Evolution of anxiety during the smoking cessation process at a Smoking Cessation Clinic
DOI:
https://doi.org/10.20882/adicciones.173Keywords:
Smoking addiction, state anxiety, trait anxiety, abstinenceAbstract
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.References
World Health Organization. The European report on tobacco control policy. WHO European ministerial conference for a tobacco-free Europe. Warsaw: World Health Organization, Feb 18-19, 2002.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed. Revised). Washington, DC: APA.; 2000.
Spielberger CD, Pollans CH, Worden TJ. Anxiety disorders. En: Turner SM Hersen M. Editores. Adult psychopathology and diagnosis. Nueva York: Wiley; 1984. p.263-303.
Bermúdez J. En: Bermúdez J, Pérez AM, Sanjuán P, editores. Psicología de la personalidad: Teoría e investigación, Volumen II. Madrid: Universidad Nacional de Educación a Distancia; 2003.p.55-108.
Jarvis MJ. A profile of tobacco smoking. Addiction 1994;89:1371-76.
West R, Hajek P. What happens to anxiety levels on giving up smoking? Am J Psychiatry 1997; 154:1589-92.
Quesada M, Carreras JM, Sánchez L. Recaída en el abandono del
consumo de tabaco: una revisión. Adicciones 2002;14: 65-78.
Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.
Nerín I, Novella P, Belmonte A, Gargallo P, Jiménez-Muro A y Marqueta A. Resultados del tratamiento del tabaquismo en una unidad especializada. Arch Bronconeumol. 2007;43:669-73.
Hughes JR, Gulliver SB, Fenwick JW, Walliera WA, Cruser K, et al. Smoking cessation among self-quitters. Health Psychol. 1992;11:331-4.
Marlatt GA, Gordon JR. Relapse prevention. Maintenance strategies in the treatment of addictive behaviours. Nueva York: Guildford Press. 1985
Gilpin EA, Pierce JP, Farkas AJ. Duration of smoking abstinence and success in quitting. J Natl Cancer Inst 1997; 89:572-6.
American Psychiatric Association. DSM-IV-TR. Manual diagnóstico
y estadístico de los trastornos mentales. Barcelona: Masson S.A.;2002
Organización Mundial de la Salud (OMS). Guía de bolsillo de la clasificación CIE-10. Clasificación de los trastornos mentales y del comportamiento (CIE-10). Madrid: Ed. Médica Panamericana; 2000.
Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The
Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict 1991;86:1119-27.
Becoña E, Gomez-Duran B, Alvarez-Soto E, Garcia MP. Scores of Spanish smokers on Fagerström’s Tolerance Questionnaire. Psychol Rep 1992;71:1227-33.
Hughes JR, Keely JP, Niaura RS, Ossip-Klein DJ, Richmond RL, Swan GE. Measures of abstinence in clinical trials: issues and recommendations. Nicotine Tob Res 2003;5:13-25.
Jarvis MJ, Russell MA, Saloojee Y. Expired air carbon monoxiD.T.=
a simple breath test of tobacco smoke intake. Br Med J 1980; 281:484-5.
Seisdedos N. Cuestionario de Ansiedad Estado-Rasgo. Adaptación
española. Madrid: TEA Ediciones; 1988.
Becoña E. Tratamiento psicológico del tabaquismo. Adicciones 2004;16:237-64.
Parrot AC. Stress modulation over the day in cigarette smokers.
Adicction 1995;90:233-44.
Morissette SB, Tull MT, Gulliver SB, Kamholz BW, Zimering RT. Anxiety, anxiety disorders, tobacco use, and nicotine: a critical review of interrelationships. Psychol Bull 2007;133 :245-72.
Sandín B, Chorot P, Valiente RM, Lostao L, Santed MA. Ansiedad
anticipatoria asociada a las pruebas complementarias de screening de cáncer de mama. Psicothema 2001;13:240-46.
Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: A population-based prevalence study. JAMA 2000;284:2606-10.
Breslau N. Psychiatric Comorbidity of Smoking and Nicotine Dependence. Behav. Genet. 1995;25:95- 101.
Becoña E, Vázquez FL. Psicopatología del tabaquismo. Trastornos
Addictivos 1999; 1:27-33.
Gurrea A, Pinet MC. Tabaco y patología afectiva. Adicciones 2004;16:155-76.
Trosclair A, Dube SR. Smoking among adults reporting lifetime depression, anxiety, anxiety with depression, and major depressive episode, United States, 2005-2006. Addict Behav 2010;35:438-43.
Nerín I, Crucelaegui A, Mas A, Guillén D. Perfil de los fumadores
que solicitan tratamiento en una unidad de tabaquismo. Arch Bronconeumol 2003;39: 298-302.
Barrueco M, Jiménez C, Palomo L, Torrecilla M, Romero P, Riesco
JA. Abstinencia puntual y continuada con el tratamiento farmacológico
del tabaquismo en la práctica clínica. Med Clin (Barc) 2004;123: 652-57.
Becoña E, Vázquez FL, Míguez MC. Smoking cessation and
anxiety in a clinical sample. Pers Individ Dif 2002;32:489-94.
Piasecki TM. Relapse to smoking. Clinical Psychology Review 2006;26:196-15.
Shiffman S, Hickcox M, Paty JA, Gnys M, Richards T, Kassel JD.
Individual differences in the context of smoking lapse episodes. Addict Behav. 1997;22(6):797-811.
Takemura Y, Akanuma M, Kikuchi S, Inaba Y. Cross- Sectional
Study on the Relationship between Smoking or Smoking Cessation and Trait Anxiety. Prev Med 1999; 29:496-500.
Balfour DJ. The influence of stress on psychopharmacological
responses to nicotine. Br J Addict 1991;86:489-93.
Kassel JD, Shiffman S. Attentional medication of cigarette smoking’s effect on anxiety. Health Psychol 1997;16:359-68.
Canals J, Doménech E, Bladé J. Smoking and trait anxiety. Psychol Rep 1996 ;79:809-10.
Becoña E, Vázquez FL, Fuentes MJ, Lorenzo MC. Anxiety, affect,
depression and cigarette consumption. Personality and Individual Differences 1999; 26:113-19.
DiFranza JR, Savageau JA, Rigotti NA, Ockene JK, McNeill AD,
Coleman M, et al. Trait anxiety and nicotine dependence in adolescents: a report from the DANDY study. Addict Behav 2004;29:911-19.
Becoña E. Tabaco, ansiedad y estrés. Health and Addictions / Salud
y drogas 2003;3:70-92.
McClave AK, Dube SR, Strine TW, Kroenke K, Caraballo RS, Mokdad AH. Associations between smoking cessation and anxiety and depression among U.S. adults. Addict Behav 2009;34:491-7.
Becoña E, Míguez MC. Ansiedad y consumo de tabaco en niños y adolescentes. Adicciones 2004;16: 91-6.
Mykletun A, Overland S, Aarø LE, Liabø HM, Stewart R. Smoking
in relation to anxiety and depression: evidence from a large population survey: the HUNT study. Eur Psychiatry 2008 Mar; 23:77-84.
Nerín I, Beamonte A, Gargallo P, Jiménez-Muro A, Marqueta A.
Ganancia ponderal al dejar de fumar y su relación con la ansiedad. Arch Bronconeumol. 2007;43:9-15.
Sánchez López MP, Aparicio García ME, Dresch V. Ansiedad, autoestima y satisfacción autopercibida como predictores de la salud: diferencias entre hombres y mujeres. Psicothema 2006;18:584-90.
Bieling PJ, Antony MM, Swinson RP. The State-Trait Anxiety Inventory, Trait version: structure and content re-examined. Behav Res Ther 1998;36:777-88.


