Tabagismo no Brasil: percepções dos resultados de pesquisas domiciliares / Smoking in Brazil: insights from the results of the household surveys / Tabaquismo en Brasil: percepciones de los resultados de encuestas en hogares

Introdução: o uso do tabaco em suas diferentes formas continua a ser uma das principais causas de morte evitáveis no Brasil. Com uma história de sucesso notável, o Brasil alcançou uma das maiores reduções significativas na prevalência do tabagismo desde 1990. No entanto, é preocupante que a taxa de declínio do consumo de tabaco tenha diminuído nos últimos anos, conforme sugerem as pesquisas. Objetivos: o presente estudo teve como objetivo comparar os resultados de três pesquisas domiciliares realizadas pelo Instituto Brasileiro de Geografia e Estatística (IBGE). Métodos: foi realizada a comparação da prevalência do uso de tabaco entre entrevistados com 18 anos ou mais, assim como foi avaliada a porcentagem de mudanças na prevalência entre 2008, 2013 e 2019, usando dados de três pesquisas: The Global Tobacco Adult Survey, do ano de 2008, e a Pesquisa Nacional de Saúde do Brasil, dos anos de 2013 e 2019. Além disso, analisamos a prevalência no Brasil e seus estados de acordo com idade, gênero, nível educacional e raça. Resultados: a prevalência do tabagismo ativo diminuiu 19% entre 2008 e 2013, passando de 18,2% (IC 95%: 17,7;18,7%), em 2008, para 14,7% (IC 95%: 14,2;15,2%), em 2013. No entanto, em 2019, a prevalência foi de 12,6% (IC 95%: 12,2;13,0%), revelando uma redução de 14,3%. O tabagismo foi maior entre a população com baixo nível de escolaridade, status de renda mais baixo e raça/cor da pele preta e parda. Conclusão: a prevalência do tabagismo diminuiu no Brasil nas últimas três décadas. No entanto, recentemente, houve uma redução na intensidade da queda, exigindo atenção e análise cuidadosa das estratégias de prevenção e abandono do tabagismo.(AU)

Tabagismo na pandemia de Covid-19: aspectos neurobiológicos do abuso de drogas em condições de estresse prolongado / Smoking on Covid-19 pandemic: neurobiological aspects of drug abuse in lasting stress conditions / Fumar en la pandemia de Covid-19: aspectos neurobiológicos del abuso de drogas en condiciones de estrés duradero

No fim de 2019 iniciou-se uma das maiores crises da saúde pública global em Wuhan, China. Essa emergência foi o aparecimento do SARS-CoV-2 e da doença COVID-19, uma síndrome respiratória aguda de alta transmissibilidade. A declaração da pandemia pela OMS em março de 2020 fez com que o mundo tomasse diversas medidas para o combate e contenção da doença. Inicialmente o isolamento social e lockdown foram as principais iniciativas, já que não havia formas de tratamento ou prevenção da doença. Essas medidas restritivas geraram uma mudança de hábito da população que deflagrou sérios comprometimentos físicos e psicológicos. Uma das consequências foi o aumento do uso de substâncias de abuso e, consequentemente, do transtornos por uso de substâncias, dentre elas o tabaco. Durante a pandemia o consumo de cigarro aumentou de 10 a 30% no mundo, o tabagismo é a principal causa de morte evitável e fator de risco para diversas doenças. Conjuntamente ao álcool, a nicotina têm um poder aditivo superior a muitas drogas ilícitas. A combinação dos transtornos por uso de substâncias e a COVID-19 acabam por ter um efeito sinérgico, dessa forma, buscamos integrar aspectos neuroquímicos, cognitivos e comportamentais que levaram ao aumento do consumo e/ou recaída nicotina e a terapêutica utilizada.

One of the biggest global public health crisis began in Wuhan, China at the end of 2019. That emergency was the emergence of SARS-CoV-2 and the disease COVID-19, a highly transmissible acute respiratory syndrome. The pandemic declaration by the WHO in March 2020 caused the world to take on several measures to combat and contain the virus. Initially, social isolation and lockdown were the main initiatives, as there were no forms of treatment or prevention of the disease. These restrictive measures generate a change in the habit of the population that triggered serious physical and psychological impairments. One of the consequences was the increase in the use of substances of abuse and, consequently, substance use disorder, including tobacco. During the pandemic, cigarette consumption increased from 10 to 30% worldwide, whereas smoking is the main cause of preventable death and a risk factor for several diseases. Along with alcohol, nicotine has a greater addictive power than illicit drugs. Substance use disorders and COVID-19 have a synergistic effect, in this way, we seek to integrate neurochemical, cognitive and behavioral aspects that led to increased consumption and/or relapse in nicotine consumption and the used therapy.

Una de las mayores crisis mundiales de salud pública comenzó en Wuhan (China) a finales de 2019. Esa emergencia fue la aparición del SARS-CoV-2 y la enfermedad COVID-19, un síndrome respiratorio agudo altamente transmisible. La declaración de pandemia por parte de la OMS en marzo de 2020 hizo que el mundo adoptara varias medidas para combatir y contener el virus. Inicialmente, el aislamiento social y el encierro fueron las principales iniciativas, ya que no existían formas de tratamiento o prevención de la enfermedad. Estas medidas restrictivas generaron un cambio en los hábitos de la población que desencadenó graves alteraciones físicas y psicológicas. Una de las consecuencias fue el aumento del consumo de sustancias de abuso y, en consecuencia, el trastorno por consumo de sustancias, incluido el tabaco. Durante la pandemia, el consumo de cigarrillos aumentó del 10 al 30% en todo el mundo, mientras que el tabaquismo es la principal causa de muerte evitable y un factor de riesgo de varias enfermedades. Junto con el alcohol, la nicotina tiene un mayor poder adictivo que las drogas ilícitas. Los trastornos por uso de sustancias y la COVID-19 tienen un efecto sinérgico, de esta manera, buscamos integrar los aspectos neuroquímicos, cognitivos y conductuales que llevaron al aumento del consumo y/o recaída en el consumo de nicotina y la terapia utilizada.

