El programa multicomponente de apoyo para el cese del tabaquismo (McSCSP) es efectivo en pacientes con trastorno mental grave sin diferencias de género

  1. María José Jaén-Moreno 1
  2. María Paz García-Portilla 2
  3. Fernando Sarramea 1
  4. Teresa Bobes Bascarán 2
  5. Gonzalo Galván 3
  6. Eva María Díaz-Mesa 3
  7. Susana Al-Halabi 4
  8. Edorta Elizagarate 5
  9. Pilar Alejandra Sáiz Martínez 2
  10. Julio Bobes 2
  11. Leticia García-Álvarez 2
  1. 1 Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España.
  2. 2 Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, España.
  3. 3 Universidad Cooperativa de Colombia, Colombia.
  4. 4 Instituto de Neurociencias del Principado de Asturias (INEUROPA), Asturias, España
  5. 5 Unidad de Psicosis Refractarias, Hospital Psiquiátrico de Álava, Vitoria, España.
Journal:
Adicciones: Revista de socidrogalcohol

ISSN: 0214-4840

Year of publication: 2022

Volume: 34

Issue: 3

Pages: 218-226

Type: Article

More publications in: Adicciones: Revista de socidrogalcohol

Abstract

High prevalence of smoking in people with severe mental disorders (SMD) contributes to their medical morbidity and reduced life expectancy. Despite the evidence of gender differences in smoking cessation, few studies have tested those differences among people with SMD. This is a non-randomized, open-label, prospective, 9-month follow-up multicentre trial to examine gender differences in the efficacy, safety and tolerability of a Multi-Component Smoking Cessation Support Programme (McSCSP). The results showed that there were no significant differences in short- (males 44.9% vs females 57.7%, chi-square = 1.112, p = 0.292) or long-term efficacy (week 24: males 40.8%, females 42.3%, chi-square = 0.016, p = 0.901; week 36: males 36.7%, females 38.5%, chi-square = 0.022, p = 0.883) between gender, neither controlled by diagnosis or treatment. Regarding safety and tolerability, there was significant increase in abdominal perimeter in males [from 105.98 (SD 13.28) to 108.52 (SD 14.01), t = -3.436, p = 0.002)], but not in females. However, there were no significant gender differences in adverse events (constipation, abnormal/vivid dreams, nausea/vomiting or skin rash/redness around patch site). In conclusion, we have demonstrated that is effective and safe to help either male or female patients with stabilized SMD to quit smoking. However, it might be a tendency in females to respond better to varenicline treatment in the short-term. Future research with larger samples is required to more clearly determine whether or not the there are differences, in addition to their reliability and robustness.

