Factores asociados al éxito en programas para dejar de fumar

Autores/as

  • J. J. Moreno Arnedillo Psicólogo. Centro de Prevención del Alcoholismo y Tabaquismo. Ayuntamiento de Madrid.
  • F. J. Herrero García de Osma Médico. Jefe de División. Centro de Prevención del Alcoholismo y Tabaquismo. Ayuntamiento de Madrid.

DOI:

https://doi.org/10.20882/adicciones.644

Palabras clave:

fumar, tabaco, dejar de fumar, predictores, tratamiento

Resumen

Las bajas tasas de eficacia en los programas para dejar de fumar imponen la necesidad de investigar qué factores están asociados al éxito terapéutico. OBJETIVO: investigar el valor predictivo de distintos factores citados en trabajos anteriores, y establecer hipótesis sobre los mecanismos responsables de su valor predictivo. MATERIAL Y MÉTODOS: se toma una muestra de 130 participantes en el Programa para Dejar de Fumar del Ayuntamiento de Madrid, y se determina la significación estadística de las diferencias entre quienes permanecían sin fumar a los 6 meses y quienes habían recaído, en las variables objeto del estudio. RESULTADOS: se encuentran diferencias significativas en sexo, expectativas de autoeficacia y existencia o no de contactos con el tabaco durante las primeras semanas; se comparan con trabajos anteriores sobre estos y otros factores. CONCLUSIONES: 1) el sexo, las expectativas de autoeficacia y el no cometer “deslices” aparecen como los mejores predictores del éxito; 2) apostamos por un enfoque altamente individualizado de las estrategias terapéuticas para dejar de fumar.

Citas

ANNIS, H. M. A relapse prevention model for treatment of alcoholics. En Blane, H., Leonard, K. (eds.). Psychological theories of drinking and alcoholism. New York. Guilford Press, 1986.

BAYOT, A., Y CAPAFONS, A. (1995). Diferencias individuales como predictores del éxito en la reducción del tabaquismo. Una revisión. Rev. Esp. Drogodep. 20 (1): 7-17.

BECOÑA, E. Tratamiento del tabaquismo. En Graña, J. L. : Conductas adictivas. Teoría, evaluación y tratamiento. Debate, 1994.

BECOÑA, E., FROJÁN, M. X., LISTA, M. J. (1988). Comparison between two self-efficacy scales in the maintenance of smoking cessation. Psychological Reports, 62: 359-362.

BJORNSON, W., RAND, C., CONNETT, J. E., LINDGREN, P., NIDES, M., POPE, F., BUIST, A., HOPPE-RYAN, C., O´HARA, P. (1995). Gender differences in smoking cessation after 3 years in the Lung Health Study. Am J Public Health. 85(2): 223-230.

BLAKE, S. M., KLEPP K. I., PECHACHEK T, F. FORSOM, A. R., LUEPKER, R. V., JACOBS, D. R., MITTERMARK, M. B. (1989). Differences in smoking cessation strategies between men and women. Addict. Behav. 14 (4): 409-418.

BOLMAN, C., DE VRIES, H. (1998). Psycho-social determinants and motivational phases in smoking behavior of cardiac inpatients. Prev Med. 27(5 Pt 1): 738-747.

BOCK, B. C., GOLDSTEIN, M. G., MARCUS, B. H. (1996). Depression following smoking cessation in women. J Subst Abuse. 8(1): 137-144.

COHEN, S. Y LICHTENSTEIN, E. (1990). Perceived stress, quitting smoking and smoking relapse. Health Psychology, 9: 466-478.

COLLINS, R. L., EMONT, S. L., ZYWIAK, W. H. (1990). Social influence processes in smoking cessation: postquitting predictors of long-term outcome. J Subst Abuse. 2(4): 389-403.

COVEY, L. S., GLASSMAN, A. H., STETNER, F. (1990). Depression and depressive symptoms in smoking cessation. Compr Psychiatry. 31(4): 350-354.

