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Vol. 41. Issue 3.
Pages 135-140 (March 2005)
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Vol. 41. Issue 3.
Pages 135-140 (March 2005)
Original Articles
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Veracity of Smokers' Response Regarding Abstinence at Smoking Cessation Clinics
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4421
M. Barruecoa,
Corresponding author
MIBAFE@telefonica.net

Correspondence: Dr M. Barrueco. Servicio de Neumología. Hospital Universitario de Salamanca. P.° de San Vicente, 58-182. 37007 Salamanca. España
, C. Jiménez Ruizb, L. Palomoc, M. Torrecillad, P. Romeroe, J.A. Riescof
a Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, Spain
b Unidad de Tabaquismo, Instituto de Salud Pública de la Comunidad de Madrid, Madrid, Spain
c Centro de Salud de Coria, Coria, Cáceres, Spain
d Centro de Salud San Juan, Salamanca, Spain
e Hospital General de Baza, Baza, Granada, Spain
f Unidad de Neumología, Hospital San Pedro de Alcántara, Cáceres, Spain
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Objective

To assess the reliability of smokers' response as criteria for measuring abstinence and the necessity or not of confirming abstinence with carbon monoxide (CO) measurement.

Patients and methods

A multicenter, prospective, longitudinal study was carried out on patients over 18 years of age from 5 smoking cessation clinics who underwent treatment with nicotine or bupropion. When the patient attended the clinic at 15,30,60,90, and 180 days, abstinence was checked by self-reporting and expired-air CO levels. Sensitivity, specificity, and positive, negative, and overall predictive value of patient reporting, measured CO levels, and the 2 procedures in combination were calculated.

Results

A total of 904 smokers (476 men and 428 women) with a mean (SD) age of 42.51 (10.09) years were enrolled in the study. Of the 904 patients that made up the study population, 820,776,687,719, and 679, respectively, attended the scheduled visits to check abstinence. Self-reported point-prevalence abstinence at 15 days was 74.5% and at 180 days was 57.6% while abstinence determined by expired-air CO was 75.7% and 59.4% respectively. Results according to self-reporting, CO measurement, and the 2 methods in combination were not significantly different (P <.05) at any of the points in time. Neither sensitivity nor specificity showed significant differences in relation to patient variables.

Conclusion

The reliability of self-reported abstinence from smoking is high. Measurement of CO is therefore not essential, although it could be advisable for motivating patients rather than as a way of confirming abstinence.

Key Words:
Tobacco
Smoking cessation
Self-report
Carbon monoxide
Objetivo

Valorar la fiabilidad de la respuesta del fuma-dor como criterio de medida de abstinencia y el carácter de prescindible o indispensable de la determinación de monóxi-do de carbono (CO) para corroborar dicho criterio.

Pacientes Y Métodos

Se ha realizado un estudio multi-céntrico, prospectivo y longitudinal en pacientes mayores de 18 años que acudieron a 5 consultas de tabaquismo y a quienes se pautó tratamiento sustitutivo con nicotina o bupropión. Se efectuaron controles a los 15, 30, 60, 90 y 180 días. En cada control se determinó la abstinencia mediante la respuesta dada por el paciente, la determinación de CO en aire espirado y ambos procedimientos conjuntamente. Se calcularon la sensibilidad, especificidad, valor predictivo po-sitivo, negativo y global de la respuesta dada por el paciente respecto de la determinación de CO.

Resultados

Se incluyó en el estudio a 904 fumadores (476 varones y 428 mujeres), con una edad media (± desviación estándar) de 42,51 ± 10,09 años. De los 904 acudieron a los controles programados 820, 776, 687, 719 y 679, respectiva-mente, que constituyen la población objeto de estudio. La abstinencia puntual a los 15 y 180 días determinada por la respuesta de los pacientes fue del 74,5 y del 57,6%, y mediante determinación de CO en aire espirado del 75,7 y del 59,4%, respectivamente. No se observaron diferencias signi-ficativas (p < 0,05) entre los 3 procedimientos a los 15, 30, 60, 90 y 180 días. Ni la sensibilidad ni la especificidad mostraron diferencias estadísticamente significativas entre las distintas categorías de las variables.

Conclusión

La fiabilidad de la respuesta dada por los pacientes sobre la abstinencia tabáquica es elevada. Por ello la determinación de CO es prescindible y no resulta indispensable, si bien en el seguimiento del proceso puede ser re-comendable como factor motivador para el paciente más que como una forma de comprobar la abstinencia.

Palabras clave:
Tabaco
Deshabituación
Autorrespuesta
Monóxido de carbono
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Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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