Bibliographic References

  • Aguilar, M. C., Gurpegui, M., Diaz, F. J. y De Leon, J. (2005). Nicotine dependence and symptoms in schizophrenia. British Journal of Psychiatry, 186, 215–221. doi:10.1192/bjp.186.3.215.
  • Aubin, H.-J., Farley, A., Lycett, D., Lahmek, P. y Aveyard, P. (2012). Weight gain in smokers after quitting cigarettes: Meta-analysis. BMJ, 345, 4439–4439. doi:10.1136/bmj.e4439.
  • Bjornson, W., Rand, C., Connett, J. E., Lindgren, P. Nides, M., Pope, F.,… O’Hara, P. (1995). Gender differences in smoking cessation after 3 years in the Lung Health Study. American Journal of Public Health, 85, 223–230. doi:10.2105/ajph.85.2.223.
  • COMMIT. (1995). Community Intervention Trial for Smoking Cessation (COMMIT): I. cohort results from a four-year community intervention. American Journal of Public Health, 85, 183–192. doi:10.2105/ajph.85.2.183.
  • Davis, L. J. J., Hurt, R. D., Offord, K. P., Lauger, G. G., Morse, R. M. y Bruce, B. K. (1994). Self-administered Nicotine-Dependence Scale (SANDS): Item selection, reliability estimation, and initial validation. Journal of Clinical Psychology, 50, 918–930. doi:10.1002/1097-4679(199411)50:6<918::aid-jclp2270500617>3.0.co;2-6.
  • De Hert, M., Correll, C. U., Bobes, J., Cetkovich-Bakmas, M., Cohen, D. A. N., Asai, I.,… Leucht, S. (2011). Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry, 10, 52–77. doi:10.1002/j.2051-5545.2011.tb00014.x.
  • Filia, S. L., Baker, A. L., Gurvich, C. T., Richmond, R. y Kulkarni, J. (2014). The perceived risks and benefits of quitting in smokers diagnosed with severe mental illness participating in a smoking cessation intervention: Gender differences and comparison to smokers without mental illness. Drug and Alcohol Review, 33, 78–85. doi:10.1111/dar.12091.
  • Filia, S. L., Baker, A. L., Gurvich, C. T., Richmond, R., Lewin, T. J. y Kulkarni, J. (2014). Gender differences in characteristics and outcomes of smokers diagnosed with psychosis participating in a smoking cessation intervention. Psychiatry Research, 215, 586–593. doi:10.1016/j.psychres.2014.01.002.
  • Garcia-Portilla, M. P., Garcia-Alvarez, L., Saiz, P. A., Diaz-Mesa, E., Galvan, G., Sarramea, F.,… Bobes, J. (2014). Effectiveness of a multi-component Smoking Cessation Support Programme (McSCSP) for patients with severe mental disorders: Study design. International Journal of Environmental Research and Public Health, 11, 373–389. doi:10.3390/ijerph110100373.
  • Garcia-Portilla, M. P., Garcia-Alvarez, L., Sarramea, F., Galvan, G., Diaz-Mesa, E., Bobes-Bascaran, T.,… Bobes, J. (2016). It is feasible and effective to help patients with severe mental disorders to quit smoking: An ecological pragmatic clinical trial with transdermal nicotine patches and varenicline. Schizophrenia Research, 176, 272–280. doi:10.1016/j.schres.2016.05.011.
  • Gurpegui, M., Martínez-Ortega, J. M., Aguilar, M. C., Diaz, F. J., Quintana, H. M. y De Leon, J. (2005). Smoking initiation and schizophrenia: A replication study in a Spanish sample. Schizophrenia Research, 76, 113–118. doi:10.1016/j.schres.2004.12.007.
  • Hahn, L., Rigby, A. y Galletly, C. (2014). Determinants of high rates of smoking among people with psychosis living in a socially disadvantaged region in South Australia. Australian and New Zealand Journal of Psychiatry, 48, 70–79. doi:10.1177/0004867413491158.
  • Jiménez-Treviño, L., Velasco, Á., Rodriguez-Revuelta, J., Abad, I., De la Fuente-Tomás, L., González-Blanco, L. y Sáiz, P. A. (2019). Factors associated with tobacco consumption in patients with depression. Adicciones, 31, 298-308. doi:10.20882/adicciones.1191.
