M. Carmen Míguez

Evaluating the Effectiveness of a Single Telephone Contact as an Adjunct to a Self-Help Intervention for Smoking Cessation in a Randomized Controlled Trial

This study evaluated the effects of including a single brief prequit telephone counseling session in a self-help program for smoking cessation conducted through the mail, by comparison with the effects of the self-help program alone. Volunteer participants from northwestern Spain (N = 228) were randomly assigned to one of two groups: (a) the self-help-only group (n = 110, mean age = 37.4 years, pretreatment cigarette consumption = 26.5 cigarettes/day) or (b) the telephone-support group (n = 118, mean age = 36.8 years, pretreatment cigarette consumption = 27.7 cigarettes/day). Using a conservative data analysis method (missing data considered as treatment failures), we found that the point-prevalence abstinence rate was significantly higher in the telephone-support group than in the self-help-only group at the end of treatment (44.9% vs. 21.8%) and at the 3-month follow-up (39.0% vs. 26.4%). Likewise, sustained abstinence was significantly higher in the telephone-support group at the 3-month follow-up (33.9% vs. 13.6%), the 6-month follow-up (25.4% vs. 12.7%), and the 12-month follow-up (21.2% vs. 9.1%). The results of this randomized controlled trial indicate that both treatments are an effective aid for smoking cessation, and that a single brief telephone call before the quit date is a low-cost and effective procedure for improving abstinence rates in a mailed self-help program.

Group Behavior Therapy for Smoking Cessation

ABSTRACT The efficacy of behavioral treatment for smoking cessation is clear, whether applied individually or in groups. However, group intervention is more cost-effective, basically because it makes better use of the therapists time. The aims of this article are to demonstrate the utility and advantages of group-behavior therapy in smokers, and to report our clinical and experimental experience in this area, focusing on key aspects to be taken into account, and summarizing some results obtained. We conclude that group intervention should be used in treatments for smoking cessation wherever possible, as it is generally more efficient that individual intervention.

Smoking and depressive symptoms among children ages 11 to 16 years.

Relationships between cigarette smoking and depressive symptoms were analysed in a representative random sample of 1447 secondary-school children aged 11 to 16 years in Galicia (NW Spain). The sample comprised 797 boys (55.1%) and 650 girls (44.9%). Their mean age was 12.8 yr. (SD = 1.2). Depressive symptoms, evaluated with the Childrens Depression Inventory, were reported by 11.0% of children who responded they had never smoked, versus 23.7% of those who said they sometimes smoked, and 44.2% of those who identified themselves as current daily smokers. These results indicate an association between smoking and depression among children in this age group.

Abstinence from smoking ten years after participation in a randomized controlled trial of a self-help program

This study was based on a ten-year follow-up of smokers who had participated in a randomized controlled trial of a behavioral self-help program for smoking cessation. The original sample was made up of 200 smokers assigned at random to two treatment groups. Ten years later 93.5% (n=187) of the sample were successfully located (of the 13 not located, 6 had died), from whom information was obtained about their current state and the evolution of their smoking over the 10-year period. Reported abstinence at this follow-up was confirmed by carbon monoxide in expired air. Significant differences were found in the abstinence rates of the two groups at the follow-ups 1 year (14% vs. 28%) and 2 years (13% vs. 24%) after the end of the treatment. After 10 years 26% (n=52) of the total sample were abstinent. Over the ten-year period, 62.0% tried to give up smoking at some point, the mean figure for attempts being 1.3. According to the results of the 10-year follow-up, low nicotine dependence at pretreatment is a major factor predicting long-term cessation in smokers.

Tobacco consumption and spontaneous quitting at the first trimester of pregnancy

INTRODUCTION The purpose of this study was to examine the association between pregnant womens socio-demographic characteristics, smoking-related variables and psychological symptoms (anxiety and depression) and both tobacco consumption and spontaneous quitting at the first trimester of pregnancy. In particular, we wished to examine the contribution of depressive symptoms to tobacco consumption and spontaneous quitting, while controlling for anxiety symptoms, socio-demographic and smoking-related variables. METHODS The sample was comprised of 901 Spanish pregnant women. Assessment included an ad hoc questionnaire with socio-demographic and tobacco consumption information, the Edinburg Postnatal Depression Scale (EPDS), and The State-Anxiety Inventory (STAI-S). Two multiple logistic regression analyses were performed, respectively to predict tobacco consumption and to predict spontaneous quitting. RESULTS Having a partner who smokes (OR=5.578), not having a college education (OR=2.803), higher scores on the EPDS (OR=1.073) and higher scores on the STAI-S (OR=1.027) increase the probability of continuing smoking. Being primiparous (OR=2.463), having a college education (OR=2.141), smoking fewer cigarettes before pregnancy (OR=1.175), and lower scores on the STAI-S (OR=1.045) increase the probability of spontaneously quitting smoking at the first trimester of pregnancy. CONCLUSIONS Depressive symptoms were a predictor of tobacco consumption but not of spontaneous quitting; spontaneous quitting was better predicted by anxiety symptoms. These findings support recommendations that women with depressive symptoms are at risk for smoking during pregnancy and highlight that anxious symptoms should be targeted in interventions for smoking cessation during pregnancy.

