Can we modify the enrollment in a postpartum smoking cessation intervention in Spain?

OBJECTIVE: it is known that very few women who continue to smoke at the time of delivery stop smoking during the postpartum period. Discovering strategies that can be incorporated during pregnancy to help improve women's participation in postpartum interventions could increase the number of women non-smokers. The aim of this study is to identify the predictors of participation by pregnant women smokers in a postpartum smoking cessation intervention. DESIGN: a cross-sectional study was carried out amongst women smokers who had attended to give birth. SETTING: women attended the University Clinical Hospital 'Lozano Blesa' of Zaragoza (Spain) who were smokers before pregnancy and reported at delivery to have continued smoking during pregnancy were eligible and were invited to participate in the study. FINDINGS: 2044 women completed the questionnaire 24 hours after giving birth. The smoking prevalence during pregnancy was 18.2% (n=372) and 62.9% of them (n=234) participated. The logistic regression model provided five significant predictors for women who participated: intention to breast feed, having less of an urge to smoke the first cigarette of the day before pregnancy, having reduced consumption during pregnancy by 50% or more, having received advice and being willing to get help. CONCLUSIONS AND IMPLICATIONS FOR THE PRACTICE: the factors associated with participation show aspects that can be modified by maternal and child health professionals. Advice to stop smoking, received during pregnancy, encourages participation in a postpartum intervention. From the point of view of public health, the huge increase in the prevalence of smoking women poses the need to take advantage of the pregnancy as an opportunity for giving up smoking definitely. It would be necessary to identify what programmes of smoking cessation have better results in pregnant women and to know how to motivate health professionals to implement them.

A multicentre randomized trial of combined individual and telephone counselling for smoking cessation.

OBJECTIVE: The present study assessed the effectiveness of smoking cessation programs combining individual and telephone counselling, compared to individual or telephone counselling alone. METHOD: A randomized, multicentre, open-label trial was performed between January 2009 and July 2011 at six smoking cessation clinics in Spain. Of 772 smokers assessed for eligibility, 600 (77%) met inclusion criteria and were randomized. Smokers were randomized to receive individual counselling, combined telephone and individual counselling, or telephone counselling. The primary outcome was biochemically validated continuous abstinence at 52 weeks. RESULTS: The 52-week abstinence rate was significantly lower in the telephone group compared to the combined group (20.1% vs. 29.0%; OR, 1.32; 95% CI, 1.1-2.7) and to the individual counselling group (20.1% vs. 27.9%; OR, 1.37; 95% CI, 1.0-2.8). The 52-week abstinence rates were not significantly higher in the combined group than the individual group (OR, 0.97; 95% CI, 0.7-1.4). CONCLUSION: Individual counselling and combined individual and telephone counselling were associated with higher 52-week abstinence rates than telephone counselling alone. A combined approach may be highly useful in the clinical treatment of smokers, as it involves less clinic visits than individual counselling alone, thus reducing the program cost, and it increases patient compliance compared to telephone counselling alone.

Factores predictores de éxito según género en el tratamiento del tabaquismo / Predictors of outcome of a smoking cessation treatment by gender

Objetivo: Analizar los factores predictores de los resultados del tratamiento del tabaquismo según sexo,en personas fumadoras que solicitan tratamiento para dejar de fumar en una unidad de tabaquismo.Métodos: Estudio transversal en personas fumadoras que iniciaron tratamiento en una unidad de tabaquismo entre los anos 2002 y 2007. Se recogieron variables sociodemográficas, de patrón de consumo, ˜del entorno del paciente respecto al tabaco y la presencia de comorbilidad psiquiátrica. Se realizó tratamiento multicomponente: psicológico y farmacológico. Se consideró éxito del tratamiento la abstinenciacontinua validada con CO ≤10 ppm, y se realizó el análisis mediante el criterio de intención de tratar.Para analizar los factores predictores se llevó a cabo un análisis de regresión logística.Resultados: Se analizaron 1302 personas, 52,1% (678) hombres y 47,9% (624) mujeres, con una media deedad de 43,4 (10,2) anos. El consumo medio de cigarrillos era de 25,3 (10,4) y la dependencia física de ˜6,2 (2,2) puntos. El 41,3% (538) logró el éxito, sin encontrar diferencias. Los factores predictores del éxitoen los hombres fueron la menor dependencia física y una pareja no fumadora, y en las mujeres fueron lamayor edad, el menor consumo de cigarrillos, la minoría de amigos fumadores y no padecer ansiedad odepresión durante el tratamiento.Conclusiones: Hombres y mujeres tienen un porcentaje de éxito similar en los tratamientos para dejar defumar, aunque hay factores predictores del éxito diferentes según el sexo que condicionan la abstinencia.Es necesario incorporar la perspectiva del sexo en el consumo de tabaco, tanto en la prevención como enel tratamiento (AU)

