Tratamiento de la dependencia del tabaco en un fumador que ha tenido un cáncer de pulmón

The relationship between smoking and lung cancer is well established. The leading known cause of lung cancer is the consumption of tobacco, which is responsible for 90% of lung cancer cases. In this article we present the case of a smoker who has had lung cancer in the past (survivor of lung adenocarcinoma a total of twelve years), who requires treatment to stop smoking, motivated by the fear of suffering from lung cancer again and dying from diseases related to the consumption of tobacco. He was given the cognitive-behavioral psychological treatment “Smoking Cessation Program.” It describes the assessment, treatment and subsequent follow-ups over twelve months. The result of this treatment shows that it is possible to quit smoking and remain abstinent from it during a year. This case highlights the physical and psychological benefits of quitting smoking, as well as the increase of health-related quality of life.La relación entre fumar y el cáncer de pulmón está bien establecida. La principal causa conocida del cáncer de pulmón es el consumo de tabaco, que es el responsable del 90% de los casos de cáncer de pulmón. En el presente artículo presentamos el caso de un fumador que ha tenido un cáncer de pulmón en el pasado (superviviente de doce años de un adenocarcinoma de pulmón), que demanda tratamiento para dejar de fumar por el miedo a padecer otro cáncer de pulmón y a morir por las enfermedades relacionadas con el consumo de tabaco. Se le aplicó el tratamiento psicológico cognitivo-conductual “Programa Para Dejar de Fumar”. Se describe la evaluación, tratamiento y seguimientos realizados durante doce meses. El resultado del tratamiento muestra que es posible dejar de fumar y mantenerse abstinente a lo largo de un año. También manifiesta claros beneficios del abandono del tabaco a nivel físico, psicológico y en su aumento de la calidad de vida relacionada con la salu

Trends in cause-specific mortality : deaths of despair in Spain, 1980-2019

Altres ajuts: Programa CERCABackground: Research from various countries has shown increases in alcohol- and drug-related deaths and suicide, known as 'deaths of despair' over recent decades, particularly among low-educated middle-aged individuals. However, little is known about trends in death-of-despair causes in Spain. Therefore, we aim to descriptively examine this among 25-64-year-olds from 1980 to 2019 and by educational attainment for the years 2017-19. Methods: We obtained mortality and population data from the National Institute of Statistics to estimate age-standardized mortality rates and assess educational inequalities using the relative index of inequality (RII). Results: Deaths of despair as a share of total mortality slightly increased from 2000 onwards, particularly among 25-64-year-old men (from 9 to 10%). Only alcohol-related mortality declined relatively more since 1980 compared with all-cause mortality. Regarding educational differences, low-educated men presented higher mortality rates in all death-of-despair causes (alcohol-related: RII 3.54 (95% CI: 2.21-5.66); drug-related: RII 3.49 (95% CI: 1.80-6.77); suicide: RII 1.97 (95% CI: 1.49-2.61)). Women noteworthy differences were only observed for alcohol-related (RII 3.50 (95% CI: 2.13-5.75)). Conclusions: Findings suggest an increasing proportion of deaths of despair among 25-64-year-olds since 2000, particularly among men. Public health policies are needed to reduce and prevent these premature and preventable causes of mortalit

Estimation of smoking-related mortality and its contribution to educational inequalities in life expectancy in Spain : an observational study, 2016-2019

To estimate smoking-related mortality and its contribution to educational inequalities in life expectancy in Spain. Nationwide, observational study from 2016 to 2019. Population-attributable fractions were used to estimate age, sex and education-specific cause-of-death smoking-attributable mortality. Life table techniques and decomposition methods were used to estimate potential gains in life expectancy at age 35 and the cause-specific contributions of smoking-related mortality to life expectancy differences across educational groups. Spain. We use cause-specific mortality data from population registers and smoking prevalence from the National and the European Health Survey for Spain from 2017 and 2019/2020, respectively. We estimated 219 086 smoking-related deaths during 2016-2019, equalling 13% of all deaths, 83.7% of those in men. In the absence of smoking, potential gains in male life expectancy were higher among the low-educated than the high-educated (3.1 vs 2.1 years). For women, educational differences were less and also in the opposite direction (0.6 vs 0.9 years). The contribution of smoking to life expectancy differences between high-educated and low-educated groups accounted for 1.5 years among men, and −0.2 years among women. For men, the contribution of smoking to these differences was mostly driven by cancer in middle age, cardiometabolic diseases at younger ages and respiratory diseases at older ages. For women, the contribution to this gap, although negligible, was driven by cancer at older ages among the higher educated. Smoking remains a relevant preventable risk factor of premature mortality in Spain, disproportionately affecting life expectancy of low-educated men

La máquina en Julio Cortázar y Raymond Roussel

Este trabajo pretende discutir el concepto de máquina a partir del texto “De otra máquina célibe”, de Júlio Cortázar. A través de la lectura que Cortázar hace del escritor francés Raymond Roussel, nos interesa observar cómo tal concepto atraviesa el proyecto estético del autor en cuestión y cómo este despliega una mirada crítica del lenguaje en la cual su doble carácter de lengua de comunicación e instrumento verbal juega productivamente en la creación artística.Simposio: Literatura y técnicaCentro de Estudios de Teoría y Crítica Literari

