Mecanismos de iniciación al tabaco. Dependencia no farmacológica

[Prevalence of tobacco dependency and its prevention in patients with persistent asthma]

OBJECTIVES

To analyse in patients with persistent bronchial asthma the prevalence of tobacco dependency and its degree; and to assess measures of prevention.

DESIGN

Cross-sectional, descriptive study.

SETTING

Allergy Service of the Lozano Blesa University Hospital, Zaragoza, Spain.

PARTICIPANTS

A total of 121 patients, from systematic selection of asthmatics attending for consultation.

MAIN MEASUREMENTS

Questionnaire filled out in the consulting room, recording social, demographic and clinical variables.

RESULTS

A sample of 121 patients was obtained, 62.7% women and 37.3% men. They had 5.87 +/- 4.99 years mean evolution of asthma. 21.5% were daily smokers, 4.1% occasional smokers, 27.3% ex-smokers, and 47.1% non-smokers. The ages of starting to smoke were < 10 years old, 1.7%; 10-15, 30%; 15-20, 56.7%; 20-25, 6.7%, and > 25, 5% (P > .05). There were significant differences between gender and tobacco dependency and between age and tobacco dependency (P < .01 and P < .014, respectively). 96.8% of smokers thought that tobacco was harmful to their health. This figure was 100% in daily smokers and 80% in occasional smokers (P < .02). 83.9% of smokers had the intention of giving up. Counselling to give up was received from the specialist (41.9%), the primary care doctor (12.9%), and both (9.7% of cases). 35.5% received no counselling.

CONCLUSIONS

The prevalence of tobacco dependency in patients with persistent asthma is lower than in the population as a whole; over a third receive no counselling about giving up. Interventions must be conducted in still healthy smokers and chronically ill patients in both primary and specialist care.

[Books published in Spain on smoking]

Tobacco dependence, considered for a long time as a habit and, more recently, as an addiction, has many bad effects in health. The objective of this study was to analyse books published in this field in Spain. Books indexed in the ISBN Spanish database in CD-ROM (updated to 1993) dealing with addiction to tobacco, that included one of the following words: tabac*, tabak*, tabaq*, fuma*, fumad*, nicotine*, alquitran*, antitabac*, antitabaq*, cigarro*, cigarri*, exfumad*, pipa*, puro*, picadura* or filtro, were included in the study. Authors, ISBN classification, year of publication, language (of publication and original) and publishers were descriptively analysed. One hundred and four books were analysed. The highest number was published during the period 1990-1993 (42%); being 1993 (n = 15) and 1991 (n = 14) the most productive years. A big increase was observed from 1985. A great number (76% of books, n = 79) was written by personal authors and the 14% (n = 14) by public organizations. Most of the books (n = 88; 85%); were published in Spanish, followed by Catalan (n = 13; 13%); 21 books (20%) were translations: most of them from English (n = 12; 60%) or from French (n = 3; 14%). Forty six per cent of books was published by trade publishers and 31% by public organizations. According to the ISBN classification, these books were grouped in 20 different topics; but, most of them (70%) were included in three of these topics: hygiene (n = 42, 40%), pharmacology-toxicology-drugs (n = 18, 17%) and pathology-diseases and medical/therapeutical clinical practice (n = 14; 13%). The number of books published in Spain dealing with tobacco dependence has increased very much from 1985; it suggests that interest in this area in SPain has also increased. Most of the books are published in Spanish, and the most frequently translated language is English. These books are basically published by trade publishers and public organizations. These results have to be considered taking into account that fighting against consumption of tobacco and tobacco dependence is a relatively new area of research and study.