Abordaje interdisciplinario del tabaquismo en la consulta odontológica: Aplicación de técnicas de intervención psicológicas / Interdisciplinary Approach to Smoking in Dental Practice: Psychological Intervention Techniques Application

Resumen Actualmente, en la comunidad odontológica existe confusión y duda sobre la extensión de la responsabilidad del profesional en la intervención y prevención del tabaquismo, lo cual se podría atribuir, en gran medida, al desconocimiento al respecto. Sin embargo, el odontólogo tiene el compromiso de participar activamente en esta adicción como parte del tratamiento bucodental. Por lo tanto, este artículo presenta una revisión actualizada de la literatura internacional relacionada con el tabaquismo desde la perspectiva de la consulta odontológica, enfocada al empleo de estrategias psicológicas para ofrecer un abordaje interdisciplinario, donde se enmarca el rol del odontólogo y su equipo de trabajo. De esta forma, la psicología de la salud ofrece diversas técnicas de intervención que resultan altamente efectivas para reducir o eliminar el tabaquismo, a saber: entrevista motivacional, exposición con prevención de respuesta, control de estímulos, entrenamiento en solución de problemas, terapia cognitivo-conductual, entrenamiento progresivo en reducción de la ansiedad y el estrés, entrenamiento en habilidades sociales, manejo de la ira y la agresividad, manejo de contingencias, autocontrol, técnicas de estimulación aversiva, técnica de reducción gradual de ingestión de nicotina y alquitrán (RGINA), terapia de pareja y familiar para atender situaciones de conflictos en relaciones interpersonales y terapia grupal.

Abstract Currently, in the dental community there is confusion and doubt about the extent of professional responsibility in the intervention and prevention of smoking, which could be attributed, to a large extent, to lack of knowledge about it. However, the dentist is committed to actively participate in this addiction as part of oral treatment. Therefore, this article presents an updated review of the international literature related to smoking from the perspective of dental consultation, focused on the use of psychological strategies to offer an interdisciplinary approach, which frames the role of the dentist and his team. In this way, health psychology offers several intervention techniques that are highly effective in reducing or eliminating smoking, namely: motivational interviewing, response prevention, stimulus control, problem solving training, cognitive-behavioral, progressive training in anxiety and stress reduction, social skills training, anger management and aggressiveness, contingency management, self-control, aversive stimulation techniques, gradual reduction technique of nicotine and tar consumption (RGINA), couple and family therapy to deal with conflict situations in interpersonal relationships and group therapy.

Relación entre estrés y hábito de fumar en personal de salud, ciudad de La Paz Bolivia, 2014 / Relationship between stress and smoking habits, city of La Paz Bolivia, 2014

PREGUNTA DE INVESTIGACIÓN: ¿cuál será el perfil del consumo de tabaco y el estrés en personal del sector salud? OBJETIVO: describir las características del consumo de tabaco del personal de salud relacionado al estrés percibido, por las variables de edad, sexo. MÉTODO: investigación observacional de corte transversal analítico. RESULTADOS: los resultados muestran que una diferencial importante entre ocupación de los profesionales en salud, son los médicos en servicios los que están en condición de estrés en un porcentaje de 48,8%. La prevalencia de hábito de fumar en el personal de salud es de 26,9% (IC 24,4 ­ 29,4), siendo mayor la prevalencia en el sexo masculino con 30,87 (IC 26,9 -34,9), si consideramos la prevalencia de la exposición la más alta fue en el sexo femenino con 57,99% (IC 55,2 ­ 60,08). Se determinó la dependencia probabilística de la condición de estrés y el hábito de fumar con la prueba de chi2 = 7,06 p valor=0,008, que indica un nivel de asociación significativa entre el estrés y el hábito de fumar. Las personas en situación de estrés tienen 1, 4 veces más probabilidad de tener hábito de fumar que los que no se encuentran con estrés (RMP= 1,4 IC 1,09 -1,81). El 14% de los casos de personas con hábito de fumar se pudieron haber prevenido si las personas no estuvieran con estrés. Se podría prevenir el 29,1% de los casos de hábito tabáquico si las personas que están con estrés salieran de esta condición. CONCLUSIONES: se estableció que existe una alta prevalencia de consumo de tabaco en el personal de salud, vinculado al estrés. Es evidente la diferencia de condiciones de tabaquismo y estrés valorados por razón de género y ocupación.