La máquina en Julio Cortázar y Raymond Roussel

Este trabajo pretende discutir el concepto de máquina a partir del texto “De otra máquina célibe”, de Júlio Cortázar. A través de la lectura que Cortázar hace del escritor francés Raymond Roussel, nos interesa observar cómo tal concepto atraviesa el proyecto estético del autor en cuestión y cómo este despliega una mirada crítica del lenguaje en la cual su doble carácter de lengua de comunicación e instrumento verbal juega productivamente en la creación artística.Simposio: Literatura y técnicaCentro de Estudios de Teoría y Crítica Literari

La máquina en Julio Cortázar y Raymond Roussel

Este trabajo pretende discutir el concepto de máquina a partir del texto “De otra máquina célibe”, de Júlio Cortázar. A través de la lectura que Cortázar hace del escritor francés Raymond Roussel, nos interesa observar cómo tal concepto atraviesa el proyecto estético del autor en cuestión y cómo este despliega una mirada crítica del lenguaje en la cual su doble carácter de lengua de comunicación e instrumento verbal juega productivamente en la creación artística.Simposio: Literatura y técnicaCentro de Estudios de Teoría y Crítica Literari

Treatment of tobacco dependence in a smoker who has had lung cancer in the past

La relación entre fumar y el cáncer de pulmón está bien establecida. La principal causa conocida del cáncer de pulmón es el consumo de tabaco, que es el responsable del 90% de los casos de cáncer de pulmón. En el presente artículo presentamos el caso de un fumador que ha tenido un cáncer de pulmón en el pasado (superviviente de doce años de un adenocarcinoma de pulmón), que demanda tratamiento para dejar de fumar por el miedo a padecer otro cáncer de pulmón y a morir por las enfermedades relacionadas con el consumo de tabaco. Se le aplicó el tratamiento psicológico cognitivo-conductual “Programa Para Dejar de Fumar”. Se describe la evaluación, tratamiento y seguimientos realizados durante doce meses. El resultado del tratamiento muestra que es posible dejar de fumar y mantenerse abstinente a lo largo de un año. También manifiesta claros beneficios del abandono del tabaco a nivel físico, psicológico y en su aumento de la calidad de vida relacionada con la saludThe relationship between smoking and lung cancer is well established. The leading known cause of lung cancer is the consumption of tobacco, which is responsible for 90% of lung cancer cases. In this article we present the case of a smoker who has had lung cancer in the past (survivor of lung adenocarcinoma a total of twelve years), who requires treatment to stop smoking, motivated by the fear of suffering from lung cancer again and dying from diseases related to the consumption of tobacco. He was given the cognitive-behavioral psychological treatment “Smoking Cessation Program.” It describes the assessment, treatment and subsequent follow-ups over twelve months. The result of this treatment shows that it is possible to quit smoking and remain abstinent from it during a year. This case highlights the physical and psychological benefits of quitting smoking, as well as the increase of healthrelated quality of lifeS

Gender differences in personality patterns and smoking status after a smoking cessation treatment

Background The lack of conclusive results and the scarce use of the Millon Clinical Multiaxial Inventory-III (MCMI-III) in the study of the relationship between smoking and personality are the reasons that motivated the study reported here. The aim of the present study was to analyze the influence of personality patterns, assessed with the MCMI-III, and of nicotine dependence on treatment outcomes at the end of the treatment and at 12 months follow-up in men and women smokers receiving cognitive-behavioral treatment for smoking cessation. Methods The sample was made up of 288 smokers who received cognitive-behavioral treatment for smoking cessation. Personality patterns were assessed with the Millon Clinical Multiaxial Inventory-III (MCMI-III). Abstinence at the end of the treatment and at 12-month follow-up was validated with the test for carbon monoxide in expired air. Results The results showed significant differences by personality patterns that predict nicotine dependence (Narcissistic and Antisocial in men and Schizoid in women). At the end of the treatment it is more likely that quit smoking males with a Compulsive pattern and less likely in those scoring high in Depressive, Antisocial, Sadistic, Negativistic, Masochistic, Schizotypal and Borderline. In women, it is less likely that quit smoking those with the Schizoid pattern. At 12 months follow-up it is more likely that continue abstinent those males with a high score in the Compulsive pattern. Furthermore, nicotine dependence was an important variable for predicting outcome at the end of the treatment and smoking status at 12 months follow-up in both men and women. Conclusions We found substantial differences by gender in some personality patterns in a sample of smokers who received cognitive-behavioral treatment for smoking cessation. We should consider the existence of different personality patterns in men and women who seek treatment for smoking cessationFunding for this study was provided by the Spanish Ministry of Science and Innovation (Ministerio de Ciencia e Innovación) (National Basic Research Projects). Project reference: PSI2008-02597/PSIC. Bárbara Piñeiro is the beneficiary of a Pre-Doctoral Research Training Grant (FPI) from the Ministry of Science and Innovation; reference BES-2009-012929S