Objective: To identify factors predictive of the outcome of a smoking cessation program by gender.Methods: A cross-sectional study of smokers starting treatment in a smoking cessation clinic from 2002to 2007 was conducted. The variables consisted of data on sociodemographic factors, smoking habits,the social context of smoking and psychiatric comorbidity prior to or during the smoking cessationprocess. All patients received multicomponent treatment consisting of psychological and pharmacological interventions. Success was defined as self-reported continuous abstinence confirmed by cooximetry(CO ≤10 ppm). Logistic regression was used to analyze the factors predictive of success.Results: A total of 1302 persons (52.1% men and 47.9% women), with a mean age of 43.4 (10.2) years,were included. The mean number of cigarettes smoked per day was 25.3 (10.4) and the mean Fagerströmtest score was 6.2 (2.2) points. The success rate was 41.3% (538) with no differences by gender. Positivepredictors were lower nicotine dependence and having a non-smoking partner in men and older age,smoking fewer cigarettes per day, having fewer smoking friends and not experiencing depression oranxiety during the treatment in women.Conclusions: Men and women have similar tobacco abstinence outcomes although gender factors play arole in determining abstinence. The gender perspective should be incorporated in smoking preventionand cessation programs (AU)

[Predictors of outcome of a smoking cessation treatment by gender]. / Factores predictores de éxito según género en el tratamiento del tabaquismo.

OBJECTIVE: To identify factors predictive of the outcome of a smoking cessation program by gender. METHODS: A cross-sectional study of smokers starting treatment in a smoking cessation clinic from 2002 to 2007 was conducted. The variables consisted of data on sociodemographic factors, smoking habits, the social context of smoking and psychiatric comorbidity prior to or during the smoking cessation process. All patients received multicomponent treatment consisting of psychological and pharmacological interventions. Success was defined as self-reported continuous abstinence confirmed by cooximetry (CO ≤10 ppm). Logistic regression was used to analyze the factors predictive of success. RESULTS: A total of 1302 persons (52.1% men and 47.9% women), with a mean age of 43.4 (10.2) years, were included. The mean number of cigarettes smoked per day was 25.3 (10.4) and the mean Fagerström test score was 6.2 (2.2) points. The success rate was 41.3% (538) with no differences by gender. Positive predictors were lower nicotine dependence and having a non-smoking partner in men and older age, smoking fewer cigarettes per day, having fewer smoking friends and not experiencing depression or anxiety during the treatment in women. CONCLUSIONS: Men and women have similar tobacco abstinence outcomes although gender factors play a role in determining abstinence. The gender perspective should be incorporated in smoking prevention and cessation programs.

A proactive smoking cessation intervention in postpartum women.

OBJECTIVE: to analyse the efficacy of a proactive intervention during the postpartum period to prevent a relapse in recent quitters and to promote progress in the behavioural process of change in smokers. DESIGN: randomised controlled trial designed for women at the end of the pregnancy using a proactive intervention. Motivational Interviewing (MI) and relapse prevention served as principles for the programme. In the intervention group, four telephone supporting sessions were performed in weeks 3, 6, 9 and 12. For the control group only two check calls in weeks 3 and 12. SETTING: women who attended the University Clinical Hospital 'Lozano Blesa' of Zaragoza (Spain) to give birth between January 2009 and March 2010. The intervention began after delivery, lasted for 3 months, and finished with a visit to validate abstinence biochemically. FINDINGS: a total of 2,044 women were studied, 30.6% (n=626) smoked before pregnancy; 65.8% (n=412) of them agreed to participate. The results for recent quitters by self-report showed that the probability of remaining abstinent after 12 weeks was 74% for the intervention group and 37% for the control group. Only the half of the sample attended the visit at 3 months to confirm the abstinence biochemically. For smokers, 90.7% of the intervention group said that they would be ready to try to quit in the following 6 months, vs. 18.3% for the control group. CONCLUSIONS AND IMPLICATIONS FOR THE PRACTICE: a proactive intervention in the postpartum period may reduce the probability of relapse in recent quitters and helps female smokers to make progress in the behavioural process of change. Such interventions should be included systematically in mother-child health services.