CURRY, S., THOMPSON, B., SEXTON, M., OMENN, G. S. (1989). Psychosocial predictors of outcome in a worksite smoking cessation program. Am J Prev Med. 5(1): 2-7.

DAUGHTON, D.M., ROBERTS, D., PATIL, K. D., RENNARD, S. I. (1990). Smoking cessation in the workplace: evaluation of relapse factors. Prev Med. 19(2): 227-230.

DE VRIES, H., MUDDE, A.N., DIJKSTRA, A., WILLEMSEN, M. C. (1998). Differential beliefs, perceived social influences, and self-efficacy expectations among smokers in various motivational phases. Prev Med. 27(5 Pt 1): 681-689.

EPSTEIN, L. H., DICKSON, B.E., MCKENZIE, S., RUSSELL, P. O. (1984).The effect of smoking on perception of muscle tension. Psychofarmacology, 83

FARKAS, A. J., PIERCE, J. P., ZHU S. H., ROSBROOK, B., GILPIN, E. A., BERRY, C., KAPLAN, R. M. (1996). Addiction versus stages of change models in predicting smoking cessation. Addiction. 91(9): 1281-1292.

FIORE, M., NOVOTNY, T., PIERCE, J., GIOVINO, G., HATZIANDREU, E., NEWCOMB, P., SURAWICZ, T., DAVIS, R. (1990). Methods used to quit smoking in the United States. Do cessation programs help? J of the American Medical Association, 263: 2760-2765.

FROJÁN, M. X. (1991). Eficacia de las variables de control en un programa de tratamiento del hábito de fumar. Revista de Psicología de la Salud, 3(2): 133-153.

GARCÍA MERINO, I. Prevención del tabaquismo desde la Comunidad de Madrid. Comunicación Oral. Primeras Jornadas Municipales sobre prevención y tratamiento del Tabaquismo. Ayuntamiento de Madrid. 1998.

GARVEY, A. J., BLISS, R. E., HITCHCOCK, J. L., HEINOLD, J. W., ROSNER, B. (1992). Predictors of smoking relapse among self-quitters: a report from the normative aging study. Addict. Behav. 17 (4): 367-377.

GINSBERG, J. P., KLESGES, R. C., JOHNSON, K. C., ECK, L. H., MEYERS, A. W., WINDERS, S. A. (1997). The relationship between a history of depression and adherence to a multicomponent smoking-cessation program. Addict Behav. 22(6): 783-787.

GOURLAY, S. G., FORBES, A., MARRINER, T., PETHICA, D., MCNEILL, J. J. (1994). Prospective study of factors predicting outcome of transdermal nicotine treatment in smoking cessation. BMJ Br Med 309(6958): 842-847.

GROVE, J. R. (1993). Attributional correlates of cessation self-efficacy among smokers. Addict Behav. 18(3): 311-320.

GULLIVER, S. B., HUGHES, J. R., SOLOMON, J. L., DEY, A. N. (1995). An investigation of self-efficacy, partner support and daily stresses as predictors of relapse to smoking in self-quitters. Addiction. 90(6): 767-772.

HAAGA, D. A., STEWART, B. L. (1992). Self-efficacy for recovery from a lapse after smoking cessation. J Consult Clin Psychol. 60(1): 24-28.

HALL, S. M., MUÑOZ, R. F., REUS, V. I. Depression and smoking treatment: a clinical trial of an affect regulation treatment. In Problems of drug dependence: proceedings of the 52nd Annual Scientific Meeting. NIDA, 1991.

HALL, S. M., MUÑOZ, R. F., REUS, V. I., SEES, K. L. (1993). Nicotine, negative affect and depression. J Cons. Clin. Psychology, 61: 761-767.

HATSUKAMI, D. K. Treatment of special populations. Addicted to Nicotine: A National Research Forum. National Institute on Drug Abuse. 1998.

HAVASSY, B.E., HALL, S. M., WASSERMAN, D. A. (1991). Social support and relapse: commonalities among alcoholics, opiate users, and cigarette smokers. Addictive Behaviors, 16: 235-246.