Analysis of tobacco dependence level and its influencing factors on Tianjin residents / 中华流行病学杂志

Objective: To understand the prevalence and influencing factors of tobacco dependence among the population aged 15-69 in Tianjin to provide the basis for formulating targeted smoking control intervention policies and carrying out scientific smoking cessation intervention services. Methods: The data of this study comes from the 2018 Tianjin residents' health literacy monitoring survey. Probability-proportional-to-size sampling is adopted for sampling. SPSS 26.0 software was used for data cleaning and statistical analysis, and χ2 test and binary logistic regression were used to analyze the influencing factors. Results: A total of 14 641 subjects aged 15-69 were included in this study. After standardized, with a smoking rate of 25.5%, including 45.5% for men and 5.2% for women. Among the population aged 15-69, the prevalence of tobacco dependence was 10.7%; among current smokers, the prevalence rate of tobacco dependence is 40.1%, of which the prevalence rate of male tobacco dependence is 40.0%, and the prevalence rate of female tobacco dependence is 40.6%. According to multivariate logistic regression analysis, people who live in rural areas, have an education level of primary school or below, smoke every day, smoke the first cigarette ≤15 years old, smoke ≥21 cigarettes per day, and smoke for more than 20 packet years, people who report poor physical health are more likely to suffer from tobacco dependence (all P<0.05); age and smoking age did not affect the possibility of tobacco dependence (all P>0.05). Among current smokers, there was no significant difference in their willingness to quit smoking whether they had tobacco dependence (P>0.05). The proportion of people with tobacco dependence who have tried to quit smoking and failed is higher (P<0.001). Conclusions: The prevalence of tobacco dependence among smokers aged 15-69 in Tianjin is high, and the demand for quitting smoking is great. Therefore, smoking cessation publicity should be carried out for key groups, and smoking cessation intervention work in Tianjin should be continuously promoted.

Identifying the Potential Determinants of Tobacco Counseling Implementation among Oral Health Professionals of India: A Cross-Sectional Survey

ABSTRACT Objective: To identify the potential determinants of tobacco counseling implementation among oral health professionals in India. Material and Methods: A cross-sectional survey was carried out among the 298 dentists of Aligarh and Gwalior. The questionnaire used in the study had sections on dentists' sociodemographic data and a 35-item questionnaire to assess the potential determinants of tobacco cessation counseling. Descriptive statistics were carried out, and a Chi-square test was utilized to determine the association. P-value <0.05 was considered statistically significant. Results: Domains "knowledge", "Professional Responsibility and Identity", and "Remembrance, awareness, and judgment" showed a statistically significant correlation with most tobacco cessation counseling behaviors. In addition, undergraduate education received in Tobacco Cessation counseling, and Continuing education received in Tobacco Cessation counseling had significantly impacted the practice of tobacco cessation counseling (p=0.02 and 0.04, respectively). Conclusion: This study suggests that "Knowledge", "Professional Responsibility and Identity" and "Remembrance, awareness, and judgment" are the potential determinants that could be used to design effective strategies to enhance tobacco counseling among dentists in India.

Consumo de sustancias: caracterización de pacientes pertenecientes a la unidad de salud mental adultos- Hospital Hernán Henríquez Aravena / Substance use: characterization of patients belonging to the adult mental health unit - Hernán Henríquez Aravena Hospital

Introducción: las sustancias psicoactivas han formado parte de la existencia humana por miles de años, han sido empleadas con distintos fines, consolidando su uso y abuso durante los últimos años como una condición altamente prevalente en la sociedad. Actualmente, existen gran cantidad de sustancias y, así mismo, diversas formas de clasificación. En términos de prevalencia mundial hasta el momento no hay un estándar de oro que permita medir de manera exacta el consumo según cada región geográfica, lo que dificulta el estudio y constituye un desafío al momento de realizar comparaciones entre regiones. No obstante, en términos de prevalencia mundial, la sustancia más consumida es el alcohol, seguida por cannabis, opioides, anfetaminas y cocaína respectivamente. Objetivo: caracterizar pacientes adultos del policlínico de salud mental del Hospital Hernán Henríquez Aravena con diagnóstico relacionado al consumo de sustancias y establecer las principales sustancias consumidas. Materiales y Método: se realizó un estudio descriptivo transversal en la población objetivo mediante revisión de fichas clínicas de pacientes adultos atendidos en policlínico de salud mental del Hospital Hernán Henríquez Aravena, durante los años 2018, 2019, 2020. Los antecedentes recolectados del estudio se analizaron según la población general y se compararon según género. Resultados: en la muestra estudiada, 73.2% de los consumidores son de sexo masculino, siendo el alcohol la sustancia de mayor consumo, seguida por cocaína, marihuana y benzodiacepinas.

Introduction: psychoactive substances have been part of the existence of humanity for thousands of years and have been used for different purposes, consolidating its use and abuse in recent years as a highly prevalent condition in our society. They are a large number of substances, and also various forms of classification. In terms of world prevalence, to date, there is no gold standard method that allows the exact measurement of substance consumption to each geographical region, which makes the study difficult and constitutes a challenge when making comparisons between regions. However, in terms of world prevalence, the most consumed substance is alcohol, followed by cannabis, opioids, amphetamines, and cocaine respectively. Objective: characterize adult patients of the mental health polyclinic of the Hernán Henríquez Aravena Hospital with a diagnosis related to substance use and establish the main substances consumed. Material and Method: A cross-sectional descriptive study was carried out in the target population by reviewing the clinical records of adult patients treated at the mental health polyclinic of the Hernán Henríquez Aravena Hospital, during the years 2018, 2019, and 2020. The antecedents collected from the study were analyzed according to the general population and compared according to gender. Results: In the sample studied, 73.2% of the users are male, alcohol being the substance most consumed, followed by cocaine, marijuana, and benzodiazepines

Infecciones periprotésicas en artroplastia total de rodilla: ¿cuál es nuestra realidad? / Periprosthetic infections in total knee arthroplasty: what is our reality?

INTRODUCCIÓN La infección periprotésica (IPP) es una de las complicaciones más serias en una artroplastia total de rodilla (ATR). Pese a esto, existe poca literatura chilena respecto de esta patología. OBJETIVOS Determinar la incidencia, las comorbilidades, los microorganismos aislados y su susceptibilidad antibiótica, y la morbimortalidad en pacientes con IPP. MATERIALES Y MÉTODOS Estudio descriptivo y retrospectivo en pacientes operados entre 2001 y 2020 por gonartrosis, con una ATR primaria, en un mismo centro de salud, con al menos 1 año de seguimiento. Se excluyeron pacientes operados en otros centros o con registros clínicos incompletos. Se registraron las comorbilidades, los microorganismos aislados, la susceptibilidad antibiótica, y la sobrevida por medio de una búsqueda sistemática de las fichas clínicas de los pacientes con IPP. Se utilizó estadística descriptiva para presentar los datos. RESULTADOS Se incluyeron 544 ATRs, de las cuales 8 (1,47%) presentaron IPP, y los pacientes tenían una edad promedio de presentación de 66 (±5,7) años, e índice de masa corporal (IMC) promedio de 30,3 (±4,5) kg/m2. La mediana de tiempo de presentación de la IPP fue de 411 (±1.034) días. Las principales comorbilidades registradas fueron hipertensión arterial en 5 (62,5%), tabaquismo en 4 (50%) casos, y dislipidemia in 4 (50%) casos. En total, 5 (62,5%) pacientes presentaron etiología polimicrobiana, y en 3 (37,5%) se aisló un solo microorganismo. Los principales agentes aislados fueron Staphylococcus aureus y Staphylococcus coagulasa negativo, ambos multirresistentes, en 6 (75%) y 3 (37,5%) pacientes respectivamente. Todos los pacientes recibieron tres dosis de cefazolina como profilaxis quirúrgica. Se describe una sensibilidad del 100% frente a vancomicina y rifampicina (12/12 cultivos), y una resistencia del 83,4% al ciprofloxacino (4/9 cultivos). Un total de 2 (25%) pacientes fallecieron después de 3 años de la ATR por causas no relacionadas con la IPP. No hubo casos de recidiva infecciosa tras la revisión. CONCLUSIÓN Se encontró una incidencia de 1,47% (8 casos) de IPP. Todos los pacientes con IPP presentaron alguna comorbilidad prequirúrgica. Los principales agentes microbiológicos identificados fueron multirresistentes y susceptibles a vancomicina y rifampicina.