Prevalencia de tabaquismo y exposición al humo ambiental de tabaco en las mujeres embarazadas: diferencias entre españolas e inmigrantes / Prevalence of smoking and second-hand smoke exposure: differences between Spanish and immigrant pregnant women

Objetivos Conocer las diferencias que hay entre las mujeres embarazadas españolas e inmigrantes en la prevalencia de tabaquismo y la exposición al humo ambiental de tabaco, así como los factores asociados a que las mujeres continúen fumando durante la gestación. Métodos Estudio epidemiológico transversal en mujeres atendidas en el momento del parto en la provincia de Zaragoza. Variables recogidas mediante cuestionario: características sociodemográficas y de consumo de tabaco de la mujer y la pareja, exposición al humo ambiental de tabaco y percepción de riesgo. Resultados Se incluyeron 2.440 mujeres (35% inmigrantes). El 31,1% fumaba a diario antes de quedarse embarazada y el 18,2% (n=445) fumó durante toda la gestación, con diferencias entre españolas e inmigrantes (21,9% frente 8,7%; p<0,001). Las inmigrantes conviven con mayor número de fumadores, fuman más dentro de casa, están más horas al día expuestas, evitan menos lugares con humo ambiental y trabajan más en hostelería. Los factores asociados a continuar fumando durante el embarazo fueron: ser española, fumar más cigarrillos antes del embarazo, mayor número de horas de exposición al humo ambiental de tabaco en el hogar, tener una baja percepción de riesgo y una pareja con menor nivel de estudios. Conclusiones La prevalencia de tabaquismo en las mujeres embarazadas es mayor entre las españolas que en las inmigrantes, aunque estas últimas están más expuestas en su entorno familiar y laboral al humo ambiental de tabaco. Hay diferencias socioculturales que deberían tenerse en cuenta al realizar intervenciones en mujeres en edad reproductiva (AU)

Objectives To identify differences in the prevalence of smoking and second-hand smoke exposure between Spanish and immigrant pregnant women, as well as the factors associated with continued smoking during pregnancy. Methods An epidemiologic cross-sectional study was carried out in women attended at delivery in Zaragoza (Spain). A smoking questionnaire was used to collect the following variables: the women's and partners’ sociodemographic factors and smoking behavior, second-hand smoke exposure and perception of the risks of this exposure. Results We included 2440 women (35% immigrants). A total of 31.1% smoked before becoming pregnant and 18.2% during pregnancy, with significant differences between Spanish and immigrant women (21.9% versus 8.7%; p<0.001). Immigrant women lived with a greater number of smokers, smoked more inside the home, were exposed to second-hand smoke for a greater number of hours per day, avoided public places with second-hand smoke less, and more often worked in bars and restaurants. The following factors were associated with smoking during pregnancy: being Spanish, smoking a greater number of cigarettes before pregnancy, being exposed to second-hand smoke at home for a greater number of hours, having a low perception of risks and having a partner with lower educational attainment. Conclusions The prevalence of smoking is higher among Spanish pregnant women than immigrant women, although the immigrant population is more exposed to second-hand smoke at home and at work. There are socio-cultural differences that should be taken into account when carrying out interventions in women of reproductive age (AU)

[Prevalence of smoking and second-hand smoke exposure: differences between Spanish and immigrant pregnant women]. / Prevalencia de tabaquismo y exposición al humo ambiental de tabaco en las mujeres embarazadas: diferencias entre españolas e inmigrantes.