RESEARCH QUESTION: what is the profile of tobacco consumption and stress in personnel of the health sector? GOAL: Describe the characteristics of tobacco consuming in personnel of the health sector related to perceived stress, by the variables of age, sex. METHOD: analytical observational cross-sectional research, observational research. RESULTS: the results show that an important difference between occupation of physician practices, medical services are those in stress condition at a rate of 48.8%. The prevalence of smoking among health personnel is 26.9% (CI 24.4 to 29.4), with a higher prevalence in males with 30.87 (CI 26.9 -34.9), considering the prevalence of exposure was highest in women with 57,99% (CI 55.2 to 60.08). Probabilistic dependence on the condition of stress and smoking with chi2 test = 7.06 p = 0.008 value, indicating a level of significant association between stress and smoking was determined. People under stress have 1.4 times more likely to have smoking than those who are under stress (RMP = 1.4 CI 1.09 -1.81). 14% of cases of people with smoking could be prevented if people were not stressed. It could prevent 29.1% of the cases of smoking if the people who are under stress come out of this condition. CONCLUSIONS: it was established that there is a high prevalence of tobacco on health personnel, linked to stress. The difference in terms of smoking and stress valued by gender and occupation is evident.

Estudio transversal bioquímico clínico en pacientes con artritis reumatoidea y su relación con el tabaquismo / Clinical laboratory transversal study in patients with rheumatoid arthritis and its relationship with smoking habits / Estudo transversal bioquímico clínico em pacientes com artrite reumatóide e sua relação com o tabagismo

En una población de pacientes con artritis reumatoidea (AR) se estudió la relación de esta patología con el tabaquismo, su perfil hormonal, la concentración de interleuquina 6 (IL 6) y la coexistencia de fibromialgia. Casi en el 50% de los pacientes, los valores de IL 6 fueron seis veces superiores al valor considerado normal. El hábito del tabaco, la edad y el tipo de tratamiento no influyeron en los valores de IL 6. En el subgrupo de pacientes con fibromialgia se observaron tanto altos niveles de IL 6 como bajos niveles de dehidroepiandrosterona (DHEA).

The relation between rheumatoid arthritis and smoking habits, hormonal status, interleuquin-6 levels and fibromyalgia in a population of patients was analyzed. Almost 50% showed IL6 values six times higher than the normal level. Smoking habits, age and the type of treatment did not influence IL-6 concentrations. Patients with fibromyalgia had high levels of IL6 as well as low dehydroepiandrosterone values.

Estuda-se numa população de pacientes com artrite reumatóide a relação desta patologia com o tabagismo, seu perfil hormonal, a concentração de interleucina 6 e a coexistência de fibromialgia. Quase no 50% dos pacientes os valores de IL 6 foram seis vezes superiores ao valor considerado normal. O hábito de fumar, a idade e o tipo de tratamento não influíram nos valores de IL 6. No subgrupo de pacientes com fibromialgia observa-se tanto altos níveis de IL 6 como baixos níveis de DHEA.

Caracterización del hábito de fumar en un grupo de escolares adolescentes / Characterization of smoking in a group of school teenagers

