesão, cessação do tabagismo, motivação, transtorno por uso de tabaco, comorbidade

References

Pesquisa Nacional de Saúde 2013 - Percepção do estado de saúde, estilos de vida e doenças crônicas: Brasil, Grandes Regiões e Unidades da Federação. 2014.

A situação do tabagismo no Brasil: dados dos inquéritos do Sistema Internacional de Vigilância, da Organização Mundial da Saúde, realizados no Brasil, entre 2002 e 20. 2011.

Chapman S, MacKenzie R. The global research neglect of unassisted smoking cessation causes and consequences. PLoS Med. 2010;7:e1000216.

Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2005:CD001007.

Plano para implantação da abordagem e tratamento do tabagismo no SUS e Protocolo Clínico e Diretrizes Terapêuticas - Dependência à Nicotina. 2013.

Wright EC. Non-compliance - or how many aunts has Matilda. Lancet. 1993;342:909-13.

Horwitz RI, Horwitz SM. Adherence to treatment and health outcomes. Arch Intern Med. 1993;153:1863-8.

Dunbar-Jacob J, Mortimer-Stephens MK. Treatment adherence in chronic disease. J Clin Epidemiol. 2001;54:S57-60.

van Dulmen S, Sluijs E, van Dijk L, de Ridder D, Heerdink R, Bensing J. Patient adherence to medical treatment a review of reviews. BMC Health Serv Res. 2007;7:55.

A clinical practice guideline for treating tobacco use and dependence 2008 update. A U.S. Public Health Service report. Am J Prev Med. 2008;35:158-76.

Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment three decades of research. A comprehensive review. J Clin Pharm Ther. 2001;26:331-42.

Patterson F, Jepson C, Kaufmann V, Rukstalis M, Audrain-McGovern J, Kucharski S. Predictors of attendance in a randomized clinical trial of nicotine replacement therapy with behavioral counseling. Drug Alcohol Depend. 2003;72:123-31.

Fucito LM, Toll BA, Salovey P, O'Malley SS. Beliefs and attitudes about bupropion implications for medication adherence and smoking cessation treatment. Psychol Addict Behav. 2009;23:373-9.

Klesges RC, Brown K, Pascale RW, Murphy M, Williams E, Cigrang JA. Factors associated with participation, attrition, and outcome in a smoking cessation program at the workplace. Health Psychol. 1988;7:575-89.

Rosenbaum P, O'Shea R. Large-scale study of freedom from smoking clinics- factors in quitting. Public Health Rep. 1992;107:150-5.

Curtin L, Brown RA, Sales SD. Determinants of attrition from cessation treatment in smokers with a history of major depressive disorder. Psychol Addict Behav. 2000;14:134-42.

Camarelles F, Asensio Á, Jiménez-Ruiz C, Becerril B, Rodero D, Vidaller O. Effectiveness of a group therapy intervention to quit smoking. Randomized clinical trial. Med Clin (Barc).. 2002;119:53-7.

Asfar T, Weg MV, Maziak W, Hammal F, Eissenberg T, Ward KD. Outcomes and adherence in Syria's first smoking cessation trial. Am J Health Behav. 2008;32:146-56.

Paul CL, McLennan J, Baxendale A, Schnelle B, Rawson J, Turon HE. Implementation of a personalized workplace smoking cessation programme. Occup Med (Lond). 2013;63:568-74.

Sales MP, de Figueiredo MR, de Oliveira MI, de Castro HN. Outpatient smoking cessation program in the state of Ceará, Brazil patient profiles and factors associated with treatment success. J Bras Pneumol. 2006;32:410-7.

Azevedo RC, Fernandes RF. Factors relating to failure to quit smoking a prospective cohort study. Sao Paulo Med J. 2011;129:380-6.

Mesquita AA. Avaliação de um programa de tratamento do tabagismo. Rev Bras Ter Comp Cogn. 2013;15:35-44.

Pawlina MM, Rondina RC, Espinosa MM, Botelho C. Abandonment of nicotine dependence treatment a cohort study. Sao Paulo Med J. 2016;134:47-55.

Reach G. Role of habit in adherence to medical treatment. Diabet Med. 2005;22:415-20.

Ginsberg JP, Klesges RC, Johnson KC, Eck LH, Meyers AW, Winders SA. The relation between a history of depression and adherence to a multicomponent smoking-cessation program. Addict Behav. 1997;22:783-7.

Patten CA, Drews AA, Myers MG, Martin JE, Wolter TD. Effect of depressive symptoms on smoking abstinence and treatment adherence among smokers with a history of alcohol dependence. Psychol Addict Behav. 2002;16:135-42.

