Tratamiento de la adicción a la nicotina en una persona fumadora de puros Treating a nicotine addict smoking cigars

Autores/as

  • Mª Carmen Miguez Universidad de Santiago de Compostela. Enviar correspondencia: María del Carmen Míguez. Universidad de Santiago de Compostela. Unidad de Tabaquismo. Facultad de Psicología. Departamento de Psicología Clínica y Psicobiología. Campus Universitario Sur. 15782 Santiago de Compostela.
  • E. Becoña Universidad de Santiago de Compostela.

DOI:

https://doi.org/10.20882/adicciones.446

Palabras clave:

puros, dejar de fumar, programa psicológico conductual multicomponente cigars, smoking cessation, multicomponent behavioral psychological programme

Resumen

Aunque la prevalencia del consumo de cigarros puros es inferior a la de otras formas de consumir tabaco, como los cigarrillos, su consumo también crea adicción y conlleva riesgos para la salud. En este trabajo, se presenta la evaluación y el tratamiento de la conducta de fumar en un varón de 48 años de edad con una historia de 27 años de consumo. Éste asistió a un programa psicológico conductual multicomponente para dejar de fumar de seis sesiones (una por semana). El tratamiento incluyó un contrato motivacional, autorregistro de la conducta de fumar, representación gráfica, información acerca del tabaco, reducción gradual de ingestión de nicotina y alquitrán, control de estímulos, tareas para evitar el síndrome de abstinencia de la nicotina y feedback fisiológico (cantidad de monóxido de carbono en aire espirado). El sujeto dejó de fumar al final de tratamiento y continuó abstinente en los seguimientos llevados a cabo a 1, 3, 6, 9, 12 y 24 meses después de finalizado el tratamiento.
Althought cigar smoking is less prevalent among smokers, cigar consumption also becomes addictive and is a health hazard. We report in this study on the evaluation and treatment of a cigar smoker -a 48- year old man- with a consumption history of 27 years. The subject attended a multicomponent behavioral psychological programme for smoking cessation in six weekly sessions. The treatment included a motivational contract, self-monitoring and graphical representation of cigarette consumption, information regarding tobacco, nicotine fading, stimulus control procedure, strategies to avoid withdrawal syndrome, and physiological feedback (knowledge of amount of expired air carbon monoxide). The subject was abstinent at the end of treatment, and at the 1-, 3-, 6-, 9-, 12- and 24-month follow-ups.

Citas

American Psychiatric Association (1996). Practice guideline for the treatment of patiens with nicotine dependence. American Journal of Psychiatry, 153 (Suppl.), s1-s31.

American Psychiatric Association (2002). Manual Diagnóstico

y Estadístico de los trastornos mentales (4º edicición-Texto revisado) (DSM-IV-TR). Barcelona: Masson.

Baer, J.S. y Lichtenstein, E. (1988). Cognitive assessment in

smoking cessation. En D.M. Donovan y G.A. Marlatt (Eds.), Assessment of Addictive Behaviors (pp.189-213) Nueva York: Guildford.

Baker, F., Ainsworth, S.R,. Dye, J.T., Crammer, C., Thun, M.J., Hoffmann, D., Repace, J.L., Henningfield, J.E., Slade, J. Pinney, J., Shanks, T., Burns, D.M., Connolly, G.N. y Shopland, D.R. (2000). Health risks associated with cigar smoking. JAMA, 284, 735-740.

Baker, F., Dye, J.T., Denniston, M.M. y Ainsworth, S.R. (2001). Risk perception and cigar smoking behavior. American Journal of Health Behavior, 25, 106-114.

Beck, A.T., Rush, A.J., Shaw, B.F. y Emery, G. (1979). Cognitive therapy of depression. Nueva York: Guildfor Press. (Trad. cast.: Terapia cognitiva de la depresión. Bilbao: Desclee de Brouwer, 1983).

Becoña, E. (1993). Programa para deixar de fumar. Santiago

de Compostela: Servicio de Publicacións da Universidade de Santiago de Compostela.

Becoña, E. (1994a). Tratamiento del tabaquismo. En J.L. Graña (Ed.), Conductas adictivas (pp. 457-493). Madrid: Debate.

Becoña, E. (1994b). Evaluación de la conducta de fumar. En

J.L. Graña (Ed.), Conductas adictivas (pp. 373-402). Madrid: Debate.

Becoña, E., Córdoba, R., Díaz-Maroto, J.L., López, V., Jiménez,

C., Planchuelo, Mª A., Salvador, T. y Villalbí, J. (2001). Guía de procedimientos para ayudar a los fumadores a dejar de fumar. Adicciones, 13, 211-216.

Becoña, E. y Míguez, M.C. (1995). El cuestionario de evaluación

de la recaída/ abstinencia de los cigarrillos: primeros resultados. Revista Española de Drogodependencias, 20, 25-40.

Becoña, E., Palomares, A. y García, M.P. (1994). Tabaco y

salud.Guía de prevención y tratamiento del tabaquismo. Madrid: Pirámide.

Becoña, E. y Vázquez, F.L. (1997). Does using relapse prevention increase the efficacy of a program for smoking

cessation? An empirical study. Psychological Reports, 83, 1455-1458

Becoña, E. y Vázquez, F.L. (1998a). Self-reported smoking

and measurement of expired air carbon monoxide in a clinical treatment. Psychological Reports, 83, 316-318.

Becoña, E. y Vázquez, F.L. (1998b). Tratamiento del tabaquismo. Madrid: Dykinson.

