Elisardo Becoña

The Fagerström Test for Nicotine Dependence in a Spanish Sample

The Fagerström Test for Nicotine Dependence was developed to improve the reliability and validity of the Fagerström Tolerance Questionnaire. In this study, we examined the applicability of the Spanish version of such test as well as its relationship to sex, age, and consumption of cigarettes, in a representative sample of smokers from Galicia, Spain (N = 646).

Pathological gambling and depression.

A number of previous studies have indicated that pathological gambling is often associated with depression. Equally, a number of theoretical models of pathological gambling have included depression as a key variable. Here we report a study of depression in pathological gamblers identified within a random sample of 1,615 adults living in the major cities of Galicia (northwest Spain). Pathological gamblers were identified on DSM–IV diagnostic criteria. Depression was evaluated with the Beck Depression Inventory, subjects being classified ‘depressive’ if they obtained a score of 18 or more. Of 19 pathological gamblers who completed the Beck Depression Inventory, 21% were depressive; by contrast, only 9% of the other subjects were depressive. The Beck scores of pathological gamblers were positively correlated with the severity of their addiction as indicated by the number of DSM–IV-specified symptoms reported.

Exploring brief measures of nicotine dependence for epidemiological surveys.

A score > or = 6 in the Fagerström Test for Nicotine Dependence (FTND), identifying high nicotine dependence, was compared with three briefer classifications: (1) Item 4: heavy smoking (more than 30 cigarettes per day); (2) Item 1: high early smoking (smoking within 30 min of waking up); and (3) a score > or = 4 by combining Items 1 and 4. The FTND scores from 1642 smokers from five samples in the US and Spain were analyzed. Heavy smoking had low sensitivity. High early smoking had low specificity. A score > or = 4 by combining Items 1 and 4 had relatively good sensitivity (94%) and specificity (88%). Researchers needing definition of nicotine dependence briefer than FTND may want to only use Items 1 and 4 of FTND with a cutting score > or = 4.

Pathological Gambling in Spanish Children and Adolescents: An Emerging Problem

Several studies have shown a high prevalence of pathological gamblers among adults in Spain (between 1.5% and 1.7%) of the population (18 years and older). In other countries the prevalence of pathological gambling in children and adolescents has been higher than in adults. Here some results of the first studies conducted in Spain concerning the prevalence of pathological gambling in school children and adolescents (11–16 years) are presented for two cities located in different northern regions of Spain, A Coruña (Galicia) and Gijón (Asturias), with representative samples of school children. The prevalence was 2.2% (n = 1,200) and 1.6% (n = 2,185), respectively, for the use of slot machines, using the 1993 DSM-IVJ Questionnaire of Fisher, and 2.4% in the first city with the South Oaks Gambling Screen-Revised Adolescent for all types of gambling. The analyses suggest there is an emerging problem among children and adolescents in Spain perhaps leading to an increased number of pathological gamblers as adults.

Parental styles and drug use: A review

The family plays a fundamental role in the prevention and treatment of substance use. Parental styles are among the family variables most widely studied. This review covers the studies published in the last 30 years on the relationship between parental styles and their offsprings drug use. Research indicates that the authoritative style is the most protective against substance use, whilst the neglectful style would increase the risk of drug use; research on the authoritarian and permissive styles is as yet inconclusive. We discuss the need to take into account other family variables in addition to parental style, such as parents’ drug use, emotional support and warmth, family structure and the influence of culture.

DOES USING RELAPSE PREVENTION INCREASE THE EFFICACY OF A PROGRAM FOR SMOKING CESSATION?: AN EMPIRICAL STUDY '

The aim of this study was to assess the effectiveness of relapse prevention taught as a problem-solving procedure in increasing the efficacy of a behavioral program for smoking cessation at short- and longer-term, 12-mo. follow-up. 75 smokers were assigned randomly to two treatment groups, using an additional 40 smokers who attended an information session but did not receive any treatment session as a control group. The first group (n = 40) received the standard behavioral multicomponent program of Becoña. The program included motivational contract, self-monitoring, information on smoking, nicotine fading, stimulus control, avoidance of withdrawal symptoms, physiological feedback, and progressive self-control. The second group (n = 36), the relapse prevention group, were given the above program and an additional component of relapse prevention using a problem solving procedure. Both groups had 8 sessions of treatment. Analysis showed that at the end of treatment abstinence in the two groups was 80.0% and 61.1%, respectively, at the 12-mo. follow-ups 30.0% and 36.1%. These differences were not significant; however, both groups were significantly different from the control group at the end of treatment (0% abstinence) and at 12-mo. follow-ups (2.5% abstinence). These results show that the addition of this relapse prevention does not increase the number of smokers who quit or decrease the number who relapse. Further research should focus on the process of relapse and develop more effective procedures to help maintain abstinence.

Effectiveness of telephone contact as an adjunct to a self-help program for smoking cessation: A randomized controlled trial in Spanish smokers

This study evaluated the effect of telephone counseling as an adjunct to a self-help program for smoking cessation conducted through the mail. We obtained demographic and consumption information on those smokers who requested participation in the study. These participants (N = 200) were randomized into two study groups: (1) the standard self-help group (n = 100) (median age: 35.1 years; pretreatment consumption of 28.0 cigarettes/day); (2) the self-help group receiving additional multiple-contact telephone counseling (n = 100) (median age: 36.7 years; pretreatment consumption of 27.3 cigarettes/day). At the 12-month follow-up, the carbon monoxide in expired air was used to distinguish nonsmokers from smokers. Significant differences were found in the rates of continuous abstinence in both groups for each period evaluated. In the standard self-help group, the continuous abstinence rate at the 3-month follow-up was 21%, 18% at the 6-month follow-up, and 14% at the 12-month follow-up. The telephone counseling group yielded a 48% continuous abstinence rate at the 3-month follow-up, 40% at the 6-month follow-up, and 27% at the 12-month follow-up. The results of this randomized controlled trial show that telephone counseling was an effective aid for the smoking cessation program.

Self-Reported Smoking and Measurement of Expired Air Carbon Monoxide in a Clinical Treatment:

In this study was evaluated the relationship between self-reported smoking rate and expired air carbon monoxide in 208 smokers who had attended a behavioral program for smoking cessation. A close relationship between carbon monoxide levels and self-reports was found at the end of treatment and in all follow-ups (6 and 12 mo.), around 100% concordance. Thus, support was found for the use of an expired air carbon monoxide measure as a valid and easy way of corroborating self-report data when required.

Anxiety, affect, depression and cigarette consumption

Abstract In recent years several studies have shown that cigarette consumption is related to anxiety, affect and depression. In the present study we analyze this relationship in a representative sample of the adult population of Galicia (Spain) (N=1,615, 18 or more years). Anxiety is assessed with the Trait-Scale of STAI by Spielberger et al., affect with the PANAS Scales by Watson and Tellegen and depression with the Beck Depression Inventory both in smokers and in non-smokers. Results of our study confirm a relationship between depression, negative affect and cigarette consumption and, especially, in the subjects with a consumption of 31 or more cigarettes daily.

Depression and Cocaine Dependence

Presence of depression in cocaine-dependent users is relevant for treatment of these persons. This study assessed the presence of depressive symptomatology with a published Spanish translation of the Beck Depression Inventory for a sample of 115 Spanish cocaine-dependent users who were in outpatient treatment at Centers of Drug Dependence of Galicia, Spain. The mean score was 13.7 (SD=10.3), with 24.3% of the sample having scores which indicate clinical depression (cut off ≥ 21). These data underscore the need to assess the presence of depression in cocaine-dependent users who require treatment.