INTRODUCTION Periprosthetic infection (PPI) is one of the most serious complications in total knee arthroplasty (TKA). Despite this, there is little Chilean literature regarding this pathology. OBJETIVES To determine the incidence, comorbidities, isolated microorganisms and their antibiotic susceptibility, morbidity, and mortality in patients with PPI. MATERIALS AND METHODS A descriptive and retrospective study in patients operated between 2001 and 2020 for gonarthrosis, with a primary TKA, in the same health center, with at least 1 year of follow-up. Patients operated on in other centers or with incomplete clinical records were excluded. Comorbidities, isolated microorganisms, antibiotic susceptibility, and survival were recorded through a systematic search of the clinical records of patients with PPI. Descriptive statistics were used to present the data. RESULTS We included 544 TKAs, 8 (1.47%) of which presented PPI, and the patients had an average age at presentation of 66 years ( 5.7 years) and an average body mass index (BMI) of 30.3 ( 4, 5) kg/m2 . The median time of presentation of the PPI was of 411 ( 1,034) days. The main comorbidities recorded were arterial hypertension in 5 (62.5%), smoking in 4 (50%) cases, and dyslipidemia in 4 (50%) cases. In total, 5 (62.5%) patients presented polymicrobial etiology, and in 3 (37.5%), a single microorganism was isolated. The main isolated agents were Staphylococcus aureus and coagulasenegative Staphylococcus, both multidrug-resistant, in 6 (75%) and 3 (37.5%) patients respectively. All patients received three doses of cefazolin as surgical prophylaxis. A sensitivity of 100% to vancomycin and rifampicin (12/12 cultures), and a resistance of 83.4% to ciprofloxacin (4/9 cultures) were described. Overall, 2 (25%) patients died 3 years after the TKA, due to causes unrelated to PPI. There were no cases of infectious relapse after the review. CONCLUSION An incidence of 1.47% (8 cases) of PPI was found. All patients with PPI presented some presurgical comorbidity. The main microbiological agents identified were multidrug-resistant and susceptible to vancomycin and rifampicin

Epidemiology of tobacco use and nicotine dependence in truck drivers

ABSTRACT OBJECTIVE To investigate the epidemiology of tobacco use and nicotine dependence in a sample of truck drivers in Brazil. METHODS Between 2015 and 2016, a cross-sectional study was conducted on 624 truck drivers who operate on the BR-050 highway in Brazil. Participants were interviewed about sociodemographic data, occupational characteristics, mental health, behavioral data, and tobacco use. Then, the Fagerstrom test for nicotine dependence (FTND) was used to verify nicotine dependence in smoking truck drivers. Logistic regression and linear regression were also used to verify factors associated with tobacco use in the previous 30 days and nicotine dependence scores, respectively. RESULTS The prevalence of tobacco use among truck drivers was 21.1% (n = 132;95%CI: 18.1-24.5). Of the total number of smokers who responded to the FTND (n = 118; 89.4%), most had high/very high nicotinic dependence (68.6%; 95%CI: 59.8-76.3). Tobacco use was associated with absence of religion (adjusted odds ratio [AOR]: 2.60; 95%CI: 1.35-5.01), employment relationship of the contract (AOR = 1.98; 95%CI: 1.26-3.13); > 12 hours daily working time (AOR = 1.80; 95%CI: 1.09-2.98) and alcohol use in the previous 30 days (AOR = 2.92; 95%CI: 1.86-4.57). Irregular physical activity was associated with higher scores of nicotine dependence (β = 1.87; 95%CI: 0.55-3.19). CONCLUSION The results showed a high prevalence of tobacco use and high/very high nicotine dependence among the truck drivers.

Impacto da exposição domiciliar ao tabaco e da composição familiar sobre a precocidade de uso de tabaco e álcool em adolescentes brasileiros / Impact of household exposure to tobacco and family composition on the early onset of alcohol use in Brazilian adolescents

O uso precoce de tabaco e álcool associa-se à maior morbimortalidade e manutenção desse consumo na vida adulta. Esta tese investiga o papel de fatores domiciliares e familiares sobre o início precoce do uso dessas substâncias entre adolescentes. Os dados analisados são do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA), que investigou 74.589 adolescentes de escolas públicas e privadas, com idades entre 12 e 17 anos, residentes de 124 municípios com mais de 100 mil habitantes no país. O primeiro manuscrito teve como objetivo estimar o efeito da presença de fumantes no domicílio sobre o início mais precoce de tabagismo entre adolescentes. O segundo manuscrito teve como objetivo estimar o efeito da composição familiar sobre o início mais precoce de tabagismo e do uso de álcool entre adolescentes. Em ambas as análises foram usados Modelos de Regressão de Cox não ajustados e ajustados por um conjunto de variáveis com intuito de controlar vieses de confundimento. Os Hazard Ratios estimados no manuscrito 1 mostraram um aumento de 51% (IC95%: 31%-65%) na chance de um adolescente não fumante e exposto ao tabaco em casa começar a fumar mais precocemente do que aquele que não convivia com tabagistas no domicílio. Nos resultados do segundo manuscrito observou-se uma influência importante da composição familiar sobre a precocidade de início do uso de tabaco e álcool entre adolescentes. Segundo os Hazard Ratios estimados, houve um aumento de 68% (IC95%: 50%-89%) na chance de um adolescente não fumante que não residia com ambos os pais iniciar o uso de tabaco antes de um adolescente que residia com pai e mãe. Quanto àqueles que residiam apenas com a mãe ou apenas com o pai, esse aumento foi de 46% (IC95%: 32%-60%) e 54% (IC95%: 28%-84%), respectivamente. Em relação ao início do consumo de bebidas alcoólicas, observou-se um aumento de 35% (IC95%: 21%-52%) na chance de um adolescente que não bebe e não reside com pai e mãe de iniciar o uso de álcool mais precocemente do que aqueles que residiam com ambos os pais. Quanto aos adolescentes que residiam apenas com a mãe ou apenas com o pai, esse aumento foi de 22% (IC95%: 17%-28%) e 36% (IC95%: 24%-50%), respectivamente. O terceiro manuscrito teve como objetivo investigar o uso conjunto de tabaco e álcool através de análises de coocorrência e de agrupamento, assim como descrever a relação temporal do início do uso das duas substâncias entre adolescentes tabagistas e usuários de álcool. Para a análise de agrupamento foram obtidas razões entre os valores observados (O) e esperados (E) de uso de tabaco e álcool. Na amostra total a razão O/E foi 3,51 (IC95%: 3,39-3,65) indicando o agrupamento do uso dessas substâncias. Já a Razão de Chances de Prevalência foi de 14,7 (IC95%: 12,4-17,4). A maior parte dos usuários (45,2%) de ambas as substâncias iniciou pelo uso de álcool. Nossos resultados reforçam as propostas de que ações preventivas não devem estar focadas em cada droga isoladamente, e devem incluir não só o adolescente, mas também seu universo familiar.