  • Kim, S. S., Chung, S., Park, J. Il, Jung, A. J., Kalman, D. y Ziedonis, D. M. (2013). Smoking among individuals with schizophrenia in korea: Gender differences. Archives of Psychiatric Nursing, 27, 241–245. doi:10.1016/j.apnu.2013.06.002.
  • Kumari, V. y Postma, P. (2005). Nicotine use in schizophrenia: The self medication hypotheses. Neuroscence y Biobehavioral Reviews, 29, 1021–1034. doi:10.1016/j.neubiorev.2005.02.006.
  • McKee, S. A., O’Malley, S. S., Salovey, P., Krishnan-Sarin, S. y Mazure, C. M. (2005). Perceived risks and benefits of smoking cessation: Gender-specific predictors of motivation and treatment outcome. Addictive Behaviors, 30, 423–435. doi:10.1016/j.addbeh.2004.05.027.
  • Okoli, C. T. C., Khara, M., Torchalla, I., Ensom, M. H. H., Oliffe, J. L., Bottorff, J. L. y Stanley, P. J. (2011). Sex differences in smoking cessation outcomes of a tailored program for individuals with substance use disorders and mental illness. Addictive Behaviors, 36, 523–526. doi:10.1016/j.addbeh.2010.12.029.
  • Ostacher, M. J., Nierenberg, A. A., Perlis, R. H., Eidelman, P., Borrelli, D. J., Tran, T. B.,… Sachs, G. S. (2006). The relationship between smoking and suicidal behavior, comorbidity, and course of illness in bipolar disorder. The Journal of Clinical Psychiatry, 67, 1907–1911. doi:10.4088/jcp.v67n1210.
  • Perkins, K. A. (2001). Smoking cessation in women. Special considerations. CNS Drugs, 15, 391–411. doi:10.2165/00023210-200115050-00005.
  • Perkins, K. A. y Scott, J. (2008). Sex differences in long-term smoking cessation rates due to nicotine patch. Nicotine and Tobacco Research, 10, 1245–1251. doi:10.1080/14622200802097506.
  • Reid, R. D., Pipe, A. L., Riley, D. L. y Sorensen, M. (2009). Sex differences in attitudes and experiences concerning smoking and cessation: Results from an international survey. Patient Education and Counseling, 76, 99–105. doi:10.1016/j.pec.2008.11.001.
  • Rodriguez Muñoz, P. M., Carmona Torres, J. M., Hidalgo Lopezosa, P., Cobo Cuenca, A. I. y Rodríguez Borrego, M. A. (2019). Evolution of alcohol and tobacco consumption in young people in Spain, after the law 42/2010 against smoking: 2011-2014. Adicciones, 31, 274-283. doi:10.20882/adicciones.1035.
  • Sarramea Crespo, F., Jaén-Moreno, M. J., Gutiérrez-Rojas, L., Balanzá-Martínez, V., García-Alvarez, L., Saiz Martínez, P. A. y Bobes, J. (2019a). “Readiness to change” predicts efficacy of reduction among smokers with severe mental illness. European Addiction Research, 25, 256-262. doi:10.1159/000500450.
  • Sarramea, F., Jaen-Moreno, M. J., Balanza-Martinez, V., Osuna, M. I., Alcala, J. A., Montiel, F. J.,… Gutierrez-Rojas, L. (2019b). Setting the stage to quit smoking in Bipolar Disorder patients: Brief advice in clinical practice. Adicciones, 31,136-146. doi:10.20882/adicciones.1006.
  • Scharf, D. y Shiftman, S. (2004). Are there gender differences in smoking cessation, with and without bupropion? Pooled- and meta-analyses of clinical trials of Bupropion SR. Addiction, 99, 1462–1469. doi:10.1111/j.1360-0443.2004.00845.x.
  • Smith, P. H., Bessette, A. J., Weinberger, A. H., Sheffer, C. E. y McKee, S. A. (2016). Sex/gender differences in smoking cessation: A review. Preventive Medicine, 92, 135–140. doi:10.1016/j.ypmed.2016.07.013.
  • Walker, N. J., Van Woerden, H. C., Kiparoglou, V., Yang, Y., Robinson, H. y Croghan, E. (2016). Gender difference and effect of pharmacotherapy: Findings from a smoking cessation service. BMC Public Health, 16, 1–8. doi:10.1186/s12889-016-3672-y.
  • Wetter, D. W., Kenford, S. L., Smith, S. S., Fiore, M. C., Jorenby, D. E. y Baker, T. B. (1999). Gender differences in smoking cessation. Journal of Consulting and Clinical Psychology, 67, 555–562. doi:10.1037//0022-006x.67.4.555.