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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To evaluate weight gain and its relation to anxiety in a group of smokers after 3 months of cessation treatment&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">The target population for this prospective&#44; analytical&#44; longitudinal study was smokers being treated in a specialist smoking cessation clinic who were still abstinent at the conclusion of a 3-month treatment program&#46; The following variables were analyzed&#58; age&#44; sex&#44; nicotine dependence &#40;Fagerstr&#246;m test&#41;&#44; daily cigarette consumption&#44; number of pack-years&#44; pharmacological treatment &#40;nicotine replacement&#47;bupropion&#41;&#44; use of nicotine gum &#40;yes&#47;no&#41;&#44; weight gain&#44; body mass index&#44; and degree of state and trait anxiety&#46; Successful cessation was defined as self-reported abstinence confirmed by measurement of expired carbon monoxide &#40;CO&#41; level &#40;&#8804;10 ppm&#41;&#46; Anxiety was evaluated using the State-Trait Anxiety Inventory&#46; The state anxiety and weight variables were measured on 5 occasions&#58; before smoking cessation&#44; and at the end of week 1&#44; month 1&#44; month 2&#44; and month 3 after cessation&#46; Results for the quantitative variables were expressed as means &#40;SD&#41;&#44; and results for the qualitative variables were expressed as percentages and absolute frequencies&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The study population consisted of 122 individuals&#44; 76 of whom were men &#40;62&#37;&#41; and 46 of whom were women &#40;38&#37;&#41;&#46; The mean age was 43&#46;9 &#40;9&#46;9&#41; years&#44; and mean nicotine dependence according to the Fagerstr&#246;m scale was 6&#46;2 &#40;2&#46;2&#41; points&#46; Average weight gain was 2&#46;6 kg &#40;3&#46;6&#37;&#41;&#44; with no significant difference between the sexes&#46; Weight gain in 25&#37; of this population was greater than 4&#46;2 kg&#44; and maximum weight gain was 9&#46;2 kg&#46; Levels of state anxiety fell progressively as weight increased&#44; although there was no evident relationship between the 2 variables&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Weight gain is moderate as smokers quit&#46; Anxiety levels&#44; which are greater in the first few weeks after cessation&#44; do not explain weight variation&#44; which is more related to the metabolic effects of nicotine rather than to psychological variables&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Evaluar la ganancia ponderal en un grupo de fumadores que permanecen abstinentes 3 meses despu&#233;s de dejar de fumar y valorar su relaci&#243;n con la ansiedad&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se trata de un estudio prospectivo&#44; anal&#237;tico y longitudinal&#44; en el que la poblaci&#243;n objetivo eran fumadores atendidos en una unidad especializada de tabaquismo que permanec&#237;an abstinentes al finalizar el trata-miento &#40;3 meses&#41;&#46; Se estudiaron las siguientes variables&#58; edad&#44; sexo&#44; dependencia a la nicotina mediante el test de Fagerstr&#246;m&#44; cigarrillos&#47;d&#237;a&#44; paquetes-a&#241;o&#44; tratamiento farma-col&#243;gico &#40;sustitutivo de nicotina&#47;bupropi&#243;n&#41;&#44; ingesta de chicles de nicotina &#40;s&#237;&#47;no&#41;&#44; incremento ponderal&#44; &#237;ndice de masa corporal y grado de ansiedad &#40;rasgo y estado&#41;&#46; Se consider&#243; &#233;xito la abstinencia mantenida seg&#250;n refer&#237;a el paciente junto con cooximetr&#237;a &#40;mon&#243;xido de carbono &#8804;10 ppm&#41;&#46; La ansiedad se evalu&#243; con el cuestionario STAI-E&#47;R &#40;State-Trait Anxiety Inventory&#41;&#46; Las variables ansiedad de estado y peso se midieron en 5 momentos&#58; antes de dejar de fumar&#44; a la se-mana&#44; al mes&#44; a los 2 meses y a los 3 meses&#46; Los resultados se expresan como medias &#177; desviaci&#243;n est&#225;ndar &#40;variables cuantitativas&#41; y como proporciones y frecuencias absolutas &#40;variables cualitativas&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La poblaci&#243;n de estudio estaba compuesta por 122 individuos -76 varones &#40;62&#37;&#41; y 46 mujeres &#40;38&#37;&#41;-&#44; con una edad media &#40;&#177; desviaci&#243;n est&#225;ndar&#41; de 43&#44;9 &#177; 9&#44;9 a&#241;os y dependencia a la nicotina &#40;test de Fagerstr&#246;m&#41; de 6&#44;2 &#177; 2&#44;2 puntos&#46; El incremento ponderal fue en promedio de 2&#44;6 kg &#40;3&#44;6&#37;&#41;&#44; sin que hubiera diferencias por sexo&#46; Un 25&#37; de la poblaci&#243;n tuvo una ganancia mayor de 4&#44;2 kg&#44; pero en nin-g&#250;n caso se superaron los 9&#44;2 kg&#46; La ansiedad de estado dis-minuy&#243; progresivamente&#44; mientras que el peso mostr&#243; una evoluci&#243;n ascendente&#44; sin que hubiera relaci&#243;n entre ambos&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La ganancia ponderal al dejar de fumar es moderada&#46; La ansiedad&#44; m&#225;s intensa en las primeras semanas&#44; no justifica el incremento del peso&#44; que est&#225; m&#225;s re-lacionado con los efectos metab&#243;licos de la nicotina que con variables psicol&#243;gicas&#46;</p>"
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                        "tituloSerie" => "Prim Care"
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                        "paginaInicial" => "611"
                        "paginaFinal" => "631"
                        "link" => array:1 [
                          0 => array:2 [
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                        "paginaFinal" => "364"
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                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "J Fam Pract"
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                        "paginaInicial" => "460"
                        "paginaFinal" => "464"
                        "link" => array:1 [
                          0 => array:2 [
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                        "paginaFinal" => "230"
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                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "US Department of Health and Human Services"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "titulo" => "The health benefits of smoking cessation&#58; a report of the Surgeon General"