Early use of tobacco and alcohol is associated with increased morbimortality and maintenance of their use during adulthood. This thesis investigates the role of household and family factors on adolescents' early onset of these substances. The data analyzed are from the Cardiovascular Risk Factors Study (ERICA), which investigated 74,589 adolescents from public and private schools, aged between 12 and 17 years old, living in 124 municipalities with more than 100 thousand inhabitants in the country. The first manuscript aimed to estimate the effect of the presence of smokers in the household on the earlier onset of smoking habit among adolescents. The objective of the second manuscript was to estimate the effect of family composition on the earlier onset of smoking and alcohol use among adolescents. In both analyses, unadjusted and adjusted Cox Regression Models were used to control for confounding variables. The Hazard Ratio estimated in manuscript 1 showed a 51% increase (95% CI: 31%-65%) in the chance that a nonsmoking adolescent exposed to tobacco at home would start smoking earlier than one who did not live with smokers. The results of the second manuscript depicted an important impact of family composition on the early onset of tobacco and alcohol use among adolescents. According to the estimated Hazard Ratios, there was a 68% increased chance (95% CI: 32%-60%) that a nonsmoking adolescent who did not live with both parents would initiate tobacco use earlier than an adolescent living with both parents. As for those who resided with only the mother or only the father, the increase was 46% (95% CI:32%-60%) and 54% (95%CI: 28%-84%), respectively. Regarding the onset of consumption of alcoholic beverages, there was a 35% increase (95% CI:21%-52%) in the chance of an adolescent who does not drink and does not reside with both parents to initiate alcohol use earlier than those living with the mother and the father. As for adolescents living only with the mother or only the father, this increase was 22% (95%CI: 17%-28%) and 36% (95%CI: 24%-50%), respectively. The third manuscript investigated the concurrent use of tobacco and alcohol through co-occurrence and clustering analyses. It also described the temporal relationship between the onset of tobacco and alcohol use among adolescents consuming both substances. For the clustering analysis, we calculated ratios between observed (O) and expected (E) values of tobacco and alcohol use. In the total sample, the O/E ratio was 3.51 (95% CI: 3.39-3.65), indicating the clustering of the use of these substances. The prevalence odds ratio was 14.7 (95% CI: 12.4- 17.4). Most of the users (45.2%) of both substances started with the use of alcohol. Our results reinforce the proposal that preventive actions should not be focused on each drug separately and should include the adolescents and their families.

Indicadores referentes à cessação do comportamento de fumar no Brasil, Pesquisa Nacional de Saúde, edições 2013 e 2019 / Indicadores relacionados con el abandono del comportamiento de fumar en Brasil, Encuesta Nacional de Salud, ediciones 2013 y 2019 / Indicators related to smoking cessation in Brazil, National Health Survey, 2013 and 2019 editions

Objetivo: Descrever os indicadores de abandono do uso de tabaco, em 2013 e 2019, para o Brasil e as Unidades da Federação, segundo variáveis sociodemográficas, coletadas na Pesquisa Nacional de Saúde (PNS). Métodos: Estudo transversal, populacional e descritivo realizado com dados da PNS 2013 e 2019, uma pesquisa domiciliar coletada por entrevistadores treinados. Foram calculadas a prevalência de ex-fumantes e a proporção de fumantes que tentaram parar de fumar nos últimos 12 meses imediatamente anteriores à data da entrevista, e os respectivos intervalos de confiança (IC95%), segundo as variáveis sociodemográficas. Ademais, calculou-se a variação percentual entre os anos estudados. Resultados: Em 2013, a prevalência de ex-fumantes foi 17,5% (IC95% 16,9;18,0) e, em 2019, 26,6% (IC95% 26,1;27,2). Tentaram parar de fumar 51,1% (IC95% 49,3;52,9), em 2013, e 46,6% (IC95% 45,0;48,3) em 2019. Conclusão: É importante o fortalecimento e manutenção de estratégias para enfrentamento do uso de tabaco no país, de forma a aumentar a disposição e a capacidade do fumante atual de parar de fumar.

Objetivo: Describir los indicadores de abandono del hábito tabáquico en 2013 y 2019 para Brasil y Unidades Federadas, según variables sociodemográficas, recogidas en la Encuesta Nacional de Salud (PNS). Métodos: Estudio transversal, poblacional y descriptivo con datos de las PNS, 2013 y 2019, una encuesta de hogares recolectada por entrevistadores capacitados. Se calculó la prevalencia de exfumadores y proporción de fumadores que intentaron dejar de fumar en los últimos 12 meses y respectivos intervalos de confianza (IC95%), según variables sociodemográficas. Además, se calculó la variación porcentual entre los años. Resultados: En 2013, la prevalencia de exfumadores fue de 17,5% (IC95% 16,9;18,0), en 2019, 26,6% (IC95% 26,1;27,2). En 2013, el 51,1% intentó dejar de fumar (IC95% 49,3;52,9), y, en 2019, el 46,6% (IC95% 45,0;48,3). Conclusión: Es importante fortalecer y mantener las estrategias de afrontamiento del tabaquismo, para incrementar la disposición y capacidad del fumador actual para dejar de fumar.

