Maria Eugènia Gras

Smoking Cessation 1 Year Poststroke and Damage to the Insular Cortex

Background and Purpose— Hospitalization as a result of stroke provides an opportunity to stop smoking that is often not taken up. The present study analyzes sociodemographic, psychological, and lesion-related variables to identify associated factors for smoking cessation during the first year after stroke. Methods— We conducted a prospective longitudinal study with a 1-year follow-up of a cohort of 110 patients with acute stroke who were smokers at the time of diagnosis and were admitted consecutively between January 2005 and July 2007. Results— On hospital release, 69.1% had given up smoking but at 1 year, only 40% had stopped smoking. Of the 110 patients, 27 (24.5%) had an acute stroke lesion in the insular cortex, of which 19 (70.3%) were nonsmokers at 1 year. Strongly associated factors in giving up smoking were the location of the lesion in the insular cortex (OR, 5.42; 95% CI, 1.95–15.01; P=0.001) and having the intention of giving up before the stroke, comparing precontemplating patients (without intention of giving up in the near future) with contemplating and prepared patients (intention of stopping in the near future; OR, 7.29; 95% CI, 1.89–28.07; P=0.004). Conclusions— Of patients with stroke who were smokers, only 4 of 10 patients had stopped smoking 1 year after admission. Our results show that the variables best predicting smoking cessation in patients with a stroke diagnosis 1 year after hospital discharge are insular damage and the prestroke intention to stop.

Types of polydrug use among Spanish adolescents

OBJECTIVE This study examined the types of polydrug use among Spanish adolescents. METHOD 1501 high school students (50.6% female) aged 12 to 17years old (mean age=14.03, SD=1.28), from public schools in the city of Girona (Catalonia, Spain), completed the survey. RESULTS In the previous six months 20.9% of the Spanish adolescents used alcohol, 18.8% tobacco, 10.5% cannabis and 0.7% cocaine. Specifically, 28.6% of the sample (n=429; 29% males and 28.2% females) used at least one drug and 13.9% reported polydrug use (n=208; 12.6% males and 15.1% females). The present research also found that the most critical ages for starting polydrug use were 14 and 15years old. More than one quarter (27.9%) of the adolescent polydrug users were type A (tobacco and alcohol), 67.8% were type B (cannabis together with tobacco and/or alcohol) and 3.4% were type C (cannabis together with tobacco and/or alcohol, and cocaine). CONCLUSIONS These results suggest that Spanish adolescents, particularly males, commence polydrug use at an earlier age than other European adolescents. Early preventative strategies and a multisubstance perspective are greatly needed in Spain to avoid the initiation of polydrug use or to prevent progress onto heavier drugs.

Policonsumo de drogas y su relación con el contexto familiar y social en jóvenes universitarios

The prevalence of polydrug use continues to grow among Spanish college students. The European Observatory for Drugs and Addictions establishes three different types of polydrug use: Pattern A (consumers of alcohol and tobacco), Pattern B (consumers of cannabis plus alcohol and/or tobacco) and Pattern C (consumers of cannabis plus alcohol plus tobacco plus at least one other kind of illegal drug). The objectives are: 1) to study the frequency of substance consumption among a sample of young Spanish undergradudates studying health and sports science according to their sex; 2) to describe the patterns of polydrug use; 3) to study the relationship between the polydrug use of the participants and polydrug use within their closest environment (parents, sisters or brothers, best friend and partner). The sample was composed of 480 Spanish undergraduates (43.7% females) aged 18 to 36. The level of drug consumption of students and their closest reference persons was evaluated by means of a self-report measure. A total of 46% of the participants reported consumption of two or more substances; among them 29.4% corresponded to Pattern A, 50.7% to Pattern B and 16.7% to Pattern C, while 3.2% corresponded to other multiple consumption patterns (alcohol + cocaine; alcohol + cocaine + tobacco; alcohol + inhalants; amphetamines + hallucinogens + Spice). An important correlation was observed concerning polydrug use between participants and their closest reference persons: the more the reference person is a multiple consumer, the more the participant tends to consume. Polydrug use within the closest environment emerges as one of the key elements to be taken into account in further prevention programs.

Calidad de vida relacionada con la salud y consumo de tabaco

La calidad de vida relacionada con la salud se ha descrito como un concepto multidimensional que incluye la identificacion de sintomas, el estado funcional, la percepcion de bienestar psicologico y la percepcion general de salud. En el caso de la adiccion al consumo de tabaco, la preocupacion por la salud actual o futura es uno de los motivos mas informados para dejar de fumar. En el presente estudio se analiza la relacion entre la percepcion de la calidad de vida relacionada con la salud y la etapa de cambio en el abandono del consumo de tabaco propuesta desde el modelo transteorico a fin de mejorar las estrategias de intervencion comunitaria y clinica para la cesacion tabaquica. Se ha administrado el cuestionario SF-36 a una muestra formada por 201 fumadores y exfumadores. Los datos obtenidos indican peor salud fisica percibida en las etapas de cambio mas proximas al abandono de tabaco y una peor salud mental percibida en las etapas con tabaquismo activo. Se comparan los resultados con los observados en otras poblaciones y se discuten las implicaciones a nivel de tratamiento y prevencion del tabaquismo.

Types of Polydrug Usage

Abstract The purpose of this chapter is to describe the different types of polydrug use among adolescents and adults. The examination of the natural heterogeneity in the typologies of polydrug users may be a helpful strategy to understand the etiology and problematic use. Alcohol is present among almost all types of polydrug users. Alcohol and tobacco, followed by illegal drugs (marijuana in particular), are a combination frequently used by adolescents and young adults. The majority of studies focus either on specific populations or on specific substances, or even only on indicators of polydrug use. Few studies have provided apparent evidence concerning similar types of polysubstance use. Future studies should be based on participants from the general population, clarify the concept of polydrug use, examine wider ranges of drugs, and measure polysubstance use over time. Early preventive interventions are needed, which provide a polysubstance perspective required to avoid the initiation and maintenance of polydrug use.

Concurrent and Simultaneous Use of Cannabis and Tobacco and Its Relationship with Academic Achievement amongst University Students

The combined use of cannabis and tobacco is frequent in Europe. Few studies have nonetheless explored this pattern of consumption and its relationship with academic achievement in Spanish population. The aim of the present study was to analyze (1) the frequency of four patterns of polydrug use the last year (non-dual users of cannabis and tobacco; concurrent users: cannabis and tobacco separately; simultaneous users: tobacco in cannabis “joints”; simultaneous users: tobacco in cannabis joints alongside alcohol) by gender and age; (2) grade point average (GPA) by gender and age; (3) the association between the frequency of the four patterns of use and the GPA amongst a sample of 477 Spanish university students. The use of cannabis and tobacco (concurrent and simultaneous) and GPA were assessed by means of self-reported questionnaires. Statistically significant differences were found for the GPA with respect to gender. The GPA by the non-dual users of cannabis and tobacco was significantly higher than the GPA corresponding to the concurrent and simultaneous users. The combined use of cannabis and tobacco, regardless of the type of use (concurrent or simultaneous), is moderately related to poor academic achievement amongst university students.