Avaliação da dependência comportamental pelo questionário de Glover-Nilsson em fumantes
Arquivos
Data
2022-12-08
Autores
Sampaio, Lygia de Carvalho 
Orientadores
Jardim, José Roberto de Brito
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A dependência química é rotineiramente avaliada nas clínicas de cessação de tabagismo, a dependência comportamental não tem recebido a mesma importância na avaliação dos fumantes. O Questionário Comportamental de Tabagismo de Glover-Nilsson avalia as várias situações que estão associadas ao hábito de fumar, de maneira rápida, com fácil entendimento do fumante e com informações que são essenciais para que o profissional da saúde ajude o fumante na cessação. Objetivo: Avaliar a dependência comportamental com a utilização do Questionário Comportamental de Tabagismo de Glover-Nilsson (GN), identificar o perfil dos subgrupos e fazer associação com o Teste de Fagerström (FG) para Dependência ao cigarro. Métodos: Estudo transversal que avaliou as características sociodemográficas, dependência comportamental, dependência ao cigarro e as análises de classes latentes dos pacientes atendidos no Ambulatório de Cessação do Tabagismo da Disciplina de Pneumologia da Escola Paulista de Medicina e as correlações entre elas. Resultados: foram avaliados 1713 pacientes e classificados como dependência comportamental ao cigarro leve 128 (8,4%); como moderado 611 (40%), como acentuado 666 (43,7%) e como muito acentuado 121 (7,9%).GN leve associou-se ao sexo masculino, divorciados/separados, analfabetos e ensino fundamental incompleto, classe D e, FG baixo, grau de possibilidade de ansiedade e depressão baixo; GN moderado associou-se ao sexo masculino , analfabetos e ensino fundamental incompleto, FG baixo, grau de possibilidade de ansiedade e depressão baixo, IMC até 29,9 kg/m2; GN acentuado associou-se ao sexo feminino, ensino médio completo, superior incompleto, ensino superior completo ou pós-graduação, FG alto, grau de possibilidade de ansiedade e depressão alto e IMC ≥30 kg/m2; GN muito acentuado associou-se ao sexo feminino, solteiros, ensino médio completo e superior incompleto, classe C, FGN alto e grau de possibilidade de ansiedade e depressão alto. Análise de Classes Latentes mostrou cinco grupos: classe 1,3 e 4: mulheres mais velhas, casadas, alta carga tabagística e maior tempo de tabagismo; classe 4 associou-se à ansiedade e depressão. Classe 2 associou-se com homens mais jovens, solteiros, mais escolarizados e classe socioeconômica mais elevada. Classe 5 associou-se às mulheres, jovens, mais escolarizadas e ansiedade e depressão. Tendo como referência a classe 3, a classe 1 tem 2 vezes mais chance de associar-se ao Glover-Nilsson acentuado, classe 2, 6 vezes ao GN muito acentuado, classe 4,18 vezes ao GN muito acentuado e classe 5, 41 vezes ao GN muito acentuado. Houve correlação significante e positiva entre os escores de GN e FG. Conclusão: A maioria dos fumantes está nos grupos de dependência comportamental moderado e acentuado. A dependência comportamental associou-se às categorias sexo, estado civil, escolaridade, classe social, IMC, ansiedade e depressão. Houve associação entre a dependência ao cigarro e à dependência comportamental.
Descritores: Tabagismo; Dependência Comportamental; Glover-Nilsson.