                        "fecha" => "1990"
                        "editorial" => "Office on Smoking and Health"
                        "editorialLocalizacion" => "Rockville"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking cessation and weight gain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C Filozof"
                            1 => "MC Fern&#225;ndez Pinilla"
                            2 => "A Fern&#225;ndez-Cruz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1467-789X.2004.00131.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Obes Rev"
                        "fecha" => "2004"
                        "volumen" => "5"
                        "paginaInicial" => "95"
                        "paginaFinal" => "103"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15086863"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics associated with excessive weight gain after smoking cessation in men"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "GE Swan"
                            1 => "D Carmelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Public Health"
                        "fecha" => "1995"
                        "volumen" => "85"
                        "paginaInicial" => "73"
                        "paginaFinal" => "77"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7832265"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nicotine withdrawal versus other drug withdrawal syndromes&#58; similarities and dissimilarities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "JR Hughes"
                            1 => "ST Higgins"
                            2 => "WK Bickel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Addiction"
                        "fecha" => "1994"
                        "volumen" => "89"
                        "paginaInicial" => "1461"
                        "paginaFinal" => "1470"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7841857"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Concepto y categorizaci&#243;n de los trastornos de ansiedad"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B Sand&#237;n"
                            1 => "P Chorot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Manual de psicopatolog&#237;a"
                        "paginaInicial" => "54"
                        "paginaFinal" => "78"
                        "serieFecha" => "1995"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Measuring nicotine dependence&#46; A review of the Fagerstr&#246;m tolerance questionnaire"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K Fagerstr&#246;m"
                            1 => "N Schneider"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Behav Med"
                        "fecha" => "1989"
                        "volumen" => "12"
                        "paginaInicial" => "159"
                        "paginaFinal" => "182"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2668531"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Measures of abstinence in clinical trials&#58; issues and recommendations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "JR Hughes"
                            1 => "JP Keely"
                            2 => "RS Niaura"
                            3 => "DJ Ossip-Klein"
                            4 => "RL Richmond"
                            5 => "GE Swan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Nicotine Tob Res"
                        "fecha" => "2003"
                        "volumen" => "5"
                        "paginaInicial" => "13"
                        "paginaFinal" => "25"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12745503"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resultados de un programa integral del tabaquismo en el entorno laboral"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "I Ner&#237;n"
                            1 => "A Crucelaegui"
                            2 => "A Mas"
                            3 => "JA Villalba"
                            4 => "D Guill&#233;n"
                            5 => "A Gracia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2005"
                        "volumen" => "41"
                        "paginaInicial" => "197"
                        "paginaFinal" => "201"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15826529"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consenso SEEDO&#39;2000 para la evaluaci&#243;n del sobrepeso y la obesidad y el establecimiento de criterios de intervenci&#243;n terap&#233;utica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Conferencia de consenso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2000"
                        "volumen" => "115"
                        "paginaInicial" => "587"
                        "paginaFinal" => "597"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cuestionario de Ansiedad Estado-Rasgo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "N Seisdedos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "titulo" => "Adaptaci&#243;n espa&#241;ola"
                        "fecha" => "1988"
                        "editorial" => "TEA Ediciones"
                        "editorialLocalizacion" => "Madrid"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What happens to anxiety levels on giving up smoking&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R West"
                            1 => "P Hajek"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1176/ajp.154.11.1589"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Psychiatry"
                        "fecha" => "1997"
                        "volumen" => "154"
                        "paginaInicial" => "1589"
                        "paginaFinal" => "1592"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9356569"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Open randomised trial of intermittent very low energy diet together with nicotine gum for stopping smoking in women who gained weight in previous attempts to quit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T Danielsson"
                            1 => "S R&#246;ssner"
                            2 => "A Westin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1999"