Objective: To describe the indicators of smoking cessation in 2013 and 2019 for Brazil and federative units, according to sociodemographic variables, collected in the National Health Survey (PNS). Methods: Cross-sectional, population-based and descriptive study with data from the 2013 and 2019 PNS, a household survey collected by trained interviewers. The prevalence of ex-smokers and the proportion of smokers who tried to quit smoking in the 12 months prior to the interview, and respective confidence intervals (95%CI) were calculated, according to sociodemographic variables. Additionally, the percentage variation between the years was calculated. Results: In 2013, the prevalence of ex-smokers was 17.5% (95%CI 16.9;18.0) and, in 2019, 26.6% (95%CI 26.1;27.2). In 2013, 51.1% tried to quit smoking (95%CI 49.3;52.9) and, in 2019, 46.6% (95%CI 45.0;48.3). Conclusion: It is important to strengthen and maintain strategies for coping with tobacco use in Brazil, to increase the current smoker's willingness and ability to quit smoking.

Fatores associados à piora no estilo de vida durante a pandemia de COVID-19 na população brasileira de lésbicas, gays, bissexuais, transexuais, travestis e identidades relacionadas: estudo transversal / Factores asociados con el deterioro del estilo de vida durante el COVID-19 entre lesbianas, gays, bisexuales, transexuales, travestis e identidades relacionadas de Brasil: estudio transversal / Factors associated with lifestyle deterioration during the COVID-19 pandemic among Brazilian lesbians, gays, bisexuals, transsexuals, transvestites and related identities: a cross-sectional study

OBJETIVO: Verificar fatores associados à piora do estilo de vida, incluindo atividade física e consumo de cigarros e álcool, durante a pandemia de COVID-19, entre lésbicas, gays, bissexuais, transexuais, travestis e identidades relacionadas, Brasil, 2020. MÉTODOS: Estudo transversal, com indivíduos ≥18 anos de idade. Odds ratio (OR) e intervalos de confiança de 95% (IC95%) foram estimados pela regressão logística. RESULTADOS: Dos 975 participantes, 48,9% (IC95% 45,7;52,1) diminuíram sua atividade física; 6,2% (IC95% 4,8;7,9) e 17,3% (IC95% 15,0;19,8) aumentaram o consumo de cigarros e de álcool, respectivamente. Houve piora na realização de atividade física nos que aderiram às máscaras (OR=2,26; IC95% 1,20;4,23), piora no consumo de cigarros naqueles com alguma condição crônica (OR=2,39; IC95% 1,03;5,56) e de álcool nas mulheres cis (OR=1,95; IC95% 1,31;2,92) e indivíduos morando com companheiro(a) (OR=1,89; IC95% 1,23;2,91) CONCLUSÃO: Destacou-se piora do estilo de vida em mulheres cis, indivíduos com uma condição crônica e aqueles que aderiram às máscaras.

OBJETIVO: Verificar factores asociados al empeoramiento del estilo de vida durante la pandemia, incluida actividad física, consumo de cigarrillos y alcohol, en lesbianas, gays, bisexuales, transexuales, travestis e identidades relacionadas (LGBT+). MÉTODOS: Estudio transversal realizado en Brasil en agosto-noviembre, 2020, con individuos ≥18 años. Se utilizó regresión logística para estimar odds ratio (OR) y intervalos de confianza del IC95%. RESULTADOS: De 975 participantes, 48,9% (IC95% 45,7;52,1) disminuyó la práctica de actividad física, 6,2% (IC95% 4,8;7,9) aumentó el consumo de cigarrillos y 17,3% (IC95% 15,0;19,8) aumentó el consumo de alcohol. Hubo empeoramiento en la actividad física entre individuos que adhirieron a mascarillas (OR=2,26; IC95% 1,20;4,23), empeoramiento en consumo de cigarrillos entre individuos con una condición crónica (OR=2,39; IC95% 1,03;5,56), y de alcohol entre mujeres-cis (OR=1,95; IC95% 1,31;2,92) y personas que vivían en pareja (OR=1,89; IC95% 1,23;2,91). CONCLUSIÓN: Se destacó empeoramiento en mujeres cis, individuos con una condición crónica y que adhirieron a las mascarillas.

OBJECTIVE: To verify factors associated with deteriorating lifestyle during the COVID-19 pandemic, including physical activity, cigarette and alcohol intake in lesbians, gays, bisexuals, transsexuals, transvestites and people with related identities (LGBT+). METHODS: This was a cross-sectional study with individuals aged ≥18 years. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Of the 975 participants, 48.9% (95%CI 45.7;52.1) decreased physical activity, 6.2% (95%CI 4.8;7.9) increased cigarette smoking, and 17.3% (95%CI 15.0;19.8) increased alcohol intake. Physical activity deteriorated among individuals who adhered to mask use (OR=2.26; 95%CI 1.20;4.23), cigarette smoking increased among individuals who had a chronic health condition (OR=2.39; 95%CI 1.03;5.56), and alcohol intake increased among cisgender women (OR=1.95; 95%CI 1.31;2.92) and individuals living with a partner (OR=1.89; 95%CI 1.23;2.91). CONCLUSION: Lifestyle deterioration stood out among cisgender women, individuals with a chronic health condition and those who adhered to mask use.

Hábitos tóxicos y enfermedades crónicas no transmisibles en una población de la tercera edad / Toxic Habits and Chronic Noncommunicable Diseases in an Aged Population

Introducción: Los hábitos tóxicos son uno de los principales factores que convierten a las enfermedades crónicas no transmisibles en una importante causa de morbilidad y mortalidad. Objetivo: Describir la presencia de enfermedades crónicas no transmisibles y hábitos tóxicos como el consumo de café, alcohol y tabaco en una población de la tercera edad. Métodos: Se realizó un estudio descriptivo en el Consultorio médico 20 del municipio Arroyo Naranjo de La Habana entre octubre de 2018 y mayo de 2019. La población en estudio estuvo conformada por 365 pacientes geriátricos con diagnóstico de enfermedades crónicas no transmisibles. Las variables analizadas fueron edad, sexo, enfermedades crónicas no transmisibles asociadas y sustancias tóxicas consumidas. Los datos fueron obtenidos mediante revisión de historias clínicas y entrevistas realizadas a cada paciente. Los resultados se expresaron mediante tablas y gráficos estadísticos. Resultados: Predominó el sexo femenino y la hipertensión arterial como enfermedad de mayor prevalencia. La enfermedad pulmonar obstructiva crónica fue mayor en hombres y fueron estos los más fumadores. La presencia de úlceras y el consumo de café fueron mayores en las mujeres. En los pacientes entre 60-71 años fue donde se encontró el mayor número de hipertensos y los mayores consumidores de bebidas alcohólicas. Los del grupo 72-82 años fueron los mayores consumidores de tabaco y los más afectados por el asma bronquial. Conclusiones: Las enfermedades crónicas no transmisibles constituyen un problema de salud en la población estudiada. Los hábitos tóxicos detectados se asocian a la presencia de dichas enfermedades en los pacientes estudiados(AU)

