This article is a literature review of the psychological aspects of smoking behavior, highlighting personality characteristics of the smoker as an obstacle to smoking cessation. It describes the relationship between smoking behavior and personality, and between smoking and the principal psychiatric disorders. Studies reveal that smokers tend to be more extroverted, anxious, tense, and impulsive, and show more traits of neuroticism and psychoticism than do ex-smokers or nonsmokers. The literature also reveals a strong association between smoking and mental disorders, such as schizophrenia and depression. Understanding the psychological factors associated with tobacco smoking and dependence can further the development and improvement of therapeutic strategies to be used in smoking-cessation programs, as well as of programs aimed at prevention and education. return to levels similar to those observed in controls. Excessive weight gain generally follows alterations in behavior and personality patterns, frequently manifested as depression, abstention, self-punishment, irritability, and aggression. Weight gain, together with increased stress, intensifies the impulse to eat, perpetuating the vicious cycle. At the moment, the three most widely accepted theories to explain the relationship between smoking and body weight are as follows: a) increased metabolic rate, with greater energy expenditure by smokers; b) differences in quality and quantity of food intake by smokers; c) appetite loss, via nicotine. (4,5) In this review article, emphasizing the personality profile of the smoker as an important obstacle to cessation, we describe the relationship between smoking and personality and, subsequently, the relationship between smoking and the principal psychiatric disorders. Smoking and personalityMost studies on the relationship between smoking and personality characteristics, in recent decades, were carried out according to the theoretical model proposed in 1967. (6) According to this approach, there are three predominant dimensions of character or personality supposedly related to smoking: extroversion, neuroticism, and psychoticism.The extroversion dimension comprises factors such as sociability, assertiveness, positive emotions, vivacity, and activity level. (7) It has been hypothesized that there is a relationship between extroversion and smoking. (6) In line with this interpretation, extroverts and introverts differ as to the level of necessary stimulation for their well-being. At equivalent stimulation levels, extroverts will be characterized by low cortical excitation, and introverts by high cortical excitation. At a medium level of stimulation, at which most daily activities occur, extroverts will more likely feel little stimulated, whereas introverts will feel highly stimulated. Since they operate below their ideal level of cortical excitation, extroverts might try to change their external environment through increased activity, or might try to change their internal environment by ingesting substances, su...

RESUMOEste artigo apresenta uma revisão não sistemática da literatura sobre a relação entre tabagismo e doenças mentais, destacando algumas perspectivas recentes sobre o assunto. Buscou-se identificar e descrever as hipóteses levantadas por estudiosos nas últimas décadas acerca da natureza da associação entre o tabagismo e as perturbações psiquiátricas como depressão maior, esquizofrenia e transtornos de ansiedade. Discutem-se, também, as reflexões sobre as abordagens utilizadas nas pesquisas, bem como as possíveis contribuições desse conhecimento para os programas de intervenção e assistência a pacientes psiquiátricos fumantes. Unitermos: Tabagismo; Transtornos psiquiátricos. ABSTRACT Relationship between smoking behavior and psychiatric disordersThis paper presents a non systematic literature review on the relationship between smoking behavior and psychiatric disorders, pointing out the new perspectives on the matter. The aim was to identify and describe the hypotheses on the nature of the association between smoking and major depression, schizophrenia and anxiety disorders, in the last decades. The different research approaches, as well as the possible contributions of this knowledge to intervention programs to assist smokers psychiatric patients are discussed. Keywords: Smoking behavior; Psychiatric disorders.

Objective: To evaluate changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Methods: This cohort study involved patients enrolled in a smoking cessation program in Cuiabá, Brazil. We selected patients who completed the program in six months or less (n = 142). Patient evaluations were conducted at enrollment (evaluation 1 [E1]); after 45 days of treatment with medication and cognitive-behavioral therapy (E2); and at the end of the six-month study period (E3). Patients were evaluated with a standardized questionnaire (to collect sociodemographic data and determine smoking status), as well as with the University of Rhode Island Change Assessment scale, Beck Anxiety Inventory, Beck Depression Inventory, and Lipp Inventory of Stress Symptoms for Adults. The data were analyzed with the nonparametric Wilcoxon test for paired comparisons. To compare treatment success (smoking cessation) with treatment failure, the test for two proportions was used. Results: Among the 142 patients evaluated, there were improvements, in terms of the levels of anxiety, depression, motivation, and stress, between E1 and E2, as well as between E1 and E3. In addition, treatment success correlated significantly with the levels of motivation and anxiety throughout the study period, whereas it correlated significantly with the level of depression only at E2 and E3. Conclusions: We conclude that there are in fact changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Those changes appear to be more pronounced in patients in whom the treatment succeeded.

RESUMO (ISSL). Os dados foram digitados duplamente em programa Epidata versão 3.1, e para análise dos dados foi utilizado um modelo de regressão de Poisson. Resultados: Foram encontradas associações do fracasso terapêutico com as seguintes variáveis: faixa etária jovem (RP = 1,68; IC 95% 1,11-2,56); menor tempo de tabagismo (RP = 1,32; IC 95% 1,09-1,61); maior consumo de cigarros/dia (RP = 1,24; IC 95% 1,01-1,52) e menor grau de motivação (RP = 1,55; IC 95% 1,04-2,30). No modelo final (RPa), ficaram associadas ao fracasso as variáveis: menor tempo de tabagismo (RPa 1,53; IC 95% 1,07-2,32), maior carga tabágica (RPa 1,48; IC 95% 1,12-1,95), baixo nível de motivação (RPa 1,58; IC 95% 1,07-2,32) e alto nível de ansiedade (RPa 1,22; IC 95% 1,01-1,48). Conclusão: Baixo nível motivacional (Contemplação e Pré-contemplação), alto nível de ansiedade (moderado/grave), menor tempo de tabagismo e alta carga tabágica estão associados ao fracasso terapêutico.

INTRODUÇÃO: O estudo da relação entre personalidade e tabagismo pode subsidiar o tratamento da dependência. OBJETIVOS: Identificar características de personalidade de fumantes, ex-fumantes e não-fumantes. MÉTODO: Foram selecionados 1.245 estudantes matriculados na Universidade Federal de Mato Grosso. Foi aplicado um questionário padronizado para levantamento do perfil sociodemográfico e padrão de consumo de tabaco dos estudantes, seguido pela versão revisada das Escalas Comrey de Personalidade (CPS). Utilizou-se a análise de variância ANOVA para comparação dos escores de fumantes, ex-fumantes e não-fumantes no CPS e duas análises de regressão logística múltipla para avaliar as associações entre os escores do CPS e tabagismo. RESULTADOS: Foi encontrada prevalência de 6,67% de fumantes, 6,58% de ex-fumantes e 86,73% de não-fumantes. A primeira análise de regressão logística detectou associação positiva entre a categoria fumante e os escores nas escalas de masculinidade (M) e tendenciosidade (R) e associação inversa com a escala de ordem x falta de compulsão (O) do CPS. A segunda detectou associação negativa da categoria ex-fumante com os escores obtidos em R e M e positiva com a escala de atividade x falta de energia (A) do CPS. DISCUSSÃO: Fumantes foram mais tendenciosos e adotaram mais o estereótipo social da masculinidade em relação a não-fumantes e ex-fumantes. Fumantes se descreveram mais como descuidados, relaxados, imprudentes, não-sistemáticos e pouco asseados em comparação aos não-fumantes. Ex-fumantes apresentaram mais vigor, energia e disposição em relação aos fumantes. Supõe-se que esses resultados possam subsidiar programas de tratamento da dependência nicotínica.