Gastrointestinal adverse events are the most incident in this sample of psychiatric patients and no exacerbation of psychiatric symptoms was detected, thus indicating a good safety record for varenicline use for smoking cessation in psychiatric patients.

Objective: To describe the nicotine dependence and readiness to quit smoking in the smoker population. Methods: Cross-sectional study on a representative sample of the Spanish population of ≥18 years old. We gathered information by means of telephone interviews conducted between June and July of 2006. We studied the nicotine dependence with the Fagerström Test for Nicotine Dependence (FTND) and the readiness to quit according to the stages of change from the Transtheoretical Model in a sample of cigarette smokers. Results: 22.5% of participants (95% CI: 20.9-24.2%) smokers cigarettes. They smoked an average of 14.4 cigarettes per day (standard deviation 9.15) and the mean FTND score was 2.8, with no differences by the stages of change. 64.3% (95% CI: 60.3-68.2%) of smokers were in the precontemplation stage, 25.4% (95% CI: 21.8-28.9%) in contemplation, and 10.4% (95% CI: 7.9-12.9%) in preparation, with no differences by sex. The most nicotine dependent smokers (FTND≥6) had mainly primary studies, started to smoke at earlier ages, and smoked more cigarettes per day. Conclusions: Most Spanish smokers have low nicotine dependence and are in precontemplation stage. Smoking cessation programmes should be addressed to reduce dependence, help smokers to progress through the stages of change, and, consequently, reduce the prevalence of smokers in the population.Keywords: smoking, nicotine dependence, stages of change, transtheoretical model, prevalence, epidemiology RESUMEN ABSTRACTObjetivo: Describir la dependencia a la nicotina y la preparación para dejar de fumar en la población fumadora. Métodos: Estudio transversal de una muestra representativa de la población española ≥18 años. La información se obtuvo mediante entrevistas telefónicas realizadas en junio y julio de 2006. Se estudió la dependencia a la nicotina mediante el test de Fagerström (FTND) y la preparación para dejar de fumar de acuerdo a los estadios del cambio del modelo transteó-rico en una muestra de fumadores de cigarrillos.Resultados: El 22,5% de los participantes (IC 95%: 20,9-24,2%) fumaba cigarrillos. Su consumo medio fue de 14,4 cigarrillos diarios (desviación estándar 9,15) y su puntuación media en el FTND fue de 2,8, sin diferencias según los estadios del cambio. El 64,3% (IC 95%: 60,3-68,2%) de los fumadores estaba en el estadio de precontemplación, el 25,4% (IC 95%: 21,8-28,9%) en el de contemplación y el 10,4% (IC 95%: 7,9-12,9%) en el estadio de preparación, sin diferencias por sexo. Los fumadores más dependientes a la nicotina (FTND≥6) tenían mayoritariamente estudios primarios, comenzaron a fumar a edad más temprana y fumaban más cigarrillos al día.Conclusiones: Los fumadores presentan mayoritariamente un bajo nivel de dependencia a la nicotina y se encuentran en fase de precontemplación. Los programas de deshabituación deberían ir dirigidos a reducir el nivel de dependencia, ayudar a los fumadores a avanzar a través de los estadios del cambio y, consecuentemente, disminuir la prevalencia de fumadores en la población. Dependencia a la nic...

Smoking is one of the most important causes of morbidity and mortality in developed countries. One of the priorities of public health programmes is the reduction of its prevalence, which would involve millions of people quitting smoking, but cessation programs often have modest results, especially within certain population groups. The Palabras clave: tratamiento multicomponente, deshabituación tabá-quica, trastornos mentales, pacientes con alta dependencia.Resumen

INTRODUCTION Numerous studies have evaluated the efficacy and safety of varenicline for smoking cessation in smokers in the general population and, to a lesser extent, among the psychiatric population. However, few studies have evaluated varenicline in patients with other addictions. The present study was conducted to assess outcomes of a multimodal treatment for smoking cessation intervention with varenicline in a sample of alcohol and substance use disorders and patients with psychotic disorders. METHODS This was a prospective, multicenter study. The patient sample comprised alcoholics in remission, methadone-maintained patients, and patients with psychotic disorders, all of whom wanted to stop smoking. All participants received multimodal treatment for smoking cessation therapy (psychological therapy plus varenicline). Smoking abstinence and changes in the psychopathological state of patients were assessed at predefined time points during a 12-month follow-up. The probability of tobacco abstinence after one year of treatment was computed using Kaplan-Meier life tables. RESULTS The probability of abstinence at one year was 0.225 (95% CI: 0.1430-0.319). By group, the probabilities were as follows: patients with psychotic disorders 0.254 (95% CI: 0.118-0.415); alcoholics 0.237 (95% CI: 0.098-0.409); and methadone-maintained patients 0.177 (95% CI: 0.065-0.335). Patients with previous quit attempts had a higher probability of achieving abstinence at one year (p<0.01). CONCLUSIONS The results of this study support the use of multimodal treatment with varenicline in patients with alcohol addiction in remission, patients on methadone maintenance, and patients with stable psychotic disorders. Previous smoking cessation attempts were predictive of smoking cessation success in these patients.