                        "volumen" => "319"
                        "paginaInicial" => "490"
                        "paginaFinal" => "494"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10454403"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking cessation and severity of weight gain in a national cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "DF Williamson"
                            1 => "J Madans"
                            2 => "RF Anda"
                            3 => "JC Kleinman"
                            4 => "GA Giovino"
                            5 => "T Byers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199103143241106"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1991"
                        "volumen" => "324"
                        "paginaInicial" => "739"
                        "paginaFinal" => "745"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1997840"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking cessation and body mass index of occupationally active men&#58; the Israeli CORDIS study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P Froom"
                            1 => "E Kristal-Boneh"
                            2 => "S Melamed"
                            3 => "D Gofer"
                            4 => "J Benbassat"
                            5 => "J Ribak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Public Health"
                        "fecha" => "1999"
                        "volumen" => "89"
                        "paginaInicial" => "718"
                        "paginaFinal" => "722"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10224984"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cessation from cigarette smoking&#58; changes in body weight&#44; body composition&#44; resting metabolism&#44; and energy consumption"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "RJ Moffatt"
                            1 => "SG Owens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Metabolism"
                        "fecha" => "1991"
                        "volumen" => "40"
                        "paginaInicial" => "465"
                        "paginaFinal" => "470"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2023532"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nicotinic receptor-mediated effects on appetite and food intake"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "YH Jo"
                            1 => "DA Talmage"
                            2 => "LW Role"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/neu.10147"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurobiol"
                        "fecha" => "2002"
                        "volumen" => "53"
                        "paginaInicial" => "618"
                        "paginaFinal" => "632"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12436425"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tobacco smoking in relation to body fat mass and distribution in a general population sample"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C Bamia"
                            1 => "A Trichopoulou"
                            2 => "D Lenas"
                            3 => "D Trichopoulos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Obes"
                        "fecha" => "2004"
                        "volumen" => "28"
                        "paginaInicial" => "1091"
                        "paginaFinal" => "1096"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The influence of smoking cessation on the prevalence of overweight in the United States"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "KM Flegal"
                            1 => "RP Troiano"
                            2 => "ER Pamuk"
                            3 => "RJ Kuczmarski"
                            4 => "SM Campbell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199511023331801"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1995"
                        "volumen" => "333"
                        "paginaInicial" => "1165"
                        "paginaFinal" => "1170"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7565970"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relaci&#243;n entre obesidad&#44; h&#225;bito tab&#225;quico y actividad f&#237;sica en el tiempo libre en la poblaci&#243;n espa&#241;ola de 20 a 64 a&#241;os"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "JL Guti&#233;rrez-Fisac"
                            1 => "F Rodr&#237;guez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "1995"
                        "volumen" => "104"
                        "paginaInicial" => "293"
                        "paginaFinal" => "297"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "New treatments for smoking cessation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "JR Hughes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "CA Cancer J Clin"
                        "fecha" => "2000"
                        "volumen" => "50"
                        "paginaInicial" => "143"
                        "paginaFinal" => "151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10901738"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "The Tobacco Use and Dependence Clinical Practice Guideline Panel&#44; Staff&#44; and Consortium Representatives&#46; A clinical practice guideline for treating tobacco use and dependence"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2000"
                        "volumen" => "283"
                        "paginaInicial" => "3244"
                        "paginaFinal" => "3254"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10866874"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perceived importance of being thin and smoking initiation among young girls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K Honjo"
                            1 => "M Siegel"
                          ]
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Vol. 43. Issue 1.
Pages 9-15 (January 2007)
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Vol. 43. Issue 1.
Pages 9-15 (January 2007)
Original Articles
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Weight Gain and Anxiety Levels in Recent Ex-Smokers
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Isabel Nerína,
Corresponding author
isabelne@unizar.es

