The objective of the study was to investigate whether depression is a predictor of postdischarge smoking relapse among patients hospitalized for myocardial infarction (MI) or unstable angina (UA), in a smoke-free hospital. Methods Current smokers with MI or UA were interviewed while hospitalized; patients classified with major depression (MD) or no humor disorder were reinterviewed 6 months post discharge to ascertain smoking status. Potential predictors of relapse (depression; stress; anxiety; heart disease risk perception; coffee and alcohol consumption; sociodemographic, clinical, and smoking habit characteristics) were compared between those with MD (n = 268) and no humor disorder (n = 135). Results Relapsers (40.4%) were more frequently and more severely depressed, had higher anxiety and lower self-efficacy scale scores, diagnosis of UA, shorter hospitalizations, started smoking younger, made fewer attempts to quit, had a consort less often, and were more frequently at the 'precontemplation' stage of change. Multivariate analysis showed relapse-positive predictors to be MD [odds ratio (OR): 2.

OBJECTIVEInvestigate whether social and demographic characteristics, clinical diagnosis, smoking status, alcohol consumption, and anxiety are associated with depression in patients with Acute Coronary Syndromes (ACS) stratified by gender. METHODSThree hundred forty-five consecutive patients with unstable myocardial ischemic syndrome (206 with myocardial infarction and 139 with unstable angina) were interviewed. The interviews included questions about sociodemographics, smoking status, screening for depression (Prime MD e BDI), trait and state anxiety, (IDATE), and alcohol consumption (AUDIT). RESULTSDiagnosis of depression has significantly correlated with female gender, age under 50 years, and higher average scores on trait anxiety and state anxiety. Depressed men (245) were usually younger than 50 years of age, smokers and had higher average score on trait anxiety and state anxiety than those non-depressed. The multivariate analysis highlights that age is negatively associated with depression (OR 0.9519 95% CI 0.9261 -0.9784) and that higher scores on trait anxiety are positively associated (OR 1.0691 95% CI 1.0375 -1.1017) with depression in the male gender. In the female sample (100), depressed women differ from nondepressed women in that they have a higher average score on trait anxiety and state anxiety. In the multivariate analysis of the female sample, a higher score on trait anxiety was independently associated with depression (OR 1.1267 95% CI 1.0632 -1.1940). CONCLUSIONIt was concluded that, among hospitalized patients with ACS, women, as well as men under 50 years and who suffer from anxiety are more likely to experience depression.

SummaryObjectives: To evaluate the effectiveness of and tolerability to sustained-release bupropion, in smokers with cardiovascular diseases treated in a smoking cessation service, as well as to investigate variables predictive of success or failure in smoking cessation.Methods: Sustained-release bupropion was prescribed to 100 current smokers with cardiovascular disease for 12 weeks. Patients were followed for 52 week. The variables studied were gender, age, number of cigarettes, exhaled carbon monoxide, nicotine dependence (Fagerstrom Tolerance Questionnaire), depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory), alcohol consumption (Alcohol Use Disorders Identification Test), number of diagnoses other than smoking, adverse events, and use of medications concomitantly with sustained-release bupropion.Results: Abstinence rate was 50% at week 12 and 25% at week 52. The logistic regression analysis showed that ageing was positively associated with success, whereas the worsening of the condition, as verified by the presence of a higher number of other health conditions associated with smoking, was negatively associated with success. Conclusion:We conclude that the prescription of bupropion for smokers with cardiovascular diseases proved to be safe and effective, especially during the treatment period (week 12).

The objective of this paper was to assess sex and socioeconomic inequalities in lung cancer mortality in two major cities of Europe and South America. Official information on mortality and population allowed the estimation of sex- and age-specific death rates for Barcelona, Spain and São Paulo, Brazil (1995-2003). Mortality trends and levels were independently assessed for each city and subsequently compared. Rate ratios assessed by Poisson regression analysis addressed hypotheses of association between the outcome and socioeconomic covariates (human development index, unemployment and schooling) at the inner-city area level. Barcelona had a higher mortality in men (76.9/100,000 inhabitants) than São Paulo (38.2/100,000 inhabitants); although rates were decreasing for the former (-2%/year) and levelled-off for the latter. Mortality in women ranked similarly (9.1 for Barcelona, 11.5 for São Paulo); with an increasing trend for women aged 35-64 years (+7.7%/year in Barcelona and +2.4%/year in São Paulo). The socioeconomic gradient of mortality in men was negative for Barcelona and positive for São Paulo; for women, the socioeconomic gradient was positive in both cities. Negative gradients indicate that deprived areas suffer a higher burden of disease; positive gradients suggest that prosmoking lifestyles may have been more prevalent in more affluent areas during the last decades. Sex and socioeconomic inequalities of lung cancer mortality reinforce the hypothesis that the epidemiologic profile of cancer can be improved by an expanded access to existing technology of healthcare and prevention. The continuous monitoring of inequalities in health may contribute to the concurrent promotion of well-being and social justice.

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