Introduction: Toxic habits are one of the main factors that make chronic noncommunicable diseases an important cause of morbidity and mortality. Objective: To describe the presence of chronic noncommunicable diseases and toxic habits such as consumption of coffee, alcohol and tobacco in an elderly population. Methods: A descriptive study was carried out in the family medical office # 20 of the Arroyo Naranjo Municipality, Havana, between October 2018 and May 2019. The study population consisted of 365 geriatric patients diagnosed with chronic noncommunicable diseases. The variables analyzed were age, sex, associated chronic noncommunicable diseases and toxic substances consumed. The data were obtained by reviewing medical records and through interviews with each patient. The results were expressed using statistical tables and graphs. Results: In the research, the female sex predominated, together with arterial hypertension as the most prevalent disease. Chronic obstructive pulmonary disease was higher in men, who also accounted for the higher number of smokers. The presence of ulcers and coffee consumption were higher among women. It was in patients aged 60-71 years where the highest number of hypertensive patients and the highest consumers of alcoholic beverages were found. Those in the 72-82 age group were the greatest tobacco consumers and the most affected by bronchial asthma. Conclusions: Chronic noncommunicable diseases are a health concern in the studied population. The toxic habits detected are associated with the presence of these diseases in the patients studied(AU)

Conducta fumadora en estudiantes de kinesiología y su asociación con actitudes y conocimientos sobre tabaquismo: estudio de corte transversal / Smoking behavior in Chilean physical therapist students and their association with attitudes and knowledge on cigarette smoking: a cross sectional study

INTRODUCCIÓN: El tabaquismo continúa siendo un problema sanitario en población universitaria y profesionales de la salud. Los kinesiólogos participan en la implementación de programas orientados a la prevención y cese del tabaquismo en la comunidad. El objetivo de este estudio fue explorar la prevalencia de tabaquismo y actitudes sobre consumo de tabaco en estudiantes de kinesiología. MÉTODOS: Estudio de corte transversal realizado en estudiantes de Kinesiología de Concepción (Chile), durante los años 2017 y 2018. Se determinó la conducta y actitudes sobre tabaquismo. Mediante regresión logística se determinó la asociación entre la conducta fumadora y las actitudes sobre tabaquismo. Se consideró un valor de p < 0,05 como estadísticamente significativo. RESULTADOS: Se contestaron 554 cuestionarios. El 57,8% de los estudiantes encuestados declaró no haber fumado nunca, 13 % no haber fumado los últimos 6 meses y 29,4% declaró ser fumador actual. Por su parte, el 99,5% expresó algún grado de acuerdo con que fumar es perjudicial para la salud, lo cual se relacionó con la conducta fumadora (p < 0,0002). En relación a actitudes sobre tabaquismo, comparado a los no fumadores, los fumadores actuales presentan mayor probabilidad de mostrar desacuerdo o indiferencia respecto a actitudes positivas sobre tabaquismo. Principalmente en aquellas acciones que restringen su consumo, venta y divulgación (OR ponderado = 2,43; 95%IC 2,02 - 2,92). CONCLUSIONES: La prevalencia de tabaquismo en estudiantes de Kinesiología de Concepción es del 29,2%. Los estudiantes fumadores expresan una menor aprobación relacionada a intervenciones, actitudes y consecuencias del tabaquismo para la salud comparada con los no fumadores.

INTRODUCTION: Notwithstanding control policies, smoking continues to be a health problem in university students and health professionals, who are responsible for implementing programs oriented to prevention and cessation of smoking in the community. The objective of this study was to explore the prevalence of smoking and attitudes about smoking in physical therapy students. METHODS: Cross-sectional study carried out in students of physical therapy from three universities of Concepción city (Chile), during the years 2017 and 2018. Behavior and attitudes about smoking were evaluated. Association between smoking behavior and attitudes about smoking was determined by logistic regression. A p value < 0.05 was considered statistically significant. RESULTS: 554 questionnaires were answered. 57.8% of respondents had never smoked, 13.0% had not smoked in the last 6 months and 29.4% were current smokers. Moreover 99.5% of respondents stated some degree of agreement that smoking is harmful to health, which was related to smoking behavior (p < 0.0002). In relation to attitudes about smoking, compared to non-smokers, current smokers have a greater chance of showing disagreement or indifference regarding positive attitudes about smoking. Mainly in those actions that restrict tobacco consumption, sale and disclosure (weighted OR = 2.43, 95% CI 2.02 - 2.92). CONCLUSIONS: The prevalence of current smoking in physical therapy students from Concepcion city is 29.2%. Smoking students express lower approval related to interventions, attitudes and consequences of smoking for health compared with non-smokers.

Tabaquismo y su relación con otros factores de riesgo aterogénico en mujeres de edad mediana / Smoking and its relationship with other atherogenic risk factors in middle-aged women

Introducción: El tabaquismo constituye uno de los problemas más graves de la salud pública a escala mundial, y se ha definido como la gran epidemia silenciosa del siglo XX. Objetivo: Determinar la frecuencia del tabaquismo y su relación con algunos factores de riesgo ateroscleróticos en la mujer de edad mediana. Métodos: Se realizó un estudio descriptivo de corte transversal que incluyó 301 mujeres de 40 a 59 años pertenecientes al Policlínico Universitario 19 de abril. Se estudiaron variables clínicas relacionadas con el estilo de vida como la tensión arterial, el índice de masa corporal, la circunferencia de la cintura y el tabaquismo. Resultados: La frecuencia del tabaquismo fue elevada en este grupo de mujeres de edad mediana, con un 56,5 por ciento, y un promedio de comienzo a los 19,6 años de edad. Los factores de riesgo que predominaron fueron la hipertensión arterial y el exceso de peso, así como una elevada frecuencia de mujeres que fuman y son hipertensas. El 25,9 por ciento de las que fuman tenían asociados tres factores de riesgo. Conclusiones: El tabaquismo continúa siendo un problema de salud en la mujer de edad mediana, y se asocia a otros factores de riesgo como la hipertensión arterial y el exceso de peso. Disminuir su consumo es un reto para la salud pública en Cuba(AU)

Introduction: Tobacco smoking constitutes one of the most serious public health problems worldwide, and it has been defined as the great silent epidemic of the 20th century. Objective: To determine the frequency of tobacco smoking and its relationship with some atherosclerotic risk factors in middle-aged women. Methods: A descriptive cross-sectional study was carried out including 301 women aging 40 to 59 years old from April 19 University Polyclinic. Lifestyle-related clinical variables were studied such as blood pressure, body mass index, waist circumference, and tobacco smoking. Results: The frequency of tobacco smoking was high in this group of middle-aged women (56.5 percent), and an average beginning at 19.6 years of age. The predominating risk factors were high blood pressure and overweight, we found that high frequency of women who smoke are hypertensive. 25.9 percent of those who smoke had three associated risk factors. Conclusions: Tobacco smoking continues to be a health problem in middle-aged women, and it is associated with other risk factors, such as high blood pressure and overweight. Reducing the tobacco smoking habit is a challenge for public health in Cuba(AU)

