Fernando L. Vázquez

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).

An adaptation of the Center for Epidemiologic Studies Depression Scale for use in non-psychiatric Spanish populations

To adapt the Center for Epidemiologic Studies Depression Scale for use in non-psychiatric Spanish populations, a Spanish translation of the scale was interviewer-administered to 554 subjects aged 18-34 years (65.9% women) and the ratings so obtained were compared with the SCID-CV-based diagnoses of expert clinicians. The internal consistency of the scale was satisfactory (Cronbachs alpha=0.89). Four factors identified by exploratory factor analysis (Depressive/Somatic, Positive Affect, Retarded Activity and Interpersonal Relations) accounted for 55.9% of the variance. A score of 26 was identified as a suitable cut-off for screening purposes, affording a sensitivity of 0.906 and a specificity of 0.918.

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.

Comparison of relaxation training with a cognitive-behavioural intervention for indicated prevention of depression in university students: A randomized controlled trial

Although cognitive-behavioural programmes for preventing depression have produced promising findings, their administration requires extensive training. Relaxation techniques are more straightforward psychological strategies, but they have not been investigated in the prevention of depression. This trial aimed to compare the results of relaxation training (RT) with that of a cognitive-behavioural programme (CBT) for prevention of depression in university students with elevated depressive symptoms. The 133 participants (mean age 23.3 years, 82% women) were randomly assigned to CBT or RT. Both programmes were administered to groups of 5 or 6 participants in eight weekly 90-min sessions. Participants were evaluated by independent raters before, immediately after, and 3 and 6 months after taking part in the programmes. By itself, intervention type had no significant effect on either depression or anxiety scores. The scores were lower at the follow-up time points with respect to pre-intervention scores. Effect size was greatest between pre- and immediately post-intervention scores for CBT, d = 1.32, 95% CI [1.00, 1.64], and between pre- and 6-month post-intervention scores for RT, d = 0.75, 95% CI [0.47, 1.03]. Anxiety symptoms were significantly improved by both interventions at 3-month follow-up, and by CBT at 6-month follow-up also. In the medium term (3-6 months), relaxation training produced similar reductions in depressive and anxiety symptoms as a more complex cognitive-behavioural programme.

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.

Symptoms of Depression and Related Factors among Spanish University Students

A 554-member stratified random sample of students at a Spanish university (65.9% women; aged 18–34 years) was screened for symptoms of depression using a new Castilian Spanish translation of the Center for Epidemiologic Studies Depression Scale (CES-D) that had been validated by back-translation. Mean CES-D score was 14.2 (SD = 10.3, range 0-54), with a significant difference between the scores of women (M = 15.5; SD = 10.9) and men (M = 11.8; SD = 8.4; t552 = 4.06, p <.0005). Some 33% of the sample screened positive with the usual CES-D screening threshold of 16, and 16% with the threshold of 24 recommended by Clarke and coworkers. The symptoms most commonly experienced all or most of the time were hopelessness, given the maximum rating by 18.8% of students, difficulty in concentration (17.7%), fatigue (13.9%), inadequacy (13.0%), and disturbance of sleep (12.4%).

Las mujeres y el tabaco: características ligadas al género

El porcentaje de mujeres fumadoras esta todavia aumentando en Espana. Si persisten los patrones actuales de fumar entre las mujeres, el numero de muertes continuara creciendo de modo acusado en el proximo siglo. Es posible que en un futuro cercano fumen mas mujeres que hombres entre la poblacion adulta espanola. En esta revision se actualiza lo que se conoce sobre el impacto que tiene fumar cigarrillos en la salud de las mujeres, los patrones de consumo actuales entre las mismas, los factores especiales que influyen en que fumen y las dificultades que tienen cuando consideran e intentan dejar de fumar. Tambien sugerimos formas en las cuales el consejo minimo, la terapia de conducta y los productos sustitutivos de la nicotina se pueden incorporar como estrategias de tratamiento adaptadas a las necesidades especiales de las mujeres que fuman.

Depression and smoking in a smoking cessation programme.

BACKGROUND The aim of this study has been to investigate the effect of depressive symptoms on the results of a smoking cessation programme. METHOD 186 received a multicomponent behavioural programme. At 12-month follow-up 160 subjects were contacted. Depression symptoms pretreatment and at the 12-month follow-up were evaluated using the Beck Depression Inventory (Beck et al., 1979. Cognitive Therapy of Depression. Guilford Press, New York.). RESULTS Smokers at 12-month follow-up had a mean score of 7.1 (S.D. = 5.8) and abstainers had a score of 5.2 (S.D. = 5.4). Depressive symptoms at 12 month follow-up were associated with smoking cessation at 12 month follow-up (t(1,158) = 1.98, P < 0.05), but depressive symptoms at baseline and smoking cessation end of treatment were not. LIMITATIONS The most important limitation in study has been the size of the sample (particularly in abstainers). CLINICAL RELEVANCE Depressive symptoms have an influence on efficacy at the 12-month follow-up, but not at the end of treatment. It does not seem necessary, for the moment, to introduce specific interventions targeted at the modification of negative mood.