HERRERO, F.J., MORENO, J.J., RIVERO, A. Resultados del programa para dejar de fumar del Ayuntamiento de Madrid (en preparación).

HILL, H. A., SCHOENBACH, V. J., KLEINBAUM, D. G., STRECHER, V. J., ORLEANS, C. T., GEBSKI, V. J., KAPLAN, B. H. (1994). A longitudinal analysis of predictors of quitting smoking among participants in a self-help intervention trial. Addict Behav.19(2): 159-173.

HUGHES, J. R., GULLIVER, S. B., FENWICK, J. W., VALLIERE, W. A., CRUSER, K., PEPPER, S., SHEA, P., SOLOMON, L. J., FLYNN, B. S. (1992). Smoking cessation among self-quitters. Health Psychol. 11(5): 331-334.

KAMARCK, T. W., LICHTENSTEIN, E. (1988). Program adherence and coping strategies as predictors of success in a smoking treatment program. Health Psychol. 7(6): 557-574.

KENFORD, S. L., FIORE, M. C., JORENBY, D. E., SMITH, S. S., WETTER, D., BAKER, T. B. (1994). Predicting smoking cessation. Who will quit with and without the nicotine patch. JAMA. 271(8): 589-594.

KING, T. K., MARCUS, B. H., PINTO, B. M., EMMONS, K. M., ABRAMS, D. B. (1996). Cognitive-behavioral mediators of changing multiple behaviors: smoking and a sedentary lifestyle. Prev Med. 25(6): 684-691.

KLESGES, R. C., BROWN, K., PASCALE, R. W., MURPHY, M., WILLIAMS, E., CIGRANG, J. A. (1988). Factors associated with participation, attrition, and outcome in a smoking cessation program at the workplace. Health Psychol. 7(6): 575-589.

KLESGES, R. C., KLESGES, L. M. (1988). Cigarette smoking as a dieting strategy in a university population. Int J Eating Disord. 7: 423-429.

KOWALSKI, S. D. (1997). Self-esteem and self-efficacy as predictors of success in smoking cessation. J Holist Nurs.15(2): 128-142.

LAZARUS, R. S., FOLKMAN, S. Estrés y procesos cognitivos. Martínez Roca, 1986.

MANKANI, S. K., GARABRANT, D. H., HOMA, D. M. (1996). Effectiveness of nicotine patches in a workplace smoking cessation program. An eleven-month follow-up study. J Occup Environ Med. 38(2): 184-189.

MARCUS, B. H., ALBRECHT, A. E., KING, T. K., PARISI, A. F., PINTO, B. M., ROBERTS, M., NIURA, R. S., ABRAMS, D. B. (1999). The efficacy of exercise as an aid for smoking cessation in women: a randomized controlled trial. Arch Intern Med. 159(11): 1229-1234.

MARCUS, B. H., ALBRECHT, A. E., NIAURA, R. S., TAYLOR, E. R., SIMKIN, L. R., FEDER, S. I., ABRAMS, D. B., THOMPSON, P. D. (1995). Exercise enhances the maintenance of smoking cessation in women. Addict Behav. 20(1): 87-92.

MARLATT, G. A., GORDON, J. R. Relapse prevention: maintenance strategies in the treatment of addictive behaviors. New York. Guilford Press, 1985.

MATHENY, K. B., WEATHERMAN, K. E. (1998). Predictors of smoking cessation and maintenance. J Clin Psychol. 54(2): 223-235.

MORENO, J. J., HERRERO, F.J. Tabaquismo. Programa para dejar de fumar. Díaz de Santos, 1998.

MOTHERSILL, K. J., MCDOWELL, I., ROSSER, W. (1988). Subject characteristics and long term post-program smoking cessation. Addict Behav. 13(1): 29-36.

MUÑOZ, R. F., MARTIN, B. V., POSNER, S. F., PEREZ, E. J. (1997). Mood management mail intervention increases abstinence rates for Spanish-speaking Latino smokers. Am J Community Psychol. 25(3): 325-343.