OBJECTIVES: To identify differences in the prevalence of smoking and second-hand smoke exposure between Spanish and immigrant pregnant women, as well as the factors associated with continued smoking during pregnancy. METHODS: An epidemiologic cross-sectional study was carried out in women attended at delivery in Zaragoza (Spain). A smoking questionnaire was used to collect the following variables: the women's and partners' sociodemographic factors and smoking behavior, second-hand smoke exposure and perception of the risks of this exposure. RESULTS: We included 2440 women (35% immigrants). A total of 31.1% smoked before becoming pregnant and 18.2% during pregnancy, with significant differences between Spanish and immigrant women (21.9% versus 8.7%; p<0.001). Immigrant women lived with a greater number of smokers, smoked more inside the home, were exposed to second-hand smoke for a greater number of hours per day, avoided public places with second-hand smoke less, and more often worked in bars and restaurants. The following factors were associated with smoking during pregnancy: being Spanish, smoking a greater number of cigarettes before pregnancy, being exposed to second-hand smoke at home for a greater number of hours, having a low perception of risks and having a partner with lower educational attainment. CONCLUSIONS: The prevalence of smoking is higher among Spanish pregnant women than immigrant women, although the immigrant population is more exposed to second-hand smoke at home and at work. There are socio-cultural differences that should be taken into account when carrying out interventions in women of reproductive age.

[Evolution of anxiety during the smoking cessation process at a Smoking Cessation Clinic]. / Evolución de la ansiedad en el proceso de dejar de fumar en fumadores que acuden a una Unidad de Tabaquismo.

OBJECTIVE: To assess the evolution of anxiety during the smoking cessation process (3 months) and early smoking relapse, in a group of smokers seeking treatment for giving up smoking. METHOD: Analytical, prospective and longitudinal study. STUDY VARIABLES: sex, age, marital status, educational level, anxiety and depression background, use of psychopharmacological drugs, cigarettes smoked per day, co-oximetry, nicotine dependence (Fagerström Test for Nicotine Dependence) and state and trait anxiety (State-Trait Anxiety Inventory). Trait anxiety was assessed at the same time as medical history and state anxiety over the following sessions: Medical history session, day prior to stopping smoking, the day after, and at one week, one month and three months. Continuous abstinence was assessed by self-report and confirmed by co-oximetry ≤ 10 ppm. RESULTS: 569 patients, 288 men (50.6%) and 281 women (49.4%), mean age 43 years, mean cigarettes per day 23, average score on Fagerström Test 6. State anxiety levels decreased during the smoking cessation process, and these levels were maintained three months later. Women scored higher on state and trait anxiety, and so did smokers who took psychopharmacological drugs. Relapsing patients had higher levels of state anxiety in the session prior to relapse. CONCLUSIONS: State anxiety decreases during the smoking cessation process, remaining at the same level after 3 months. There is a need to incorporate behavioural strategies in smoking cessation treatment.

Evolución de la ansiedad en el proceso de dejar de fumar en fumadores que acuden a una Unidad de Tabaquismo / Evolution of anxiety during the smoking cessation process at a Smoking Cessation Clinic

Objetivo: Conocer la evolución de la ansiedad a lo largo del proceso de cesación tabáquica (3 meses) en pacientes que solicitan tratamiento para dejar de fumar y su posible valor pronóstico en la recaída. Método: Estudio analítico prospectivo longitudinal. Variables de estudio: sexo, edad, estado civil, nivel de estudios, antecedentes de ansiedad y/o depresión, consumo de psicofármacos, cigarrillos diarios, cooximetría, dependencia a la nicotina (Test de Fagerström) y ansiedad estado/rasgo con el cuestionario STAI-E/R (State-Trait Anxiety Inventory). La ansiedad rasgo se evaluó el día de la historia clínica y la ansiedad estado en las siguientes sesiones: Hª clínica, día previo a dejar de fumar, día posterior, semana, mes y a los tres meses. Se midió la abstinencia continuada y validada con CO ≤10 ppm. Resultados: 569 pacientes, 288 hombres (50,6%) y 281 mujeres (49,4%), media de edad: 43 años; media cigarrillos/día: 23; media Test de Fagerström:6. La A/E disminuyó al dejar de fumar y se mantuvo a lo largo del tiempo (3 meses). Se encontraron mayores puntuaciones de A/R y A/E en el grupo de mujeres y en los sujetos que consumían psicofármacos. Los pacientes que recayeron tenían mayor grado de ansiedad estado en la sesión anterior a la recaída. Conclusiones: La ansiedad disminuye a lo largo del proceso de deshabituación y se mantiene en el tiempo (3 meses); los sujetos que recaen puntúan más alto en ansiedad estado. Es necesario incorporar estrategias conductuales en el tratamiento del tabaquismo (AU)