Introducción: el tabaquismo es una drogadicción universalmente extendida. Se observa un comienzo más precoz del hábito, particularmente en la adolescencia. Objetivo: evaluar las características de hábito de fumar en un grupo de escolares adolescentes. Métodos: se realizó una investigación descriptiva, transversal en un grupo de escolares adolescentes de 13 a 15 años. Se aplicó un cuestionario a cada estudiante de 8vo. y 9no. grados de la Escuela Secundaria Básica "William Soler Ledea", del municipio Centro Habana, en la provincia de La Habana, entre el 1ro. de septiembre de 2011 y el 1ro. de febrero de 2012. Se evaluaron: la edad, el sexo, el nivel escolar, si fumaba o no, el tiempo del hábito, la cantidad de cigarrillos y el entorno de fumadores como influencias o motivaciones. Para el procesamiento estadístico se calculó el riesgo relativo o razón de incidencia, y se empleó la prueba de chi cuadrado para la comparación de 3 aspectos, con nivel de significación del 5 % (p< 0,05). Resultados: el 16,8 % de los estudiantes fumaba. Predominaron con alta significación los de 14 y 15 años, los de 9no. grado y del sexo masculino. La mayoría no lo hacía diariamente y por más de un mes. El riesgo relativo para el hábito fue muy elevado cuando en su entorno lo hacían el profesor, los amigos, el novio o la novia. Los familiares constituyeron un ejemplo muy negativo en cuanto al tabaquismo en la generalidad de los casos. Conclusiones: hubo una elevada incidencia de fumadores en los adolescentes del estudio, y fue significativa la influencia de los fumadores en su entorno.

Introduction: smoking is a universally extended drug addiction. The onset is earlier in adolescence. Objective: to evaluate the characteristics of smoking in a group of school adolescents. Methods: a cross-sectional and descriptive research study was carried out in a group of school teenagers aged 13 to 15 years. Each 8th and 9th grader from "William Soler Ledea" junior high school in Centro Habana municipality, Havana province, was inquired from September 1st, 2011 to February 1st, 2012. The evaluated variables were age, sex, schooling, smoking habit, length of time of smoking, number of smoked cigarettes and living with smokers as influence or motivation for smoking. The relative risk or the incidence ratio was estimated whereas chi square test for comparison of three aspects was used, with 5 % level of significance (p< 0.05). Results: out of the participants, 16.8 % smoked. The 14-15 y age group, 9th graders and males significantly prevailed. Most of them did not smoke daily or for more than one month. The relative risk of smoking was high when the professor, the friends, the boyfriend or the girlfriend smoked too. The family was a very negative example of smoking in the vast majority of cases. Conclusions: high incidence of smoking was found in the adolescents participating in the study and the influence of smokers over their social and family environment was significant.

Prevalência e características do tabagismo na população universitária da região de Lins-SP / Prevalence and smoking characteristics in the university population of the region of Lins-SP / Predominio y características del tabaquismo en la población universitaria de la región de Lins-SP

O estudo objetivou conhecer a prevalência do tabagismo e descrever o perfil e hábitos tabágicos entre universitários de Lins-SP. Uma amostra de 368 alunos respondeu a um questionário com perguntas dirigidas a fumantes, ex-fumantes e não fumantes. A prevalência de tabagismo foi de 11,7%; 85,3% dos alunos não eram fumantes e 4,0% foram classificados como ex-fumantes. Do total de alunos entrevistados, 54,1% eram mulheres. Foi observado consumo médio de 5,1 ± 5,4 cigarros por dia, sendo que todos os universitários tabagistas utilizavam o cigarro industrializado. Este índice de prevalência assemelha-se aos de outros Centros Universitários e demanda políticas de controle do tabagismo nos meios universitários.

The study aimed to know the prevalence of smoking and to describe the profile and smoking habits of undergraduate students of Lins-SP. A sample of 368 undergraduate students answered a questionnaire with questions directed at smokers, ex-smokers and nonsmokers The prevalence of smoking was of 11,7%; about 85,3% of the students were nonsmokers and 4,0% were classified as ex-smokers. Of the students interviewed, 54,1% were women. It was noted that the average use was from 5,1 to 5,4 cigarettes per day, and that the students used industrialized cigarettes. This index of prevalence correlates to the ones of others University Centers and demands politics of smoking control among the university environment.

El estudio tuvo como objetivo conocer la prevalencia del tabaquismo y describir el perfil y hábitos de tabaquismo entre estudiantes universitarios de Lins-SP. Una muestra de 368 estudiantes respondieron a un cuestionario con preguntas dirigidas a fumadores, ex fumadores y no fumadores. La prevalencia de tabaquismo fue de 11,7%; 85,3% de los estudiantes eran no fumadores y 4,0% fueron clasificados como ex fumadores. Entre los encuestados, el 54,1% eran mujeres. Fue observado un consumo medio de 5,1 ± 5,4 cigarrillos por día, y todos los estudiantes fumadores utilizaban cigarrillos comerciales. Esta tasa de prevalencia es similar a otros centros universitarios y demanda políticas de control del tabaco en los círculos universitarios.