Craving y abstinencia de la nicotina en fumadores españoles en un tratamiento para dejar de fumar

Craving and nicotine withdrawal syndrome (NWS) are components of the tobacco use disorder in DSM-5. They both appear after smoking cessation or an abrupt reduction in tobacco use, and they are associated with both short and long-term smoking-cessation outcomes. The aim of the present study was to examine the association of craving and withdrawal with smoking cessation at the end of the treatment and relapse at 3 months follow-up in a Spanish sample of smokers. The sample comprised 342 smokers (37.7% men; 62.3% women) receiving a cognitive-behavioral treatment for smoking cessation. The assessments of craving and withdrawal were conducted using the Minnesota Nicotine Withdrawal Scale. Abstainers at the end of the treatment, compared to non abstainers, showed significantly lower post-treatment withdrawal, and post-treatment craving. Furthermore, they had lower scores in pre-treatment nicotine dependence. Among abstainers, craving decreased significantly from pre-cessation levels, while in those participants who did not quit smoking it remained on the same levels. High nicotine dependence was a predictor of smoking at the end of the treatment, whereas high nicotine withdrawal predicted relapse at 3 months. Findings support the robust role of craving and NWS in smoking cessation and relapse, although they differ in their specific patterns of change over timeEl craving y el síndrome de abstinencia de la nicotina (SAN) forman parte del trastorno por consumo del tabaco en el DSM-5. Ambos aparecen tras dejar de fumar o tras una reducción brusca del consumo de tabaco, y están relacionados con los resultados de dejar de fumar a corto y largo plazo. El objetivo del presente estudio fue analizar la relación del craving y del síndrome de abstinencia con dejar de fumar al final del tratamiento y con la recaída a los 3 meses de seguimiento en una muestra de fumadores españoles. La muestra estaba formada por 342 fumadores (37,7% hombres; 62,3% mujeres) que recibieron tratamiento cognitivo-conductual para dejar de fumar. La evaluación del craving y del síndrome de abstinencia se realizó a través de la escala Minnesota Nicotine Withdrawal Scale. Los abstinentes al final del tratamiento, comparados con los no abstinentes, mostraron un síndrome de abstinencia y un craving significativamente menor al finalizar el tratamiento. Además, los abstinentes tenían puntuaciones menores en dependencia de la nicotina antes del tratamiento. Entre los abstinentes, el craving descendió significativamente desde los valores presentados antes de dejar de fumar, mientras que en los participantes que no dejaron de fumar los valores de craving permanecieron en los mismos niveles. La dependencia de la nicotina elevada fue el predictor de fumar al final del tratamiento, mientras que el síndrome de abstinencia de la nicotina elevado fue predictor de la recaída a los 3 meses. Los resultados apoyan el papel robusto del craving y del SAN en dejar de fumar y en la recaída, aunque difieren en sus patrones de cambio a lo largo del tiempoThis study was funded by the Spanish Ministry of Science and Innovation (Ministerio de Ciencia e Innovación), “National Program for Basic Research Projects” (PSI2008-02597/PSIC)S

Motivational Interviewing in smoking treatment: a review

La Entrevista Motivacional (EM) ha demostrado su eficacia en un amplio rango de conductas adictivas. Sin embargo, con el tabaco es donde resulta más difícil demostrar su eficacia. La EM proporciona estrategias motivacionales específicas para cada estadio de cambio. El objetivo de este trabajo es revisar los estudios que investigan el uso de la EM en el tratamiento del tabaquismo con el fin de ofrecer una actualización de su eficacia. Para ello, se han revisado las investigaciones más importantes, publicadas a nivel internacional y en España. La revisión de los 33 estudios seleccionados nos lleva a concluir que es muy difícil evaluar y comparar los resultados de los estudios entre sí, debido a la variabilidad y heterogeneidad de los mismos. De ahí que sea en este campo donde se muestren los resultados más contradictorios sobre su eficacia. Se necesita, por lo tanto, más investigación para determinar la fiabilidad y las posibles explicaciones para los hallazgos discrepantes observados en el tabaquismo. Finalmente se sugiere la necesidad de conocer dónde y cómo interviene la EM dentro del tratamiento y qué condiciones podrían afectar a su eficaciaMotivational Interviewing (MI) has proved to be effective with a wide range of addictive behaviors. However, in the case of tobacco smoking it is more difficult to demonstrate its effectiveness. MI provides specific motivational strategies for each stage of change. The aim of this paper is to review studies investigating the use of MI in the treatment of smoking in order to provide an update on its effectiveness. To this end, we reviewed the most important research published internationally and in Spain. A review of 33 selected studies leads us to conclude that it is very difficult to assess and compare the results of the studies in view of their variability and heterogeneity. Hence, it is in this area that we see the most contradictory results on its effectiveness. We therefore need more research in order to determine its reliability and possible explanations for the discrepant findings observed in studies of smoking cessation. Finally, we strongly suggest the need to know which treatment location is best, how MI functions in treatment programs and which conditions may affect its effectivenessS