Tabagismo, consumo de bebidas alcoólicas e os fatores associados em estudantes de medicina / Smoking, alcohol consumption and associated factors in medical students

OBJETIVOS: Descrever a prevalência e fatores associados ao uso de bebidas alcoólicas entre estudantes de Medicina. Estimar a prevalência de tabagismo. MÉTODOS: Corte transversal com questionário autoaplicado a todos os estudantes de Medicina de uma universidade pública na Bahia (n = 616), matriculados do primeiro ao oitavo semestre. Análise multivariada por meio de Regressão de Cox identificou os fatores associados ao uso de bebidas alcoólicas, por meio de três desfechos: presença e frequência de uso e o padrão de uso denominado binge drinking. RESULTADOS: Foram estudados 556 estudantes (90,2% de resposta), entre os quais 58,7% bebem, 21% consomem álcool com uma frequência de pelo menos uma vez por semana e 36% fazem binge drinking. O público masculino e os mais ativos fisicamente no lazer apresentaram maiores prevalências de uso de bebidas alcoólicas, seja pela maior frequência de uso ou uso de mais doses em uma ocasião. Variáveis escolares se associaram a uma ou outra modalidade de mensuração do uso de álcool. A prevalência de tabagismo foi de 4,8%. CONCLUSÃO: O uso de bebidas alcoólicas e seu padrão de consumo foram altos na população estudada, consistente com outras populações de estudantes já investigadas. A baixa prevalência de tabagismo é consistente com a literatura, que admite o êxito de políticas públicas destinadas ao controle desse consumo no Brasil.

OBJECTIVES: To describe the prevalence and factors associated with the use of alcoholic beverages among medical students. Estimate the prevalence of smoking. METHODS: Cross-sectional study (census) with a self-administered questionnaire in medical students at a public university in Bahia (n = 616) enrolled from the first to the eighth semester. Multivariate analysis using Cox Regression identified the factors associated with the use of alcoholic beverages, through three outcomes: presence and frequency of use and the pattern of use called binge drinking. RESULTS: 556 students were studied (90.2% response), among which, 58.7% drink, 21% consume alcohol at least once a week and 36% do binge drinking. The male population and those more physically active at leisure time showed a higher prevalence of alcohol use, either due to the higher frequency of use or the use of more doses on one occasion. School variables were associated with one or another method of measuring alcohol use. The prevalence of smoking was 4.8%. CONCLUSION: The use of alcoholic beverages and their consumption pattern were high in the studied population, consistent with other student populations already investigated. The low prevalence of smoking is consistent with the literature that admits the success of public policies aimed at controlling this consumption in Brazil.

Grau de dependência à nicotina de pacientes atendidos para tratamento do tabagismo em universidade pública / Nicotine dependence degree of patients treated for smoking addiction at a public university / Grado de dependencia a la nicotina de pacientes tratados por fumar en una universidad pública

OBJETIVO: identificar o grau de dependência à nicotina e dados sociodemográficos segundo o gênero dos pacientes atendidos pelo projeto de extensão Educando e Tratando o Tabagismo promovido por uma universidade pública. MÉTODO: estudo transversal, com dados provenientes de 361 prontuários de pacientes que participantes do projeto no período de 2014 a 2018. Realizou-se o teste de Fagerström, por meio do qual classificou-se os pacientes com grau de dependência: muito baixo, baixo, médio, elevado e muito elevado de acordo com a soma dos pontos obtidos nas questões aplicadas. RESULTADOS: a predominância no grau de dependência a nicotina foi observada no sexo feminino com maiores percentuais de classificação para dependência elevada e muito elevada, 33,5% e 25,3% respectivamente. Entre os homens verificou-se grau de dependência elevado 28,1% e baixo 21,9%. Contatou-se que o grau de dependência química a nicotina esteve associada a dependência física (valor-p=0,002) e psicológica (valor-p=0,003). CONCLUSÃO: a evidência de maior frequência de indivíduos com alto grau de dependência química à nicotina demonstra a importância da associação de terapias medicamentosas com abordagens cognitivas comportamentais por meio de intervenções de enfermagem, relacionadas ao controle e cessação do tabagismo por meio da educação em saúde.

OBJECTIVE: to identify the nicotine dependence degree and sociodemographic data according to the gender of the patients assisted by the Educating and Treating Smoking extension project promoted by a public university. METHOD: a cross-sectional study, with data from 361 medical records of patients participating in the project from 2014 to 2018. The Fagerström test was performed, through which patients with a degree of dependence were classified as follows: very low, low, medium, high, and very high, according to the sum of the points obtained in the applied questions. RESULTS: predominance in the nicotine dependence degree was observed in women with higher percentages of classification for high and very high dependence, 33.5% and 25.3% respectively. Among men, a high degree of dependence was found to be 28.1% and low, 21.9%. It was found that the degree of chemical dependence on nicotine was associated with physical (p-value = 0.002) and psychological (p-value = 0.003) dependence. CONCLUSION: the evidence for a higher frequency of individuals with a high chemical dependence degree for nicotine demonstrates the importance of combining drug therapies with cognitive behavioral approaches through Nursing interventions, related to controlling and quitting the smoking addiction through health education.

OBJETIVO: identificar el grado de dependencia a la nicotina y los datos sociodemográficos según el género de los pacientes atendidos por el proyecto de extensión Educar y tratar el tabaquismo promovido por una universidad pública. MÉTODO: estudio transversal, con datos de 361 registros médicos de pacientes que participaron en el proyecto de 2014 a 2018. Se realizó la prueba de Fagerström, a través de la cual se clasificaron los pacientes con un grado de dependencia: muy bajo, bajo, medio, alto y muy alto de acuerdo con la suma de los puntos obtenidos en las preguntas aplicadas. RESULTADOS: el predominio en el grado de dependencia a la nicotina se observó en mujeres con porcentajes más altos de clasificación de dependencia alta y muy alta, 33.5% y 25.3% respectivamente. Entre los hombres, se encontró un alto grado de dependencia del 28,1% y bajo del 21,9%. Se encontró que el grado de dependencia química de la nicotina se asoció con el físico (valor p = 0.002) y psicológico (valor p = 0.003). CONCLUSIÓN: la evidencia de una mayor frecuencia de individuos con un alto grado de dependencia química de la nicotina demuestra la importancia de combinar las terapias farmacológicas con enfoques cognitivos conductuales a través de intervenciones de enfermería, relacionadas con el control del tabaquismo y la cesación a través de la educación sanitaria.

