[Therapeutic group for smokers: results after two-year follow-up]. / Grupo terapêutico para tabagistas: resultados após seguimento de dois anos.

OBJECTIVE: To evaluate the smokers' profile, immediate results and outcome after 25 months of treatment at a university public service. METHODS: One hundred and seventy one smokers were evaluated for treatment in the Therapeutic Group (TG) of the Service of Psychoactive Substances. We evaluated sociodemographic variables, history of smoking, presence of medical comorbidity and psychiatric symptoms, initial and late outcomes (median 25 months), by telephone contact. Frequency analysis and multiple logistic regression analysis were used, with a significance level of 5% for associated factors. RESULTS: Most patients were female (73.4%), married (48%), had basic education (74.6%), were working (57%); 65.2% started to smoke before the age of 15, 63.8% smoked for more than thirty years, 76% already had tried to stop smoking, 46.2% had severe dependence, 72.1% had medical comorbidity and 36% presented psychiatric symptoms. The service was sought by 51%, mainly concerned with health. During treatment, 79.1% stopped smoking. After 25 months, 62% remained abstinent. The variable associated with failure of smoking cessation was the presence of psychiatric symptoms. Variables related to relapse were psychiatric symptoms and lesser attendance at Motivation Group sessions. There was an association between clinical comorbidity and years of smoking and years of inactivity CONCLUSION: This study reinforces the importance of understanding the profile of the subjects to evaluate strategies employed and adequacy of treatment proposed for smokers to improve the rates of smoking cessation and reduce rates of relapse.

Grupo terapêutico para tabagistas: resultados após seguimento de dois anos / Therapeutic group for smokers: results after two-year follow-up

OBJETIVO: Descrever os pacientes atendidos em ambulatório de tratamento de tabagistas em serviço universitário, resultados de tratamento imediatos e de seguimento de dois anos. MÉTODOS: Levantamento dos 171 tabagistas avaliados para tratamento no Grupo Terapêutico do Ambulatório de Substâncias Psicoativas do HC/UNICAMP. Avaliaram-se variáveis sociodemográficas, história do tabagismo, presença de comorbidades clínicas e sintomas psiquiátricos e desfecho inicial e tardio (mediana de 25 meses), por contato telefônico. Realizaram-se análises de frequência e, para identificar fatores associados, análise de regressão logística múltipla, com nível de significância de 5 por cento. RESULTADOS: População com maioria de mulheres (73,4 por cento), casada (48 por cento), escolaridade fundamental (74,6 por cento), trabalhando (57 por cento), 65,2 por cento começaram a fumar antes dos 15 anos, 63,8 por cento tinham mais de 30 anos de tabagismo, 76 por cento já tinham tentado parar de fumar, 46,2 por cento com dependência grave, 72,1 por cento apresentavam comorbidade clínica e 36 por cento sintomas psiquiátricos; 51 por cento procuraram espontaneamente o serviço, principalmente por preocupação com a saúde. Com relação à cessação do tabagismo, 79,1 por cento pararam de fumar durante o tratamento; após 25 meses, 62 por cento continuavam sem fumar. A variável associada a não-cessação foi presença de sintomas psiquiátricos. As variáveis relacionadas à recaída foram sintomas psiquiátricos e menor número de sessões no Grupo de Motivação. Houve associação entre comorbidade clínica e tempo de tabagismo e inatividade profissional. CONCLUSÃO: Este estudo reforça a importância do reconhecimento das características da clientela atendida para avaliação das estratégias empregadas e adequação das propostas de tratamento para tabagistas visando melhora das taxas de cessação e redução dos índices de recaída.

OBJECTIVE: To evaluate the smokers' profile, immediate results and outcome after 25 months of treatment at a university public service. METHODS: One hundred and seventy one smokers were evaluated for treatment in the Therapeutic Group (TG) of the Service of Psychoactive Substances. We evaluated sociodemographic variables, history of smoking, presence of medical comorbidity and psychiatric symptoms, initial and late outcomes (median 25 months), by telephone contact. Frequency analysis and multiple logistic regression analysis were used, with a significance level of 5 percent for associated factors. RESULTS: Most patients were female (73.4 percent), married (48 percent), had basic education (74.6 percent), were working (57 percent); 65.2 percent started to smoke before the age of 15, 63.8 percent smoked for more than thirty years, 76 percent already had tried to stop smoking, 46.2 percent had severe dependence, 72.1 percent had medical comorbidity and 36 percent presented psychiatric symptoms. The service was sought by 51 percent, mainly concerned with health. During treatment, 79.1 percent stopped smoking. After 25 months, 62 percent remained abstinent. The variable associated with failure of smoking cessation was the presence of psychiatric symptoms. Variables related to relapse were psychiatric symptoms and lesser attendance at Motivation Group sessions. There was an association between clinical comorbidity and years of smoking and years of inactivity CONCLUSION: This study reinforces the importance of understanding the profile of the subjects to evaluate strategies employed and adequacy of treatment proposed for smokers to improve the rates of smoking cessation and reduce rates of relapse.

Atenção aos tabagistas pela capacitação de profissionais da rede pública / Approach on smoking cessation by training public health providers

O estudo avaliou desdobramentos de um treinamento para abordagem de tabagistas para 40 profissionais da rede pública, de novembro de 2004 a março de 2007. Os profissionais realizaram abordagem mínima individual (3.419 tabagistas) e grupal (982). Dos pacientes fumantes que participaram dessas atividades, 9,2 por cento conseguiram parar de fumar. As dificuldades relatadas pelos profissionais foram baixa adesão dos pacientes (11 por cento), falta de medicação (38 por cento) e de apoio/estrutura da unidade (29 por cento). O treinamento aumentou a população abordada pelas unidades de saúde nas estratégias de prevenção do tabagismo.

The study evaluated the results of a smoking cessation training program including 40 public health providers from November 2004 to March 2007. A total of 3,419 smokers received minimum individual intervention and 982 had group intervention. Of all, 9.2 percent quit smoking. The main difficulties for smoking cessation reported by health providers were: low patient compliance (11 percent); lack of medications (38 percent); and lack of health unit infrastructure/support (29 percent). The training allowed to reaching out a larger population through smoking cessation approaches at health units.

[Approach on smoking cessation by training public health providers]. / Atenção aos tabagistas pela capacitação de profissionais da rede pública.

The study evaluated the results of a smoking cessation training program including 40 public health providers from November 2004 to March 2007. A total of 3,419 smokers received minimum individual intervention and 982 had group intervention. Of all, 9.2% quit smoking. The main difficulties for smoking cessation reported by health providers were: low patient compliance (11%); lack of medications (38%); and lack of health unit infrastructure/support (29%). The training allowed to reaching out a larger population through smoking cessation approaches at health units.