Abstract Introduction: Chemical dependence is routinely evaluated in smoking cessation clinics, behavioral dependence has not received the same importance in the evaluation of smokers. The Glover-Nilsson Behavioral Smoking Questionnaire assesses the various situations that are associated with the habit of smoking, quickly, with easy understanding by the smoker and with information that is essential for the health professional to help the smoker with cessation. Objective: To assess behavioral dependence using the Glover-Nilsson Behavioral Smoking Questionnaire (GN), identify the profile of subgroups and associate it with the Fagerström Test (FG) for Cigarette Dependence. Methods: Cross-sectional study that evaluated the sociodemographic characteristics, behavioral dependence, cigarette dependence and analysis of latent classes of patients seen at the Smoking Cessation Outpatient Clinic of the Discipline of Pulmonology at Escola Paulista de Medicina and the correlations between them. Results: 1713 patients were evaluated and 128 (8.4%) were classified as behavioral dependence on light cigarettes; as moderate 611 (40%), as accentuated 666 (43.7%) and as very accentuated 121 (7.9%). Mild GN was associated with male gender, divorced/separated, illiterate and incomplete primary education, class D and E, low FG, low degree of possibility of anxiety and depression; moderate NG was associated with male gender, illiteracy and incomplete primary education, low GFR, low degree of possibility of anxiety and depression, BMI up to 29.9 kg/m2; accentuated GN was associated with female gender, complete high school, incomplete higher education, complete higher education or postgraduate, high GF, high degree of possibility of anxiety and depression and BMI ≥30 kg/m2; Very pronounced GN was associated with the female gender, singles, complete high school and incomplete higher education, class C, high FGN and high degree of possibility of anxiety and depression. Analysis of Latent Classes showed five groups: class 1, 3 and 4: older women, married, high smoking rate and longer smoking time; class 4 was associated with anxiety and depression. Class 2 was associated with younger, single, more educated men and higher socioeconomic status. Class 5 was associated with women, young people, more educated and anxiety and depression. Taking class 3 as a reference, class 1 is 2 times more likely to be associated with accentuated Glover-Nilsson, class 2, 6 times to very accentuated GN, class 4.18 times to very accentuated GN and class 5, 41 times to the very accentuated GN. There was a significant and positive correlation between GN and FG scores. Conclusion: Most smokers are in the moderate and severe behavioral dependence groups. Behavioral dependence was associated with the categories gender, marital status, education, social class, BMI, anxiety and depression. There was an association between cigarette dependence and behavioral dependence. Keywords: Smoking; Behavioral Dependence; Glover-Nilsson
Abstract Introduction: Chemical dependence is routinely evaluated in smoking cessation clinics, behavioral dependence has not received the same importance in the evaluation of smokers. The Glover-Nilsson Behavioral Smoking Questionnaire assesses the various situations that are associated with the habit of smoking, quickly, with easy understanding by the smoker and with information that is essential for the health professional to help the smoker with cessation. Objective: To assess behavioral dependence using the Glover-Nilsson Behavioral Smoking Questionnaire (GN), identify the profile of subgroups and associate it with the Fagerström Test (FG) for Cigarette Dependence. Methods: Cross-sectional study that evaluated the sociodemographic characteristics, behavioral dependence, cigarette dependence and analysis of latent classes of patients seen at the Smoking Cessation Outpatient Clinic of the Discipline of Pulmonology at Escola Paulista de Medicina and the correlations between them. Results: 1713 patients were evaluated and 128 (8.4%) were classified as behavioral dependence on light cigarettes; as moderate 611 (40%), as accentuated 666 (43.7%) and as very accentuated 121 (7.9%). Mild GN was associated with male gender, divorced/separated, illiterate and incomplete primary education, class D and E, low FG, low degree of possibility of anxiety and depression; moderate NG was associated with male gender, illiteracy and incomplete primary education, low GFR, low degree of possibility of anxiety and depression, BMI up to 29.9 kg/m2; accentuated GN was associated with female gender, complete high school, incomplete higher education, complete higher education or postgraduate, high GF, high degree of possibility of anxiety and depression and BMI ≥30 kg/m2; Very pronounced GN was associated with the female gender, singles, complete high school and incomplete higher education, class C, high FGN and high degree of possibility of anxiety and depression. Analysis of Latent Classes showed five groups: class 1, 3 and 4: older women, married, high smoking rate and longer smoking time; class 4 was associated with anxiety and depression. Class 2 was associated with younger, single, more educated men and higher socioeconomic status. Class 5 was associated with women, young people, more educated and anxiety and depression. Taking class 3 as a reference, class 1 is 2 times more likely to be associated with accentuated Glover-Nilsson, class 2, 6 times to very accentuated GN, class 4.18 times to very accentuated GN and class 5, 41 times to the very accentuated GN. There was a significant and positive correlation between GN and FG scores. Conclusion: Most smokers are in the moderate and severe behavioral dependence groups. Behavioral dependence was associated with the categories gender, marital status, education, social class, BMI, anxiety and depression. There was an association between cigarette dependence and behavioral dependence. Keywords: Smoking; Behavioral Dependence; Glover-Nilsson