Tobacco dependence treatment for special populations: challenges and opportunities

Although smoking rates have declined in most of the countries in the world, there are population groups within these countries whose smoking rates remain significantly higher than the general population. These "forgotten groups" who have not been receiving the needed attention in tobacco control policies and tobacco cessation efforts include people with serious mental illness, substance use disorders, tuberculosis, people living with human immunodeficiency virus (HIV), lesbian-gay-bisexual-transgender-queer people, and pregnant women. A number of steps are needed at the national level in countries where these disparities exist, including modifications to national smoking cessation treatment guidelines that address the special needs of these populations, as well as targeted smoking cessation research, since these populations are often not included in clinical trials. Because of the higher smoking prevalence in these populations, as well as their lower smoking cessation treatment success rates than the general population, more resources are needed if we are to reduce health disparities in these vulnerable populations. Additionally, we believe that more effort should be focused on integrating smoking cessation treatment in the specialized care settings frequented by these subpopulations.

Abordagem e tratamento do tabagismo / Approach and treatment of smoking

O Sistema Único de Saúde (SUS) tem papel fundamental no auxílio às pessoas que desejam parar de fumar. Para tanto, é muito importante que os profissionais atuantes na atenção básica e assistência à saúde estejam preparados para oferecer esse auxílio. Considerando esse contexto, a Diretoria de Vigilância Epidemiológica da Secretaria de Estado da Saúde de Santa Catarina (DIVE/SES/SC), por meio de sua Gerência de Análises Epidemiológicas e Doenças e Agravos Não Transmissíveis (GADNT) e a Escola de Saúde Pública de Santa Catarina (ESPSC) disponibilizam o curso "Abordagem e Tratamento do Tabagismo".

Evaluación de una intervención educativa sobre tabaquismo y su relación con la cavidad bucal / Evaluation of an educational intervention on smoking and its relationship with the oral cavity

Introducción: El tabaquismo se considera una epidemia de carácter universal y es una gravosa carga para el individuo, la familia y la sociedad. La cavidad bucal se afecta en toda su extensión y esto trae como resultado, efectos negativos sobre los tejidos que la conforman. Objetivo: Determinar las modificaciones en el nivel de conocimientos sobre tabaquismo y su relación con la cavidad bucal, con la aplicación de una intervención educativa. Métodos: Se realizó un estudio longitudinal en 55 voluntarios fumadores, de ambos sexos, adultos, del Hospital Militar Central Dr. Carlos J. Finlay, en el período comprendido de diciembre de 2017 a enero de 2018. Se les aplicó un cuestionario para determinar el nivel de conocimientos sobre tabaquismo y la cavidad bucal, antes y después de una intervención educativa. Se compararon los resultados de ambas aplicaciones. Resultados: El nivel de conocimientos fue suficiente en el 23,63 por ciento de los sujetos; después de aplicada la intervención aumentó al 83,63 por ciento. En relación con la enfermedad periodontal, predominaron los conceptos erróneos antes de la intervención (83,63 por ciento insuficiente) y después, respondió acertadamente el 65,45 por ciento. Conclusiones: La intervención aplicada fue efectiva para aumentar el nivel de conocimiento sobre el tabaquismo, relacionado con el cáncer oral y la enfermedad periodontal(AU)

Introduction: smoking is considered an epidemic of a universal nature and is a burden for the individual, the family and society. The oral cavity is affected to its full extent and this results in negative effects on its tissues. Objective: to determine the changes in the level of knowledge about smoking and its relationship with the oral cavity, with the application of an educational intervention. Methods: a longitudinal study was carried out in 55 smoking volunteers, of both sexes, adults, from the Hospital Militar Central Dr. Carlos J. Finlay, in the period from December 2017 to January 2018. A questionnaire was applied to determine the level of knowledge about smoking and the oral cavity, before and after an educational intervention. The results of both applications were compared. Results: the level of knowledge was sufficient in 23.63 percent of the subjects; after the intervention was applied, it increased to 83.63 percent. In relation to periodontal disease, misconceptions prevailed before the intervention (83.63 percent insufficient) and afterwards, 65.45 percent responded correctly. Conclusions: the intervention applied, was effective increasing the level of knowledge about smoking and oral cavity(AU)

A propósito del artículo Nivel de conocimiento sobre el tabaquismo y su relación con la cavidad bucal / About paper Level of knowledge about smoking and its relation with oral cavity

Al leer detenidamente el artículo Nivel de conocimiento sobre el tabaquismo y su relación con la cavidad bucal,1 pareció de gran importancia resaltar este tema, debido a la elevada tasa de fumadores en Cuba, y cada vez son más los jóvenes que se suman a esta práctica, ya sea por motivos recreativos o de otra índole. Al revisar exhaustivamente las cifras ofrecidas en el trabajo1 se hace relevante que el 83,63 % de la muestra no conociera la influencia negativa del hábito de fumar en los tejidos periodontales. Las enfermedades periodontales, no solo se encuentran entre las más frecuentes, sino que existen evidencias cada vez mayores, sobre su impacto sistémico, con importantes repercusiones orgánicas. Se estima que las enfermedades periodontales tienen algún grado de asociación con otras 54 enfermedades, algunas tan importantes como la diabetes, complicaciones del embarazo o algunas enfermedades cardiovasculares. La propia Sociedad Europea de Cardiología sitúa a la periodontitis como sexto factor de riesgo cardiovascular.2,3,4 Otra de las cifras a resaltar en la investigación,1 es el conocimiento sobre la relación con el cáncer bucal. Aunque se muestra una cifra relativamente alta, un porciento nada despreciable de personas aún no conocen esta relación. Los tumores de cavidad bucal, son la principal causa de mortalidad por cáncer de cabeza y cuello (localizaciones C00-C14) con un total de 826 fallecidos en 2018 (Cuba) con una razón de 4,7 hombres por cada mujer.5) Como antes se mencionaba, el hábito de fumar se ha extendido a una gran parte de la población y con ello ha disminuido la edad media de fumadores, se instaura un balance entre sexos, debido al aumento de mujeres fumadoras. Esta situación ha llevado a que cada vez sea más frecuente la presencia de estos tumores en menores de 60 años y con ello la edad media de fallecimiento disminuya. Solo queda expresar la satisfacción de leer el artículo1 e incentivar a más investigadores a abordar este tema como un problema de salud en la sociedad cubana. Además, se recomienda realizar estudios similares, pero con poblaciones mayores para lograr datos más consistentes, e impulsar estudios en adolescentes y jóvenes(AU)