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Objective: To determine whether or not nicotine addiction treatment was less effective in psychiatric than in the healthy population., Material and Methods: A retrospective, descriptive and comparative cohort study was conducted in Albacete University Hospital during years 2008-2012 on all patients that attended the Tobacco Cessation Unit. The statistical tests used were Chi-squared, likelihood ratio, and the Student t test. Statistical significance P≤.05., Results: The study included a total of 1,484 patients, of which 48.6% were female. The mean age was 46.8 years, and the mean age of starting smoking was 17.6 years. The mean number of previous attempts to quit was 1.48, and mean number of cigarettes smoked was 25.39. They had a mean Fagerström score of 6.04, a Richmond score of 8.13, and a mean carbon monoxide level of 16.65ppm. Most patients were referred from Primary Care (38.7%) and Chest Diseases department (33%), and the type of tobacco smoked was "light" in 75.8%. There was 15% with chronic obstructive pulmonary disease, 8% with asthma, and 9.4% with obstructive sleep apnoea syndrome. Furthermore, there was respiratory disease in 28.7%, cardiovascular disease in 4.6%, and both in 3.5%. Hiatus hernia was present in 7.2%, thyroid disease in 3.8%, hypertension in 19%, diabetes in 10.7%, and dyslipidaemia in 29.4%, Drugs were used by 7.1%, and 12.6% consumed alcohol. There was 39.3% psychiatric comorbidity (PC), and were comparable except in gender, age of onset, Fagerström, Richmond, source of referral, asthma, hiatus hernia, thyroid disease, hypertension, as well as drugs and treatment. Drug treatment was completed by 22.3% in the PC group, with no significant difference. There were differences in success (P=.008), but not in failure and relapse rates., Conclusion: Anti-smoking treatment in psychiatric patients is effective. An increase in the probability of treatment success is observed in patients without psychiatric comorbidity., (Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Primary Objective: To assess the evolution of smoking cessation process after using a COPD-6 Vitalograph in smokers that came to a primary care practice (PCP) during a three year period (March 2011- February 2013)., Secondary Objectives: To assess if there are any new COPD diagnoses and to compare the smoking cessation outcomes to those of a specific smoking cessation practice (SSCP) from another healthcare centre., Methodology: Two devices were used: Vitalograph (electronic device measuring the lung function) and the CO-oximeter, in 176 patients (active search of smokers)., Variables: tobacco pack-years, tobacco dependence (shortened Fagerström test), CO in exhaled breath (in parts per million-ppm), personal history of COPD or cardiovascular disease (CVD). The patients performed three forced exhalations and the Vitalograph registered the lung function (FEV1, FEV6, FEV1/FEV6) and the estimated lung age (ELA). Patient attitude was assessed (phases: pre-contemplation, contemplation, preparation) before and after the test, informing them of the outcomes. Patient progress in the smoking cessation process was also recorded., Results: A total of 176 smokers were studied in PCP and 33 in SSCP. PCP/SSCP: age: 45.9/51.6 years old (p=042); pack-years 25.5/39.3 (p=0001); patients who quit smoking and used medicines for it 2/9. In PCP: age-ELA 45.9/57.4 (p=0.000). In SSCP: age-ELA 51.6/74.3 (p=000). Smoking habit evolution PCP/SSCP: cessation 24.5%/48.5% (p=004). Difference 24%. CI difference (6.4-42.8%). In PCP new COPD diagnosis in 6 smokers., Conclusions: COPD-6 Vitalograph is a fast and easy to use tool in day-to-day practice. The percentage of smoking cessation is better in SSCP, although a high smoking cessation rate was obtained in PCP (active search)., (Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

We present in this work a descriptive study of series of cases in treatment for nicotine addiction with a multicomponent program focusing on a systemic-relational therapy. While a good number of smokers are able to stop smoking, with the help of different programs with different levels of complexity depending on their level of addiction, there is a group of smokers who associate their difficulty to stop smoking with aspects related to their life cycle situation, problems with their family of origin or with their social network. We revised the most relevant clinical aspects of the model and presented the results of a descriptive study of a series of 128 patients, of wich 60.50% expressed family and/or personal problems that made the possibilities of success in the program more difficult. After an intervention that lasted a year during wich there were 25 therapy sessions together with combined substitute therapy with nicotine (STN) during the first 3 months of treatment, 77.30% maintained abstinence. Nowadays we know much more about nicotine addictions, giving different answers to different needs, just like the different levels of complexity of each addict. We consider that the contributions of the systemic-relational model in its different ways of understanding the intervention, can better the results of the treatment. We are justified in increasing the level of complexity of the interventions when there exist complications in the clinical handling of nicotine addiction because of other models of treatment of lesser intensity.

Background and Objective: To assess the cessation and relapse rates of smoking, and analyze the associated variables in a 12-month follow-up study at a smoking cessation unit., Subjects and Method: Patients from the Area de Salud 19 of the Conselleria de Sanitat of the Generalitat Valenciana, coming to a smoking cessation unit., Variables: sociodemographic, smoking habits, smoking social context, psychiatric or medical problems, use of other substances, and treatment. Treatment was administered either individually or in group, and with or without pharmacological support. Type of pharmacological treatment: nicotine replacement therapy and/or bupropion. Evaluation of smoking cessation and relapse: at the end of the treatment, and at follow-up months 1, 3, 6, 9, and 12. Criteria to accept cessation were: it had to be uninterrupted, referred as such by the patient and corroborated by relatives or other witnesses, and supported by a co-oxymetry level < or = 6 ppm., Statistical Analyses: description of quantitative and qualitative variables, evaluation of the relationship between relapse rate and follow-up time when it happens by means of Kaplan-Meier curves, Cox regression, construction of curves of prediction of cessation for subjects with different patterns in the independent variables, and estimations of risk of relapse between any 2 subjects, according to those patterns., Results: 255 subjects (46.7% males); 41.8 (10.8) years of mean age (standard deviation); 25 years of mean duration of the smoking habit; a mean of 2 to 3 previous attempts of cessation smoking, mean duration of the longest period of cessation 6 to 7 months; smoking habit 26.5 (12.1) mean of cigarrettes per day, the average nicotine dependency was moderate, and the average co-oxymetry levels high. Of all the subjects included, 53.3% received single therapy (60% together with pharmacological treatment) and 46.7% had group therapy (18.4% also with pharmacological treatment). Pharmacological treatment was 14.9% nicotine replacement therapy, 17.3% bupropion, and 7.1% both. At the end of the treatment, 42.7% of the subjects kept smoking and, at the end of the follow-up period only 11.4% remained abstinent. Median cessation extent was one month. VARIABLES associated to the extent of the cessation: type of therapy (individual or in a group), pharmacological support, and previous daily amount of cigarrette consume., Conclusions: There were high relapse rates, that depended on the previous amount of consume and on the treatment applied. Both group therapy and pharmacological treatment are significantly useful in order to obtain the best results in long-term cessation rates.