Objective: To assess the evolution of anxiety during the smoking cessation process (3 months) and early smoking relapse, in a group of smokers seeking treatment for giving up smoking. Method: Analytical, prospective and longitudinal study. Study variables: sex, age, marital status, educational level, anxiety and depression background, use of psychopharmacological drugs, cigarettes smoked per day, co-oximetry, nicotine dependence (Fagerström Test for Nicotine Dependence) and state and trait anxiety (State-Trait Anxiety Inventory).Trait anxiety was assessed at the same time as medical history and state anxiety over the following sessions: Medical history session, day prior to stopping smoking, the day after, and at one week, one month and three months. Continuous abstinence was assessed by self-report and confirmed by co-oximetry ≤ 10 ppm. Results: 569 patients, 288 men (50.6%) and 281 women (49.4%), mean age 43 years, mean cigarettes per day 23, average score on Fagerström Test 6. State anxiety levels decreased during the smoking cessation process, and these levels were maintained three months later. Women scored higher on state and trait anxiety, and so did smokers who took psychopharmacological drugs. Relapsing patients had higher levels of state anxiety in the session prior to relapse. Conclusions: State anxiety decreases during the smoking cessation process, remaining at the same level after 3 months. There is a need to incorporate behavioural strategies in smoking cessation treatment (AU)

[Results of smoking cessation therapy in a specialist unit]. / Resultados del tratamiento del tabaquismo en una unidad especializada.

OBJECTIVE: The aim of this study was to assess the results of smoking cessation therapy in a specialist unit by calculating the probability of continued abstinence at 6-month follow-up and analyzing differences according to the characteristics of the individuals. PATIENTS AND METHODS: A prospective longitudinal study was undertaken in smokers who received multicomponent smoking-cessation therapy over a period of 3 months. Continued abstinence was assessed on the basis of self-report by participants and confirmed by measurement of exhaled carbon monoxide levels. Kaplan-Meier survival analysis was performed to assess the probability of continued abstinence. Log-rank tests were used to analyze differences in continued abstinence according to different qualitative variables. RESULTS: The 1120 patients who participated in the study (56% men and 44% women) had a mean (SD) age of 44.1 (9.5) years. The mean score on the Fagerström test was 6.3 (2.1). Nicotine replacement therapy was provided in 70.8% of patients while 29.2% received bupropion. The probability of continued abstinence at 6 months was 62.2%. Individuals with a high dependence had a lower probability of continued abstinence at 6 months, as did those in whom treatment adherence was poor. No differences were observed in the probability of abstinence according to sex or type of pharmacological treatment. CONCLUSIONS: Individuals with a high nicotine dependence can benefit from intensive smoking-cessation treatment in a specialist unit to achieve continued abstinence.

Resultados del tratamiento del tabaquismo en una unidad especializada / Results of smoking cessation therapy in a specialist unit