Ben Taleb Z, Ward KD, Asfar T, Jaber R, Auf R, Maziak W. Predictors of nicotine withdrawal symptoms findings from the first randomized smoking cessation trial in a low-income country setting. Int J Public Health. 2016;61:701-8.

Wing RR, Phelan S, Tate D. The role of adherence in mediating the relationship between depression and health outcomes. J Psychosom Res. 2002;53:877-81.

Miller WR, Rollnick S. Motivational interviewing: helping people change. 2013.

American Cancer Society. 1996.

Deixando de fumar sem mistérios. 2004.

DiClemente CC, Prochaska JO. Self-change and therapy change of smoking behavior a comparison of processes of change in cessation and maintenance. Addict Behav. 1982;7:133-42.

Carlini EA, Galduróz JCF, Noto AR. II Psychotropic drug use in Brazil: a household survey in the 108 largest cities of the country - 2005. 2007.

Results from the 2013 national survey on drug use and health: detailed tables. 2013.

Fagerström KO. Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addict Behav. 1978;3:235-41.

Carmo JT, Pueyo AA. A adaptação do português do Fagesrtröm test for nicotine dependence (FTND) para avaliar a dependência e tolerância à nicotina em fumantes brasileiros. Rev Bras Med. 2002;58:73-80.

McConnaughy E A, Prochaska JO, Velicer WF. Stages of change in psychotherapy measurement and sample profiles. Psychother Theor Res Pract. 1983;20:368-75.

Biener L, Abrams DB. The Contemplation Ladder validation of a measure of readiness to consider smoking cessation. Health Psychol. 1991;10:360-5.

Terra MB, Silveira DX, Moreira TC, Ferigolo M, Mazoni C, Arena FX. Convergent validation study of the Contemplation Ladder for application via telephone in tobacco users. J Bras Psiquiatr. 2009;58:143-9.

Prochaska JO, Diclemente C. Trans theoretical therapy toward a more integrative model of change. Psychother Theor Res Pract. 1982;19:276-88.

Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety psychometric properties. J Consult Clin Psychol. 1988;56:893-7.

Cunha JA. Manual da versão em português das escalas Beck. 2011.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71.

Hughes JR, Keely J, Naud S. Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction. 2004;99:29-38.

Hennrikus DJ, Jeffery RW, Lando HA. The smoking cessation process longitudinal observations in a working population. Prev Med. 1995;24:235-44.

Zhu S, Melcer T, Sun J, Rosbrook B, Pierce JP. Smoking cessation with and without assistance a population-based analysis. Am J Prev Med. 2000;18:305-11.

Shiffman S, Brockwell SE, Pillitteri JL, Gitchell JG. Individual differences in adoption of treatment for smoking cessation demographic and smoking history characteristics. Drug Alcohol Depend. 2008;93:121-31.

Levy DT, Romano E, Mumford E. The relationship of smoking cessation to sociodemographic characteristics, smoking intensity, and tobacco control policies. Nicotine Tob Res. 2005;7:387-96.

Hughes JR, Cohen B, Callas PW. Treatment seeking for smoking cessation among young adults. J Subst Abuse Treat. 2009;37:211-3.

Thompson B, Rich LE, Lynn WR, Shields R, Corle DK. A voluntary smokers' registry characteristics of joiners and non-joiners in the Community Intervention Trial for Smoking Cessation (COMMIT). Am J Public Health. 1998;88:100-3.

Pohl JM, Martinelli A, Antonakos C. Predictors of participation in a smoking cessation intervention group among low-income women. Addict Behav. 1998;23:699-704.

Wellman RJ, DiFranza JR, Wood C. Tobacco chippers report diminished autonomy over smoking. Addict Behav. 2006;31:717-21.

Mykletun A, Overland S, Aarø LE, Liabø HM, Stewart R. Smoking in relation to anxiety and depression evidence from a large population survey: the HUNT study. Eur Psychiatry. 2008;23:77-84.

Morrell HE, Cohen LM, al'Absi M. Physiological and psychological symptoms and predictors in early nicotine withdrawal. Pharmacol Biochem Behav. 2008;89:272-8.

Park ER, Chang Y, Quinn V, Regan S, Cohen L, Viguera A. The association of depressive, anxiety, and stress symptoms and postpartum relapse to smoking a longitudinal study. Nicotine Tob Res. 2009;11:707-14.

Irfan M, Haque AS, Shahzad H, Samani ZA, Awan S, Khan JA. Reasons for failure to quit a cross-sectional survey of tobacco use in major cities in Pakistan. Int J Tuberc Lung Dis. 2016;20:673-8.