Correspondence: Dra. I. Nerín. Departamento de Medicina y Psiquiatría. Facultad de Medicina. Edificio B. Domingo Miral, s/n. 50009 Zaragoza. España
, Asunción Beamonteb, Pilar Gargallob, Adriana Jiménez-Muroa, Adriana Marquetaa
a Unidad de Tabaquismo FMZ, Departamento de Medicina y Psiquiatría, Facultat de Medicina, Universidad de Zaragoza, Zaragoza, Spain
b Unidad de Tabaquismo FMZ, Departamento de Métodos Estadísticos, Escuela Universitaria de Estudios Empresariales, Universidad de Zaragoza, Zaragoza, Spain
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Objective

To evaluate weight gain and its relation to anxiety in a group of smokers after 3 months of cessation treatment.

Patients and methods

The target population for this prospective, analytical, longitudinal study was smokers being treated in a specialist smoking cessation clinic who were still abstinent at the conclusion of a 3-month treatment program. The following variables were analyzed: age, sex, nicotine dependence (Fagerström test), daily cigarette consumption, number of pack-years, pharmacological treatment (nicotine replacement/bupropion), use of nicotine gum (yes/no), weight gain, body mass index, and degree of state and trait anxiety. Successful cessation was defined as self-reported abstinence confirmed by measurement of expired carbon monoxide (CO) level (≤10 ppm). Anxiety was evaluated using the State-Trait Anxiety Inventory. The state anxiety and weight variables were measured on 5 occasions: before smoking cessation, and at the end of week 1, month 1, month 2, and month 3 after cessation. Results for the quantitative variables were expressed as means (SD), and results for the qualitative variables were expressed as percentages and absolute frequencies.

Results

The study population consisted of 122 individuals, 76 of whom were men (62%) and 46 of whom were women (38%). The mean age was 43.9 (9.9) years, and mean nicotine dependence according to the Fagerström scale was 6.2 (2.2) points. Average weight gain was 2.6 kg (3.6%), with no significant difference between the sexes. Weight gain in 25% of this population was greater than 4.2 kg, and maximum weight gain was 9.2 kg. Levels of state anxiety fell progressively as weight increased, although there was no evident relationship between the 2 variables.

Conclusions

Weight gain is moderate as smokers quit. Anxiety levels, which are greater in the first few weeks after cessation, do not explain weight variation, which is more related to the metabolic effects of nicotine rather than to psychological variables.