Objetivo: Valorar los resultados del tratamiento del tabaquismo en una unidad especializada, mediante el cálculo de la probabilidad de permanecer abstinente a los 6 meses del seguimiento, y analizar las diferencias existentes según las características de los individuos. Pacientes y métodos: Se ha realizado un estudio analítico prospectivo y longitudinal entre los fumadores que recibieron tratamiento multicomponente durante 3 meses. Se consideró la abstinencia continuada mediante la declaración de los propios participantes, confirmada con cooximetría. Se realizó un análisis de supervivencia por el método de Kaplan-Meier. Se aplicaron contrastes de rangos logarítmicos para estudiar las diferencias en la abstinencia continuada de los pacientes para las distintas categorías de las variables cualitativas. Resultados: Se estudió a 1.120 pacientes (un 56% varones y el 44% mujeres), con una edad media (± desviación estándar de 44,1 ± 9,5 años. La puntuación del test de Fagerström fue de 6,3 ± 2,1 puntos. El 70,8% recibió tratamiento sustitutivo con nicotina y el 29,2% con bupropión. La probabilidad de mantenerse abstinente a los 6 meses fue del 62,2%. Los individuos con alta dependencia presentaron menos probabilidad de permanecer abstinentes a los 6 meses, así como aquéllos con mal cumplimiento terapéutico. No se encontraron diferencias en la probabilidad de abstinencia según el sexo y el tratamiento farmacológico utilizado. Conclusiones: Los individuos con dependencia alta a la nicotina pueden beneficiarse del tratamiento intensivo en una unidad especializada de tabaquismo para conseguir la abstinencia mantenida

Objective: The aim of this study was to assess the results of smoking cessation therapy in a specialist unit by calculating the probability of continued abstinence at 6-month follow-up and analyzing differences according to the characteristics of the individuals. Patients and Methods: A prospective longitudinal study was undertaken in smokers who received multicomponent smoking-cessation therapy over a period of 3 months. Continued abstinence was assessed on the basis of self-report by participants and confirmed by measurement of exhaled carbon monoxide levels. Kaplan-Meier survival analysis was performed to assess the probability of continued abstinence. Log-rank tests were used to analyze differences in continued abstinence according to different qualitative variables. Results: The 1120 patients who participated in the study (56% men and 44% women) had a mean (SD) age of 44.1 (9.5) years. The mean score on the Fagerström test was 6.3 (2.1). Nicotine replacement therapy was provided in 70.8% of patients while 29.2% received bupropion. The probability of continued abstinence at 6 months was 62.2%. Individuals with a high dependence had a lower probability of continued abstinence at 6 months, as did those in whom treatment adherence was poor. No differences were observed in the probability of abstinence according to sex or type of pharmacological treatment. Conclusions: Individuals with a high nicotine dependence can benefit from intensive smoking-cessation treatment in a specialist unit to achieve continued abstinence

[Weight gain and anxiety levels in recent ex-smokers]. / Ganancia ponderal al dejar de fumar y su relación con la ansiedad.

OBJECTIVE: To evaluate weight gain and its relation to anxiety in a group of smokers after 3 months of cessation treatment. PATIENTS AND METHODS: The target population for this prospective, analytical, longitudinal study was smokers being treated in a specialist smoking cessation clinic who were still abstinent at the conclusion of a 3-month treatment program. The following variables were analyzed: age, sex, nicotine dependence (Fagerström test), daily cigarette consumption, number of pack-years, pharmacological treatment (nicotine replacement/bupropion), use of nicotine gum (yes/no), weight gain, body mass index, and degree of state and trait anxiety. Successful cessation was defined as self-reported abstinence confirmed by measurement of expired carbon monoxide (CO) level (< or = 10 ppm). Anxiety was evaluated using the State-Trait Anxiety Inventory. The state anxiety and weight variables were measured on 5 occasions: before smoking cessation, and at the end of week 1, month 1, month 2, and month 3 after cessation. Results for the quantitative variables were expressed as means (SD), and results for the qualitative variables were expressed as percentages and absolute frequencies. RESULTS: The study population consisted of 122 individuals, 76 of whom were men (62%) and 46 of whom were women (38%). The mean age was 43.9 (9.9) years, and mean nicotine dependence according to the Fagerström scale was 6.2 (2.2) points. Average weight gain was 2.6 kg (3.6%), with no significant difference between the sexes. Weight gain in 25% of this population was greater than 4.2 kg, and maximum weight gain was 9.2 kg. Levels of state anxiety fell progressively as weight increased, although there was no evident relationship between the 2 variables. CONCLUSIONS: Weight gain is moderate as smokers quit. Anxiety levels, which are greater in the first few weeks after cessation, do not explain weight variation, which is more related to the metabolic effects of nicotine rather than to psychological variables.