Smoking Prevalence and Habits of Physicians in Korea: a Mail Questionnaire Survey Conducted in 2000

BACKGROUND: Nationwide evaluation of physicians' smoking rate may be helpful to predict future trend of smoking in a general population. Thus, we investigated physicians' smoking rate and their habits in Korea. METHODS: Ten percent of physicians among the registered members of the Korean Medical Association were chosen by stratified random sampling and a mail questionnaire survey was conducted in 2000. Of the 2,977 physicians to whom the questionnaires were delivered, 1,248 (41.9%) responded. RESULTS: Overall smoking rate among Korean doctors was 29.9%. Smoking rate of males was 34.9% and that of females was 2.3%. In the current smokers, the most frequently reported age when they had begun smoking were 15~20 years (60.3%), the majority of daily smoking amount was less than or equal to 1 pack (92.5%), and those who were planning to quit smoking within 1 month were 11.9%. In the ex-smokers, the most frequently reported age when they had begun smoking were in their 20s (67.7%) and the most frequently reported age when they had stopped smoking were in their 30s (38.0%). CONCLUSION: The smoking rate of Korean physicians was estimated to be less than that of the general Korean population, but higher than that of physicians in major developed countries. More efforts to lower smoking rate of physicians and regular follow up is needed.

Investigation of Smoking Rate, Habits and Attitudes towards Smoking in Lawyers of Korea

BACKGROUND: It is well-known that a decline in the prevalence of smoking among physicians has preceded a decline in the general population. For the purpose of finding out the reason for lower smoking rate in Korean medical doctors than that of general population whether it is due to knowledge of toxicity related to smoking perceived as health professionals or as the only leader group in society this study was investigated. We selected lawyers as a representative of other professional groups. We investigated smoking rate, habits and attitudes towards smoking in Korean lawyers and compared the smoking rate and attitudes to wards smoking in lawyers with those of medical doctors. METHODS: This study investigates smoking rate, habits and attitudes towards smoking in Korean lawyers. An anonymous self-administered postal survey was used. One-third of registered lawyers were sampled according to stratified random sampling. Among 1,401 target population, 463 (38.3%) responded. RESULTS: Among male lawyers, 38.0% were current smokers, 38.9% were ex-smokers and 23.1% were non-smokers, while 7.7% were ex-smokers and 92.3% were non-smokers among female lawyers. The direct age-adjusted smoking rate among Korean male lawyers was 42.1%. CONCLUSION: In comparison of the direct age-adjusted smoking rate among male lawyers, medical doctors and general population in Korea, the rate in lawyers was 42.1%, medical doctors 34.9%, and general population 67.6%. The smoking rate of lawyers was found to be higher than that of medical doctors, but considerably lower than that of general population. In comparison of the attitudes towards smoking between lawyers and medical doctors, the lawyers were found to have a lower level of support in questions of the knowledge about the harmful effects of smoking and smoking bans on health than medical doctors.