NIDES, M. A., RAKOS, R. F., GONZALES, D., MURRAY, R. P., TASHKIN, D. P., BJORNSON-BENSON, W. M., LINDGREN, P., CONNETT, J. E. (1995). Predictors of initial smoking cessation and relapse through the first 2 years of the Lung Health Study. J Consult Clin Psychol. 63(1): 60-69.

NORREGAARD, J., TONNESEN, P., PETERSEN, L. (1993). Predictors and reasons for relapse in smoking cessation with nicotine and placebo patches. Prev Med. 22(2): 261-271.

PINTO, B. M., BORRELLI, B., KING, T. K., BOCK, B. C., CLARK, M. M., ROBERTS, M., MARCUS, B. H. (1999). Weight control smoking among sedentary women. Addict Behav. 24(1): 75-86.

PIRIE, P. L., MCBRIDE, C. M., HELLERSTEDT, W., JEFFERY, R. W., HATSUKAMI, D., ALLEN, S., LANDO, H. (1992). Smoking cessation in women concerned about weight. Am J Public Health, 82 (9): 1238-1243.

PROCHASKA, J.O., PROCHASKA, J. M. Modelo transteórico de cambio para conductas adictivas. En Casas, M. Y Gossop, M. (eds.): Recaída y prevención de recaídas. CITRAN, 1993.

RICHMOND, R. L., AUSTIN, A., WEBSTER, I. W. (1988). Predicting abstainers in a smoking cessation programme administered by general practitioners. Int J Epidemiol. 17(3): 530-534.

SCHOLTE, R. H., BRETELER, M. H. (1997). Withdrawal symptoms and previous attempts to quit smoking: associations with self-efficacy. Subst Use Misuse. 32(2): 133-148.

SECKER-WALKER, R. H., FLYNN, B. S., SOLOMON, L. J., VACEK, P. M., BRONSON, D. L. (1990). Predictors of smoking behavior change 6 and 18 months after individual counseling during periodic health examinations. Prev Med. 19(6): 675-685.

STUART, K., BORLAND, R. MCMURRAY, N. (1994). Self-efficacy, health locus of control, and smoking cessation. Addict Behav. 19(1): 1-12.

SWAN, G. E., DENK, C. E., PARKER, S. D., CARMELLI, D., FURZE, C. T., ROSENMAN, R. H. (1988). Risk factors for late relapse in male and female ex-smokers. Addict Behav. 13(3): 253-266.

TALCOTT, G. W., FIEDLER, E. R., PASCALE, R.W., KLESGES, R. C., PETERSON, A. L., JOHNSON, R. S. (1995). Is weight gain after smoking cessation inevitable? J Consult Clin Psychol. 63(2): 313-316.

VÁZQUEZ, F. L. Y BECOÑA, E. (1998): Variables predictivas del consumo de cigarrillos y de la abstinencia en un programa para dejar de fumar. Psicología Conductual 6 (3): 501-518.

WARD, K. D., KLESGES, R. C., ZBIKOWSKI, S. M., BLISS, R. E., GARVEY, A. J. (1997). Gender differences in the outcome of an unaided smoking cessation attempt. Addict. Behav. 22 (4): 521-533.

WEST, R. J., HAJEK, P., BELCHER, M. (1989). Severity of withdrawal symptoms as a predictor of outcome of an attempt to quit smoking. Psychol Med. 19(4): 981-985.

WESTMAN, E. C., BEHM, F. M., SIMEL, D. L., ROSE, J. E. (1997). Smoking behavior on the first day of a quit attempt predicts long-term abstinence. Arch Intern Med. 157(3): 335-340.

WOJCIK, J. (1988). Social learning predictors of the avoidance of smoking relapse. Addictive Behaviors, 13: 177-180.

ZIMMERMAN, R. S., WARHEIT, G. J., ULBRICH, P. M., AUTH, J. B. (1990). The relationship between alcohol use and attempts and success at smoking cessation. Addict Behav. 15(3): 197-207.

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2000-09-15

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