Health-related quality of life among smoking relapsers

Background: Previous studies have shown that smoking is associated with health‐related quality of life (HRQoL) impairment. In order to evaluate HRQoL in a sample of Spanish relapsers, a cross‐sectional study was conducted. Method: The sample was made up of 775 smokers who had relapsed after a period of abstinence. HRQoL was evaluated using the Euro‐Qol questionnaire (EQ‐5D); through the descriptive profile, the EQ‐5D index and the visual analogue scale (EQ‐VAS). Results: Higher nicotine dependence was related to worse HRQL. According to the EQ‐VAS, higher daily cigarette consumption and more years smoking were related to worse perceived health. In the EQ‐5D those who had quit smoking in the previous year perceived worse health. Mobility and anxiety / depression are the dimensions affected by smoking. Those who are more nicotine dependent (OR = 2.29) and have been smoking for longer (OR = 4.12) are more likely to have mobility problems; and those who are nicotine dependent (OR = 1.85) and relapsed more than a year ago (OR = 0.63), are more likely to experience anxiety / depression. Conclusions: Nicotine dependence demonstrated a determining effect on HRQOL deterioration in smokers who have relapsed. &NA; La calidad de vida relacionada con la salud en fumadores que han recaído. Antecedentes: estudios previos demuestran que fumar produce un deterioro de la calidad de vida relacionada con la salud (CVRS). Para evaluar la CVRS en fumadores españoles que han recaído se realizó un estudio transversal. Método: la muestra estaba formada por 775 fumadores que habían recaído tras un período de abstinencia. La CVRS se evaluó mediante el cuestionario Euro‐Qol 5D (EQ‐5D), utilizando el perfil descriptivo, el índice EQ‐5D y la escala visual‐analógica (EQ‐EVA). Resultados: a mayor dependencia de la nicotina peor CVRS. En la EQ‐EVA, a mayor consumo diario de cigarrillos y más años consumiendo, peor estado de salud percibido. En el EQ‐5D los que dejaron de fumar en el último año son los que perciben peor estado de salud. Movilidad y ansiedad/depresión son las dimensiones afectadas en esta muestra de fumadores que han recaído. Es más probable que tengan problemas en movilidad los que tienen dependencia (OR = 2,29) y llevan más años fumando (OR = 4,12), y es más probable que presenten ansiedad/depresión los dependientes (OR = 1,85) y los que recayeron hace más de un año (OR = 0,63). Conclusiones: la dependencia de la nicotina mostró un efecto determinante en el deterioro de la CVRS en fumadores que han recaído.

Smoking relapse situations among a community-recruited sample of Spanish daily smokers

INTRODUCTION Relapse is a common factor within the behavior change process. However, there is scarce and limited knowledge of smoking relapse situations in population-based samples. The aim of this study was to identify smoking relapse situations among a sample of Spanish relapsers from the general population. METHODS A sample of 775 relapsers was recruited among the general population using a snowball method. Participants completed a survey including sociodemographic, smoking-related and psychopathology variables. Smoking relapse situations were identified through specific questions assessing different aspects related to the last relapse episode. RESULTS The majority of smoking relapse situations were attributed to positive affect (36.6%) and negative affect (34.3%), followed by lack of control (10.1%), smoking habit (6.7%), craving or nicotine withdrawal (6.3%), and social pressure (5.9%). Being unemployed and having a mental disorder in the past increased the likelihood of relapse in situations of negative affect. Being single and having quit smoking to save money were associated with an increased likelihood of relapse in situations of positive affect. CONCLUSIONS Affect plays a significant role in smoking relapse among a community sample of unassisted Spanish smokers. Relapse may be much more of an affective and situational process than a habit, physiological or social pressure. Findings from this study may help develop tailored community smoking relapse prevention strategies or programs.