Métodos para abandono do tabagismo e tratamento da dependência da nicotina

Abstract

Smoki ng is related to 30% of cancer deaths. It is a risk factor for respiratory tract, esophagus, stomach, pancreas, uterine cervix, kidney and bladder carcinomas. Nicotine induces tolerance and addiction by acting on the central dopaminergic pathways, thus leading to pleasure and reward sensations within the limbic system. It stimulates the central nervous system (CNS), enhances alertness and reduces the appetite. A 50% reduction of nicotine consumption may trigger withdrawal symptoms in addicted individuals: anxiety, anger, sleep disorders, hunger, cognitive dysfunction and cigarette craving. Medical advice is the cornerstone of smoking cessation. Pharmacotherapy of nicotine addiction comprises first-line (bupropion and nicotine replacement therapy) and second-line (clonidine and nortriptyline) drugs. Bupropion is a non-tricyclic antidepressant that inhibits dopamine uptake, whose contraindications are: epilepsy, eating disorders, uncontrolled hypertension, recent alcohol abstinence and current therapy with MAO inhibitors. Nicotine replacement therapy can be done with patches or gums. Counseling groups and behavioral interventions are efficacious. The effects of acupuncture on smoking cessation are not fully elucidated. Prompt smoking cessation or gradual reduction strategies have similar success rates.

Tabagismo em usuários de um centro de atenção psicossocial alcool e drogas: um estudo piloto

“…This is a positive fact, also presented in the literature (15) , since the best results are usually achieved when the nicotine addict is highly motivated to abandon the use of tobacco. Furthermore, the abrupt cessation of smoking or its gradual reduction present the same probability of success (18)(19) . These results present implications in the organization of the service and training of the health team.…”

Impacto Do Programa De Apoio Ao Tabagista De Um Município Do Sul De Minas Gerais, Brasil

“…A predominância de fumantes de mulheres entre os ingressantes em programas de cessação do tabagismo foi também verificada em outros estudos nacionais. Em pesquisa realizada em Fortaleza (CE), observou-se predominância de 65,6% (21) e de 62%, em estudo realizado na cidade de Porto Alegre (RS) (22). Essa predominância pode ser justificada pelo fato de as mulheres exibirem maiores cuidados com a saúde do que os homens.…”

“…Em um estudo realizado na China, verificouse que indivíduos com baixa escolaridade têm uma probabilidade cerca de sete vezes maior de serem fumantes do que indivíduos com nível superior e, no Brasil, essa probabilidade é cinco vezes maior (22). As estratégias para a expansão do mercado da indústria do tabaco que estimulam o consumo e facilitam o acesso ao cigarro contribuem para o seu maior consumo pelas populações de baixa renda e escolaridade (32).…”

Prevalência do tabagismo e terapêutica da dependência de nicotina: uma revisão integrativa Smoking prevalence and of nicotine dependence’s therapeutics: an integrative review

“…The smoker is exposed to about 4,720 toxic substances including nicotine. 1,3 The estimate of the World Health Organization is that the current prevalence of smokers in the world is one billion and three hundred thousand. Associated with a high morbidity and mortality, the disease is directly or indirectly linked to six million deaths per year; although smoking is considered the leading cause of preventable death in the world, about eight million deaths are estimated for 2030 being 80% of these in developing countries.…”