Key words:
Smoking cessation
Weight gain
Nicotine
Anxiety
Weight
Body mass index
Objetivo

Evaluar la ganancia ponderal en un grupo de fumadores que permanecen abstinentes 3 meses después de dejar de fumar y valorar su relación con la ansiedad.

Pacientes y métodos

Se trata de un estudio prospectivo, analítico y longitudinal, en el que la población objetivo eran fumadores atendidos en una unidad especializada de tabaquismo que permanecían abstinentes al finalizar el trata-miento (3 meses). Se estudiaron las siguientes variables: edad, sexo, dependencia a la nicotina mediante el test de Fagerström, cigarrillos/día, paquetes-año, tratamiento farma-cológico (sustitutivo de nicotina/bupropión), ingesta de chicles de nicotina (sí/no), incremento ponderal, índice de masa corporal y grado de ansiedad (rasgo y estado). Se consideró éxito la abstinencia mantenida según refería el paciente junto con cooximetría (monóxido de carbono ≤10 ppm). La ansiedad se evaluó con el cuestionario STAI-E/R (State-Trait Anxiety Inventory). Las variables ansiedad de estado y peso se midieron en 5 momentos: antes de dejar de fumar, a la se-mana, al mes, a los 2 meses y a los 3 meses. Los resultados se expresan como medias ± desviación estándar (variables cuantitativas) y como proporciones y frecuencias absolutas (variables cualitativas).

Resultados

La población de estudio estaba compuesta por 122 individuos -76 varones (62%) y 46 mujeres (38%)-, con una edad media (± desviación estándar) de 43,9 ± 9,9 años y dependencia a la nicotina (test de Fagerström) de 6,2 ± 2,2 puntos. El incremento ponderal fue en promedio de 2,6 kg (3,6%), sin que hubiera diferencias por sexo. Un 25% de la población tuvo una ganancia mayor de 4,2 kg, pero en nin-gún caso se superaron los 9,2 kg. La ansiedad de estado dis-minuyó progresivamente, mientras que el peso mostró una evolución ascendente, sin que hubiera relación entre ambos.

Conclusiones

La ganancia ponderal al dejar de fumar es moderada. La ansiedad, más intensa en las primeras semanas, no justifica el incremento del peso, que está más re-lacionado con los efectos metabólicos de la nicotina que con variables psicológicas.