The Difference of Lung Cancer Prevalence According to Smoking Habits / 결핵

BACKGROUND: The purpose of this study was to analyze the smoking habits in patients with lung cancer and identify any difference of prevalence according to histologic types of lung cancer. METHODS: The data were calculated by total amounts of tar and nicotine inhaled during the whole lifetime according to variation of smoking habits. This study was to investigated any difference of prevalence in lung cancer according to smoking habits. The subjects comprised 150 lung cancer cases and 300 hospital control cases that were matched by age and sex. Smoking habits during the whole lifetime were surveyed by standardized questionnaire. Odds ratios were estimated by unconditional logistic regression analysis. RESULTS: There were 104 male and 34 female lung cancer cases. By histologic type, there were 53 cases of squamous cell carcinoma, 67 of adenocarcinoma and 30 of small cell lung carcinoma. The differences between lung cancer cases and controls according to smoking habits were total duration of smoking, total pack years of smoking and number of cigarettes smoked per day during the previous two years. The odds ratios were higher in Kreyberg I, but not in Kreyberg II, for the longer duration of smoking, the greater total pack years of cigarettes consumed, the more cigarettes smoked per day during the previous two years, the longer duration of non-filter smoking, the earlier life cases who began to smoke, and the higher amounts of calculated total tar and nicotine inhaled over the whole lifetime. When we added grade of inhalation to calculation of amounts of tar and nicotine inhaled over the lifetime, the odds ratios of total inhalation amounts of tar and nicotine were as high as those the without them. CONCLUSIONS: This study reconfirmed that smoking habits were strongly associated with lung cancer and that there were different associations between smoking habits and histologic types of lung cancer. In particular, calculations of total tar and nicotine amounts inhaled over the whole lifetime were calculated for the first time in trials from lung cancer epidemiologic studies.

Relation between cotinine in the urine and indices based on self-declared smoking habits

<p><b>OBJECTIVES</b>The reliability of surveys on smoking habits based on questionnaires was investigated, using the urinary cotinine content as an objective index.</p><p><b>METHODS</b>The subjects tested were 2,849 office workers of middle age, who responded to questions concerning their smoking status, and also their urinary cotinine was measured by the HPLC method.</p><p><b>RESULTS</b>The boundary value between smokers and non-smokers, determined by the histogram independent of the questionnaire, was 63.1 and 79.4 ng/mg of creatinine for males and females, respectively. The rate of misclassification of the non-smokers and former smokers as smokers was 1.3% for males and 1.8% for females, whereas that of current smokers as non-smokers was 6.3% and 2.1%. We also assessed the effect of smoke inhalation on the urinary cotinine value, and found a significant difference for males in the cotinine value by the presence of inhalation and also its depth.</p><p><b>CONCLUSIONS</b>The rate of misclassification in this study was considered to be comparatively low. Several studies have also assessed the reliability of the questionnaire on smoking habits, and found different misclassification rates, indicating the dependence on the race and number of subjects tested. To our knowledge, there were only a few surveys on smoking among large groups, particularly in Japan, such as this one, therefore the results obtained in this study are meaningful.</p>

Relation between Cotinine in the Urine and Indices Based on Self-Declared Smoking Habits

Objectives: The reliability of surveys on smoking habits based on questionnaires was investigated, using the urinary cotinine content as an objective index. Methods: The subjects tested were 2,849 office workers of middle age, who responded to questions concerning their smoking status, and also their urinary cotinine was measured by the HPLC method. Results: The boundary value between smokers and non-smokers, determined by the histogram independent of the questionnaire, was 63.1 and 79.4 ng/mg of creatinine for males and females, respectively. The rate of misclassification of the non-smokers and former smokers as smokers was 1.3% for males and 1.8% for females, whereas that of current smokers as non-smokers was 6.3% and 2.1%. We also assessed the effect of smoke inhalation on the urinary cotinine value, and found a significant difference for males in the cotinine value by the presence of inhalation and also its depth. Conclusions: The rate of misclassification in this study was considered to be comparatively low. Several studies have also assessed the reliability of the questionnaire on smoking habits, and found different misclassification rates, indicating the dependence on the race and number of subjects tested. To our knowledge, there were only a few surveys on smoking among large groups, particularly in Japan, such as this one, therefore the results obtained in this study are meaningful.