Becoña, E. y Vázquez, F.L. (2001). Effectiveness of personalized written feedback through a mail intervention for smoking cessation: A randomizedcontrolled trial in Spanish smokers. Journal of Consulting and Clinical Psychology, 69, 33-40.

Cohen, S., Kamarck, T.y Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385-396.

Condiotte, M.M. y Lichtenstein, E. (1981). Self-efficacy and

relapse smoking cessation programs. Journal of Consulting and Clinical Psychology, 49, 648-658.

Connolly, G.N. (1998). Policies regulating cigars. En: National

Cancer Institute, Cigars. Health Effects and Trends (pp. 221-249). Bethesda, Maryland: U.S. Department of Health and Human Services. Smoking and Tobacco Control, monograph 9. NIH publication 98-4302.

Fant, R.V. y Henningfield, J.E. (1998). Pharmacology and

abuse potencial of cigars.En National Cancer Institute, Cigars. Health Effects and Trends (pp. 160-191). Bethesda, Maryland: U.S. Department of Health and Human Services. Smoking and Tobacco Control, monograph 9. NIH publication 98-4302.

Feit, M.N. (2001). Exposure of adolescent girls to cigar images in women´s magazines, 1992-1998. American Journal of Public Health, 91, 286-288.

Gerlach, K.K., Cummings, K.M., Hyland, A., Gilpin, E.A., Johnson, M.D. y Pierce, J.P. (1998). Trends in cigar consumption and smoking prevalence.En: National Cancer Institute, Cigars. Health Effects and Trends (pp.21-52). Bethesda, Maryland: U.S. Department of Health and Human Services. Smoking and Tobacco Control, monograph 9. NIH publication 98-4302.

Gilpin, E.A. y Pierce, J.P. (1999). Cigar smoking in California:

-1996. American Journal of Preventive Medicine, 16, 195-201.

Heatherton, T.F., Kozlowski, L.T., Frecker, R.C. y Fagerström,

K.O. (1991). The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire. British Journal of Addiction, 86, 1119-1127.

Hughes, J.R. y Hatsukami, D.K. (1986). Signs and symptoms

of tobacco withdrawal. Archives of General Psychiatry, 43, 289-294.

Lando, H.A. (1993). Formal Quit Smoking treatments. En C.T. Orleans y J. Slade. Nicotine Addiction principles and management (pp. 221-244). Nueva York: Oxford University Press

Lichtenstein, E. y Glasgow, R.E. (1992). Smoking cessation:

What we learned over the past decade? Journal of Consulting and Clinical Psychology, 60, 804-809.

Llanos, M. (1985). El mundo del tabaco. Madrid: Alhambra.

Míguez, M.C, Vázquez, F.L. y Becoña, E. (2002). Effectiveness

of telephone contact as an adjunct to a self-help program for smoking cessation. A randomized controlled trial in Spanish smokers. Addictive Behaviors, 27, 139-144.

McConnaughy, E.A., DiClemente, C.C., Prochaska, J.O. y

Velicer, W.F. (1989). Stages of change in psychotherapy:

A follow-up report. Psychotherapy: Theory, Research,

and Practice, 26, 494-503.

McConnaughy, E.A., Prochaska, J.O. y Velicer, W.F. (1983).

Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy: Theory, Research, and Practice, 20, 368-375.

Organización Mundial de la Salud (1992). Trastornos mentales

y del comportamiento. Descripciones clínicas y pautas para el diagnóstico (CIE-10). Ginebra: Organización Mundial de la Salud.

Prochaska, J.O., Norcross, J.C. y DiClemente, C.C. (1994).

Chaging for good. Nueva York: William Morrow and Cia.

Rigotti, N.A., Lee, J.E. y Wechsler, H. (2000). US college

students´use of tobacco. Results of a national survey. JAMA, 284, 699-705

Shanks, T.G. y Burns, D.M. (1998). Disease consequences of

cigar smoking. En National Cancer Institute, Cigars. Health Effects and Trends (pp. 105-155). Bethesda, Maryland: U.S. Department of Health and Human Services. Smoking and Tobacco Control, monograph 9. NIH publication 98-4302.

Shapiro, J.A., Jacobs, F.J. y Thun, M.J. (2000). Cigar smoking

in men and risk of death from tobacco-related cancers. Journal of the National Cancer Institute, 92, 333-337.

Slade, J. (1998). Marketing and Promotion of Cigars. En National Cancer Institute (Ed.), Cigars. Health Effects

and Trends (pp. 194- 205). Bethesda, Maryland: U.S. Department of Health and Human Services. Smoking and Tobacco Control, monograph 9. NIH publication 98- 4302.

Spielberger, C.D., Gorsuch, R.L. y Lushene, R.E. (1970). STAI. Manual for the State-Trait Anxiety Inventory. Palo Alto, California: Consulting Psychologists Press. (Trad. cast.: Cuestionario de Ansiedad Estado/Rasgo. Madrid: TEA, 1982).

USDHHS (1988). The health consequences of smoking. Nicotine addiction. A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services.

USDHHS (1989). Reducing the health consequences of smoking. 25 years of progress. A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services.

USDHHS (1990). The health benefits of smoking cesssation.

A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services.

USDHHS (2000). Treating tobacco use and dependence. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services

Velicer, W. F., Prochascha, J. O., Rossi, J. S. y Snow, M. (1992). Assessing outcome in smoking cessation studies. Psychological Bulletin, 111, 23-41.

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Publicado

2003-01-15

Número

Vol. 15 Núm. 1 (2003)

Sección

Originales