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      Diretrizes para cessação do tabagismo - 2008 Translated title: Smoking cessation guidelines - 2008

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          Abstract

          Estas diretrizes constituem uma ferramenta atualizada e abrangente para auxiliar o profissional de saúde na abordagem do tabagista, recomendando atitudes baseadas em evidências clínicas como a melhor forma de conduzir cada caso. De forma reduzida e mais objetiva possível, o texto final foi agrupado em dois grandes itens: Avaliação e Tratamento. Os dois itens apresentam comentários e níveis de recomendação das referências utilizadas, bem como algumas propostas de abordagem, como por exemplo, redução de danos, em situações específicas ainda pouco exploradas, como recaídas, tabagismo passivo, tabagismo na categoria médica e uso de tabaco em ambientes específicos.

          Translated abstract

          These guidelines are an up-to-date and comprehensive tool to aid health professionals in treating smokers, recommending measures and strategies for managing each case based on clinical evidence. Written in a simplified and objective manner, the text is divided into two principal sections: Evaluation and Treatment. The sections both present comments on and levels of evidence represented by the references cited, as well as some proposals for the reduction of damage and for intervening in specific and still poorly explored situations, such as relapse, passive smoking, physician smoking, and tobacco use in specific environments.

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          Most cited references236

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          Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis.

          Observational studies have suggested an association between active smoking and the incidence of type 2 diabetes. To conduct a systematic review with meta-analysis of studies assessing the association between active smoking and incidence of type 2 diabetes. A search of MEDLINE (1966 to May 2007) and EMBASE (1980 to May 2007) databases was supplemented by manual searches of bibliographies of key retrieved articles, reviews of abstracts from scientific meetings, and contact with experts. Studies were included if they reported risk of impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes in relationship to smoking status at baseline; had a cohort design; and excluded persons with diabetes at baseline. Two authors independently extracted the data, including the presence or absence of active smoking at baseline, the risk of diabetes, methods used to detect diabetes, and key criteria of study quality. Relative risks (RRs) were pooled using a random-effects model. Associations were tested in subgroups representing different patient characteristics and study quality criteria. The search yielded 25 prospective cohort studies (N = 1.2 million participants) that reported 45 844 incident cases of diabetes during a study follow-up period ranging from 5 to 30 years. Of the 25 studies, 24 reported adjusted RRs greater than 1 (range for all studies, 0.82-3.74). The pooled adjusted RR was 1.44 (95% confidence interval [CI], 1.31-1.58). Results were consistent and statistically significant in all subgroups. The risk of diabetes was greater for heavy smokers (> or =20 cigarettes/day; RR, 1.61; 95% CI, 1.43-1.80) than for lighter smokers (RR,1.29; 95% CI, 1.13-1.48) and lower for former smokers (RR, 1.23; 95% CI, 1.14-1.33) compared with active smokers, consistent with a dose-response phenomenon. Active smoking is associated with an increased risk of type 2 diabetes. Future research should attempt to establish whether this association is causal and to clarify its mechanisms.
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            The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire.

            We examine and refine the Fagerström Tolerance Questionnaire (FTQ: Fagerström, 1978). The relation between each FTQ item and biochemical measures of heaviness of smoking was examined in 254 smokers. We found that the nicotine rating item and the inhalation item were unrelated to any of our biochemical measures and these two items were primary contributors to psychometric deficiencies in the FTQ. We also found that a revised scoring of time to the first cigarette of the day (TTF) and number of cigarettes smoked per day (CPD) improved the scale. We present a revision of the FTQ: the Fagerström Test for Nicotine Dependence (FTND).
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              Stages and processes of self-change of smoking: Toward an integrative model of change.

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                Author and article information

                Journal
                jbpneu
                Jornal Brasileiro de Pneumologia
                J. bras. pneumol.
                Sociedade Brasileira de Pneumologia e Tisiologia (São Paulo, SP, Brazil )
                1806-3756
                October 2008
                : 34
                : 10
                : 845-880
                Affiliations
                [02] orgnameUniversidade Federal do Rio de Janeiro orgdiv1Hospital Universitário Clementino Fraga Filho orgdiv2Instituto de Doenças do Tórax
                [03] orgnameUniversidade Federal do Rio de Janeiro orgdiv1COPPE
                [08] Porto Alegre RS orgnamePontifícia Universidade Católica do Rio Grande do Sul orgdiv1Faculdade de Medicina orgdiv2Hospital São Lucas Brasil
                [04] Rio de Janeiro RJ orgnamePontifícia Universidade Católica do Rio de Janeiro orgdiv1Escola Médica de Pós Graduação Brasil
                [10] São Paulo SP orgnameUniversidade Federal de São Paulo orgdiv1Sociedade Paulista de Pneumologia e Tisiologia Brasil
                [01] São Paulo SP orgnameAssociação Médica Brasileira orgdiv1Sociedade Brasileira de Pneumologia e Tisiologia Brasil
                [06] Niterói RJ orgnamePrograma Municipal de Controle do Tabagismo orgdiv1Instituto Nacional do Câncer Brasil
                [05] orgnameCentro de Estudos para Tratamento da Dependência à Nicotina
                [09] Fortaleza CE orgnameHospital de Messejana orgdiv1Programa de Controle do Tabagismo Brasil
                [07] Botucatu SP orgnameUniversidade Estadual Paulista orgdiv1Faculdade de Medicina Brasil
                Article
                S1806-37132008001000014 S1806-3713(08)03401014
                10.1590/S1806-37132008001000014
                03d0a5f4-24ca-4522-977f-9324c717aef6

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 05 August 2008
                : 07 August 2008
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 242, Pages: 36
                Product

                SciELO Brazil

                Categories
                Diretrizes da SBPT

                Smoking,Guia,Abandono do hábito de fumar,Guideline,Smoking cessation,Tabagismo

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