Kuhl EA, Fauerbach JA, Bush DE, Ziegelstein RC. Relation of anxiety and adherence to risk-reducing recommendations following myocardial infarction. Am J Cardiol. 2009;103:1629-34.

Weinberger AH, Desai RA, McKee SA. Nicotine withdrawal in U S. smokers with current mood, anxiety, alcohol use, and substance use disorders. Drug Alcohol Depend. 2010;108:7-12.

Cosci F, Bertoli G, Pistelli F, Carrozzi L. Depressive, anxious, withdrawal symptoms, and craving as possible predictors of abstinence maintenance in smokers attending a 12-week quitting program. MedicalExpress (São Paulo, online).. 2016;3.

Marqueta A, Nerín I, Jiménez-Muro A, Gargallo P, Beamonte A. Predictors of outcome of a smoking cessation treatment by gender. Gac Sanit. 2013;27:26-31.

Jesus MC, Silva MH, Cordeiro SM, Kortchmar E, Zampier VS, Merighi MA. Understanding unsuccessful attempts to quit smoking: a social phenomenology approach. Rev Esc Enferm USP. 2016;50:73-80.

McBride CM, Emmons KM, Lipkus IM. Understanding the potential of teachable moments the case of smoking cessation. Health Educ Res. 2003;18:156-70.

Persky I, Spring B, Vander Wal JS, Pagoto S, Hedeker D. Adherence across behavioral domains in treatment promoting smoking cessation plus weight control. Health Psychol. 2005;24:153-60.

Santos SR, Gonçalves MS, Leitão Filho FS, Jardim JR. Profile of smokers seeking a smoking cessation program. J Bras Pneumol. 2008;34:695-701.

Szklo AS, Otero UB. Profile of smokers not searching for smoking cessation intervention in Rio de Janeiro, Brazil. Rev Saude Publica. 2008;42:139-42.

Kviz FJ, Crittenden KS, Warnecke RB. Factors associated with nonparticipation among registrants for a self-help, community-based smoking cessation intervention. Addict Behav. 1992;17:533-42.

Covey LS, Glassman AH, Stetner F. Depression and depressive symptoms in smoking cessation. Compr Psychiatry. 1990;31:350-4.

Ong AD, Walsh DA. Nicotine dependence, depression, and the moderating role of goal cognitions. Psychol Addict Behav. 2001;15:252-4.

Niaura R, Britt DM, Shadel WG, Goldstein M, Abrams D, Brown R. Symptoms of depression and survival experience among three samples of smokers trying to quit. Psychol Addict Behav. 2001;15:13-7.

Kronish IM, Rieckmann N, Halm EA, Shimbo D, Vorchheimer D, Haas DC. Persistent depression affects adherence to secondary prevention behaviors after acute coronary syndromes. J Gen Intern Med. 2006;21:1178-83.

Hitsman B, Abrams DB, Shadel WG, Niaura R, Borrelli B, Emmons KM. Depressive symptoms and readiness to quit smoking among cigarette smokers in outpatient alcohol treatment. Psychol Addict Behav. 2002;16:264-8.

Van Der Rijt GA, Westerik H. Social and cognitive factors contributing to the intention to undergo a smoking cessation treatment. Addict Behav. 2004;29:191-8.

Piette JD, Heisler M, Ganoczy D, McCarthy JF, Valenstein M. Differential medication adherence among patients with schizophrenia and comorbid diabetes and hypertension. Psychiatr Serv. 2007;58:207-12.

Lee ML, Hassali MA, Shafie AA. A qualitative exploration of the reasons for the discontinuation of smoking cessation treatment among Quit Smoking Clinics' defaulters and health care providers in Malaysia. Res Social Adm Pharm. 2013;9:405-18.

Bala MM, Lesniak W. Efficacy of non-pharmacological methods used for treating tobacco dependence meta-analysis. Pol Arch Med Wewn. 2007;117:504-11.

Mottillo S, Filion KB, Bélisle P, Joseph L, Gervais A, O'Loughlin J. Behavioural interventions for smoking cessation a meta-analysis of randomized controlled trials. Eur Heart J. 2009;30:718-30.

Terra MB, Barros HM, Stein AT, Figueira I, Palermo LH, Athayde LD. Do alcoholics anonymous groups really work Factors of adherence in a Brazilian sample of hospitalized alcohol dependents. Am J Addict. 2008;17:48-53.

6169cb95a9539553513b4d86 trends Articles
Links & Downloads
2238-0019 (Electronic)
Trends Psychiatry Psychother ©2024 All rights reserved.

Trends Psychiatry Psychother

Share this page
Page Sections