Ganancia ponderal al dejar de fumar y su relación con la ansiedad / Weight gain and anxiety levels in recent ex-smokers

Objetivo: Evaluar la ganancia ponderal en un grupo de fumadores que permanecen abstinentes 3 meses después de dejar de fumar y valorar su relación con la ansiedad. Pacientes y métodos: Se trata de un estudio prospectivo, analítico y longitudinal, en el que la población objetivo eran fumadores atendidos en una unidad especializada de tabaquismo que permanecían abstinentes al finalizar el tratamiento (3 meses). Se estudiaron las siguientes variables: edad, sexo, dependencia a la nicotina mediante el test de Fagerström, cigarrillos/día, paquetes-año, tratamiento farmacológico (sustitutivo de nicotina/bupropión), ingesta de chicles de nicotina (sí/no), incremento ponderal, índice de masa corporal y grado de ansiedad (rasgo y estado). Se consideró éxito la abstinencia mantenida según refería el paciente junto con cooximetría (monóxido de carbono ≤ 10 ppm). La ansiedad se evaluó con el cuestionario STAI-E/R (State-Trait Anxiety Inventory). Las variables ansiedad de estado y peso se midieron en 5 momentos: antes de dejar de fumar, a la semana, al mes, a los 2 meses y a los 3 meses. Los resultados se expresan como medias ± desviación estándar (variables cuantitativas) y como proporciones y frecuencias absolutas (variables cualitativas). Resultados: La población de estudio estaba compuesta por 122 individuos ­-76 varones (62%) y 46 mujeres (38%)-­, con una edad media (± desviación estándar) de 43,9 ± 9,9 años y dependencia a la nicotina (test de Fagerström) de 6,2 ± 2,2 puntos. El incremento ponderal fue en promedio de 2,6 kg (3,6%), sin que hubiera diferencias por sexo. Un 25% de la población tuvo una ganancia mayor de 4,2 kg, pero en ningún caso se superaron los 9,2 kg. La ansiedad de estado disminuyó progresivamente, mientras que el peso mostró una evolución ascendente, sin que hubiera relación entre ambos. Conclusiones: La ganancia ponderal al dejar de fumar es moderada. La ansiedad, más intensa en las primeras semanas, no justifica el incremento del peso, que está más relacionado con los efectos metabólicos de la nicotina que con variables psicológicas

Objective: To evaluate weight gain and its relation to anxiety in a group of smokers after 3 months of cessation treatment. Patients and methods: The target population for this prospective, analytical, longitudinal study was smokers being treated in a specialist smoking cessation clinic who were still abstinent at the conclusion of a 3-month treatment program. The following variables were analyzed: age, sex, nicotine dependence (Fagerström test), daily cigarette consumption, number of pack-years, pharmacological treatment (nicotine replacement/bupropion), use of nicotine gum (yes/no), weight gain, body mass index, and degree of state and trait anxiety. Successful cessation was defined as self-reported abstinence confirmed by measurement of expired carbon monoxide (CO) level (≤ 10 ppm). Anxiety was evaluated using the State­Trait Anxiety Inventory. The state anxiety and weight variables were measured on 5 occasions: before smoking cessation, and at the end of week 1, month 1, month 2, and month 3 after cessation. Results for the quantitative variables were expressed as means (SD), and results for the qualitative variables were expressed as percentages and absolute frequencies. Results: The study population consisted of 122 individuals, 76 of whom were men (62%) and 46 of whom were women (38%). The mean age was 43.9 (9.9) years, and mean nicotine dependence according to the Fagerström scale was 6.2 (2.2) points. Average weight gain was 2.6 kg (3.6%), with no significant difference between the sexes. Weight gain in 25% of this population was greater than 4.2 kg, and maximum weight gain was 9.2 kg. Levels of state anxiety fell progressively as weight increased, although there was no evident relationship between the 2 variables. Conclusions: Weight gain is moderate as smokers quit. Anxiety levels, which are greater in the first few weeks after cessation, do not explain weight variation, which is more related to the metabolic effects of nicotine rather than to psychological variables