Palabras clave:
Deshabituación tabáquica
Ganancia ponderal
Nicotina
Ansiedad
Peso
Índice de masa corporal
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REFERENCES
[1]
US Department of Health and Human Services.
The health consequences of smoking: nicotine addiction: A report from the Surgeon General, Government Printing Office, (1988),
[2]
NL Benowitz.
Nicotine addiction.
Prim Care, 26 (1999), pp. 611-631
[3]
SI Rennard, DM Daughton.
Smoking cessation.
Chest, 117 (2000), pp. 360-364
[4]
P Froom, S Melamed, J Benbassat.
Smoking cessation and weight gain.
J Fam Pract, 46 (1998), pp. 460-464
[5]
MM Clark, PA Decker, KP Offord, CA Patten, KS Vickers, IT Croghan, et al.
Weight concerns among male smokers.
Addict Behav, 29 (2004), pp. 1637-1641
[6]
RC Klesges, AW Meyers, LM Klesges, ME la Vasque.
Smoking, body weight, and their effects on smoking behavior: a comprehensive review of the literature.
Psychol Bull, 106 (1989), pp. 204-230
[7]
US Department of Health and Human Services.
The health benefits of smoking cessation: a report of the Surgeon General, Office on Smoking and Health, (1990),
[8]
C Filozof, MC Fernández Pinilla, A Fernández-Cruz.
Smoking cessation and weight gain.
[9]
GE Swan, D Carmelli.
Characteristics associated with excessive weight gain after smoking cessation in men.
Am J Public Health, 85 (1995), pp. 73-77
[10]
JR Hughes, ST Higgins, WK Bickel.
Nicotine withdrawal versus other drug withdrawal syndromes: similarities and dissimilarities.
Addiction, 89 (1994), pp. 1461-1470
[11]
B Sandín, P Chorot.
Concepto y categorización de los trastornos de ansiedad.
Manual de psicopatología, pp. 54-78
[12]
K Fagerström, N Schneider.
Measuring nicotine dependence. A review of the Fagerström tolerance questionnaire.
J Behav Med, 12 (1989), pp. 159-182
[13]
JR Hughes, JP Keely, RS Niaura, DJ Ossip-Klein, RL Richmond, GE Swan.
Measures of abstinence in clinical trials: issues and recommendations.
Nicotine Tob Res, 5 (2003), pp. 13-25
[14]
I Nerín, A Crucelaegui, A Mas, JA Villalba, D Guillén, A Gracia.
Resultados de un programa integral del tabaquismo en el entorno laboral.
Arch Bronconeumol, 41 (2005), pp. 197-201
[15]
Conferencia de consenso.
Consenso SEEDO'2000 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de intervención terapéutica.
Med Clin (Barc), 115 (2000), pp. 587-597
[16]
N Seisdedos.
Cuestionario de Ansiedad Estado-Rasgo.
Adaptación española, TEA Ediciones, (1988),
[17]
R West, P Hajek.
What happens to anxiety levels on giving up smoking?.
Am J Psychiatry, 154 (1997), pp. 1589-1592
[18]
T Danielsson, S Rössner, A Westin.
Open randomised trial of intermittent very low energy diet together with nicotine gum for stopping smoking in women who gained weight in previous attempts to quit.
BMJ, 319 (1999), pp. 490-494
[19]
DF Williamson, J Madans, RF Anda, JC Kleinman, GA Giovino, T Byers.
Smoking cessation and severity of weight gain in a national cohort.
N Engl J Med, 324 (1991), pp. 739-745
[20]
P Froom, E Kristal-Boneh, S Melamed, D Gofer, J Benbassat, J Ribak.
Smoking cessation and body mass index of occupationally active men: the Israeli CORDIS study.
Am J Public Health, 89 (1999), pp. 718-722
[21]
RJ Moffatt, SG Owens.
Cessation from cigarette smoking: changes in body weight, body composition, resting metabolism, and energy consumption.
Metabolism, 40 (1991), pp. 465-470
[22]
YH Jo, DA Talmage, LW Role.
Nicotinic receptor-mediated effects on appetite and food intake.
J Neurobiol, 53 (2002), pp. 618-632
[23]
C Bamia, A Trichopoulou, D Lenas, D Trichopoulos.
Tobacco smoking in relation to body fat mass and distribution in a general population sample.
Int J Obes, 28 (2004), pp. 1091-1096
[24]
KM Flegal, RP Troiano, ER Pamuk, RJ Kuczmarski, SM Campbell.
The influence of smoking cessation on the prevalence of overweight in the United States.
N Engl J Med, 333 (1995), pp. 1165-1170
[25]
JL Gutiérrez-Fisac, F Rodríguez.
Relación entre obesidad, hábito tabáquico y actividad física en el tiempo libre en la población española de 20 a 64 años.
Med Clin (Barc), 104 (1995), pp. 293-297
[26]
JR Hughes.
New treatments for smoking cessation.
CA Cancer J Clin, 50 (2000), pp. 143-151
[27]
The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives. A clinical practice guideline for treating tobacco use and dependence.
JAMA, 283 (2000), pp. 3244-3254
[28]
K Honjo, M Siegel.
Perceived importance of being thin and smoking initiation among young girls.
Tob Control, 12 (2003), pp. 289-295
[29]
B Marcus, AE Albrecht, TK King, AF Parisi, BM Pinto, M Roberts, et al.
The efficacy of exercise as an aid for smoking cessation in women.
Arch Intern Med, 159 (1999), pp. 1229-1234
[30]
I Kawachi, R Troisi, A Rotnitzky, H Coakley, G Colditz.
Can physical activity minimize weight gain in women after smoking cessation?.
Am J Public Health, 86 (1996), pp. 999-1004
Copyright © 2007. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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