Marina Prista Guerra (*)
Cristina Queirós (*)
Sandra Torres (*)
Filipa Vieira (*)
Carla Branco (*)
Sofia Almeida Garrett (*)
RESUMO
]]> O tabagismo tem-se revelado como um grande inimigo da saúde pública e concomitantemente como um dos comportamentos mais difíceis de mudar. Muitos fumadores adquirem uma dependência fisiológica da nicotina associada ao “hábito” o que pode provocar uma síndrome de abstinência difícil de ultrapassar. Os processos neurobiológicos da nicotina têm vindo a ser amplamente estudados e tornando-se parcialmente responsáveis pelas reduzidas taxas de cessação a longo prazo nos estudos publicados.Considerando o passado recente da restrição ao tabagismo em Portugal (2008) e dado que a FPCE-UP foi considerada livre de fumo dois anos antes, foram propostos os seguintes objectivos para este artigo: analisar a prevalência na referida instituição; caracterizar o fumador quanto ao número de cigarros fumados e anos de fumador através da UMA; comparar fumadores que já tiveram períodos de abstinência com outros fumadores que nunca tentaram deixar de fumar quanto ao número de cigarros e anos de fumador; e comparar ex-fumadores com fumadores que já estiveram abstinentes quanto ao tempo de abstinência conseguida e número de tentativas. Partindo da análise de conteúdo de questões abertas foram ainda delineados os seguintes objectivos de natureza qualitativa: identificar as razões que mantêm os ex-fumadores abstinentes; identificar sintomas de abstinência nos fumadores que já estiveram sem fumar; identificar os motivos que levaram os fumadores a tentar deixar de fumar em algum período das suas vidas e, por último, identificar os motivos da recaída.
Os questionários foram enviados via Internet à população da instituição (alunos, docentes e funcionários), tendo-se obtido uma amostra total de 289 sujeitos respondentes.
Foram encontradas taxas de prevalência de fumador mais elevadas que as referenciadas noutros estudos em Portugal (29,4%), sobretudo no que se reporta, ao género (Masculino: 44,4%; Feminino: 27,3%) e situação (docente: 30%; aluno: 28,6%). A caracterização do fumador revelou o índice da UMA de 6,9. Não foram observadas diferenças estatisticamente significativas entre os fumadores que já deixaram de fumar e os sempre fumadores quanto ao padrão de fumo. Observámos diferenças estatisticamente significativas entre ex-fumadores e fumadores que já deixaram de fumar quanto ao tempo de abstinência conseguida, mas não quanto ao número de tentativas. Constatámos que 88,5% dos ex-fumadores referenciaram sentir-se melhor por ter deixado de fumar, apontando benefícios imediatos na saúde. Um outro dado interessante referido por 50% de respondentes do mesmo grupo foi a sensação de liberdade/auto-controlo sentida por terem deixado de fumar. Entre os fumadores que já tentaram deixar de fumar 74% relataram síndrome de abstinência em mais que uma categoria, sendo as perturbações de humor (81,2%) a principal queixa, seguida de sintomas psicossomáticos (37,5%). As razões apontadas pelos fumadores para terem tentado deixar de fumar foram informação sobre os malefícios do tabaco (60%), seguindo-se os motivos de doença (28%). Entre aos motivos apontados na base da recaída salientam-se os sintomas incómodos que não passaram com o tempo (52%) e, em menor escala, o prazer (24%) e a pressão social (24%). Os resultados foram discutidos à luz das teorias actuais de intervenção na dependência tabágica.
Palavras-chave: Tabagismo, prevalência, recaída, cessação.
ABSTRACT
Cigarette smoking has been considered one of the great enemies to public health, as well as one of the hardest to change human behaviors. For many smokers, the association between the physiological nicotine dependence and the habit of smoking makes it harder to overcome the abstinence symptoms. It has been widely investigated the partial contribution of neurobiological processes of nicotine dependence to the reduced rates of long term smoking cessation found in longitudinal studies.
Considering the smoking restriction policy that has been adopted for the last two years in the Faculty of Psychology and Sciences of Education of the University of Oporto, in Portugal (FPCE-UP) and which was implemented nationwide only recently (in 2008), the present study aimed at: analyzing the prevalence of smoking in this institution; characterizing the smokers’ sample as to the number of cigarettes smoked and duration of smoking habits through cigarette pack-years (CPY); comparing former smokers to current smokers who were abstinent for some period in the past, as to the maximum abstinence time and number of cessation attempts. The content analysis of open questions lead to the formulation of more qualitative objectives: to identify the reasons why former smokers have maintained abstinent; to identify the abstinence symptoms felt by current smokers who stopped smoking sometime in the past; to identify the smokers’ motives for smoking cessation attempts at some period in their lives; and, finally, to identify the motives for relapse.
The questionnaires were administered via the Internet to the universe of students, teachers and staff of FPCE-UP. A total sample of 289 subjects was obtained.
]]> Higher prevalence of cigarette smoking (29,4%) was found, comparatively with other Portuguese studies, mainly in what concerns distribution by gender (Men: 44%; Women: 27.3%) and institutional situation (teacher: 30%; student: 28.6%). The smokers’ characterization revealed a CPY of 6.9. No significant statistical differences were found between current smokers who were abstinent for some time and smokers who were never abstinent as to the smoking patterns. Significant statistical differences were found between former smokers and current smokers who were abstinent for some time, as to the maximum abstinence time achieved, but not as to the number of cessation attempts. 88.5% of former smokers mentioned feeling better after having quit smoking, pointing out immediate health benefits. An interesting result was that 50% of the same group mentioned a sense of freedom and/or self-control after having quit smoking. Among the current smokers who have already tried quitting, 74% describe abstinence symptoms in more than one category, being mood disturbances (81.2%) and psychosomatic symptoms (37.5%) the more frequent complaints. The main motives pointed out by smokers for having tried to quit smoking were: information regarding the prejudicial effects of tobacco (60%) and illness (28%). As far of the motives for relapse are concerned, 52% pointed out the persistence of unpleasant symptoms, 24% the pleasure of smoking and 24% social pressure. Results were discussed according to current theoretical models of intervention in nicotine dependence.Key words: Smoking, prevalence, relapse, cessation.
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(*) Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto.
Qualquer correspondência relativa a este artigo deverá ser remetida para Marina Prista Guerra, Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto, Rua Dr. Manuel Pereira da Silva, 4200-392 Porto, Portugal. E-mail: mguerra@fpce.up.pt
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