Relative Risk for Lung Cancer According to Smoking Habits in Korean / 결핵

BACKGROUND: Lung cancer incidence is gradually leveling off in developed countries but is continuing to rise in Korea. Because of the rapid increasing in smoking prevalence among women and youngers, the lung cancer incidence is expected to increase within next three and four decades. The aims of the present study are to analyses the smoking habits in patients with lung cancer and to evaluate of the relative risk of smoking habits in patients with lung cancer. METHOD: The present investigation was hospital-based, case control study. It included data from 93 case subjects with lung cancer and 1132 controls with disease unrelated to smoking using smoking history questionnaire by direct personal interview. RESULT: Compared with non-smoker, those who smoked more than 50 years had an odds ratio for lung cancer of 8.8(1.8-20.7). The odds ratios was 8.5(3.5-20.7) for those whose total number of cigarettes per days exceeded 41 and 5.5(2.3-13.3) for men with started habitual smoking less than 20 years old. The risk was increased in men with more than 41 pack years of cigarette smoking(OR:5.5, 95% CI:2.6-11.9). Odds ratios associated with cigarette smoking were 2.5(1.1-5.8), 5.1(2.6-10.4) for exsmoker and current smoker, respectively and 2.2(1.0-4.6) for non-filter smoker with more than 16 years. CONCLUSION: There was a clear dose-response relationship between the risk of lung cancer and smoking. We conclude that smoking dose is important risk factor for lung cancer and smoking habits may be, also.

Gender Differences of Susceptibility to Lung Cancer According to Smoking Habits / 결핵

BACKGROUND: With the increase of cigarette consumption by women and the young, the incidence of lung cancer is expected to increase during the next three or four decades in Korea. The purpose of this study was to analyze the smoking habits in patients with lung cancer and to identify the gender differences in terms of their susceptibility to cigarette related carcinogens. METHODS: This investigation was a hospital-based case control study, which included the data of 178 case subjects(72 females, 106 males) with lung cancer and 218 control subjects(97 females, 121 males) with diseases unrelated to smoking. The information was obtained through a direct personal interview and a questionnaire related to personal smoking history. RESULTS: The relative frequency of the squamous cell carcinoma was substantially higher in males than in females(61.3% in males, and 29.2% in females), while adenocarcinoma including bronchoalveolar cell carcinoma was higher in females(31.9% in females, 18.9% in males). Keryberg Ilung cancer was of relatively higher frequencies in males and smokers. while Kreyberg IIlung cancer was higher in females and never smokers. The odds ratios(ORs) at each exposure level were consistently higher in females than males. For all cell types, the risk of lung cancer was increased with the quantity of smoked cigarettes, duration of smoking, and depth of inhalation. Odds ratio was distinctly higher in Kreyberg Ilung cancer than in total lung cancer and a steeper gradient of risk with increased smoking was observed in females. CONCLUSION: The ralative risk for lung cancer was consistently higher in females than in males at every level of exposure to cigarette smoke. This is believed to be due to the higher susceptibility of females to tabacco carcinogens, such as gender associated differences of carcinogen activation and/or the elimination of smoking related metabolites.

Smoking Habit of Coal Workers' Pneumoconiosis Patients: Their Relationship to the Findings of Chest Radiographs / 대한산업의학회지

No abstract available.

The Serum Alpha-antitrypsin Concentration of Coal Workers' Pneumoconiosis Patients / 대한산업의학회지

This study was performed to investigate associations between serum alpha(1)-antitrypsin(AAT) concentration and radiological categories of coal workers' pneumoconlosis(CWP), between AAT concentration and pulmonary complications such as tuberculosis and emphysema, and to study associations between AAT concentration and FEV(1.0)% in CWP patients, We classified 254 CWP patients in D Hospital into categories of small opacity profusion. And we selected 86 subjects by with or without emphysematous finding in each categories by proportional stratified sampling method. Semm AAT concentrations were quantkated by single radial immunodiffusion method, and the findings of chest radiographs were evaluated by radilogist. The results were as follows: 1. Serum AAT concentrations were not significantly different among groups of radiological categories of small opacities. 2. Complication of emphysema was associated with smoking habits sigmficantlyl(chi square=12.16, p<0,01). And AAT concentraLion was higher in smokers and ex-smokers than in non-smokers. Serum AAT concentration was significantly higher in the cases with emphysema than in the cdses without emphybema{p<0.01). 3. Serum AAT concentration of the group with active pulmonary tuberculosis was significantly higher than with inactive or without: pulmonary tuberculosis group(p<0.1). 4. Serum AAT concentration of the group with low FEV(1.0)% was significantly higher than with high or normal group(p<0.05).