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Carballo JL, Rodríguez-Espinosa S, Sancho-Domingo C, Coloma-Carmona A. Validation of the Glover-Nilsson Smoking Behavioral Questionnaire (GN-SBQ) to Evaluate Nicotine Dependence in Spanish Clinical Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1119. [PMID: 36673877 PMCID: PMC9858870 DOI: 10.3390/ijerph20021119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 12/27/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
An assessment of the different aspects of tobacco addiction is central to adapting interventions to the profiles and needs of smokers. The Glover−Nilsson Smoking Behavioral Questionnaire (GN-SBQ) is one of the few and most used scales to evaluate the behavioral aspects of tobacco addiction. However, few studies involve the validation of the GN-SBQ in clinical settings. Thus, this study aimed to analyze the psychometric properties of the GN-SBQ in a sample of Spanish smokers. A total of 341 smokers attending clinical services in Spain participated in this cross-sectional study. Measures included the psychological factors related to tobacco addiction, assessed with the GN-SBQ, the physical factors of nicotine addiction, withdrawal symptoms, smoking-related variables, and alcohol use. Data analysis included descriptive statistics, internal consistency coefficients, confirmatory factor analyses, Spearman correlations, and the Kruskal−Wallis test. The GN-SBQ showed adequate reliability (α = 0.76 and ω = 0.76) and a unidimensional structure. GN-SBQ scores also provided evidence of convergent and concurrent validity. GN-SBQ scores significantly correlated with the physical symptoms of addiction, age, number of cigarettes, and withdrawal symptoms. The results of discriminant validity were also adequate, as no correlation was observed between GN-SBQ scores and CO levels or alcohol use. Significant differences were found between all levels of psychological addiction based on the GN-SBQ scores regarding physical nicotine addiction, withdrawal symptoms, and age. Thus, this questionnaire is a reliable and valid instrument to assess the psychological aspects of tobacco addiction in smokers in clinical settings. The short length of the GN-SBQ proves advantageous for its use in time-limited assessments, which are common in public health services.
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Affiliation(s)
- José Luis Carballo
- Center for Applied Psychology, Miguel Hernández University, Avenida Universidad, s/n, 03202 Elche, Spain
| | | | | | - Ainhoa Coloma-Carmona
- Center for Applied Psychology, Miguel Hernández University, Avenida Universidad, s/n, 03202 Elche, Spain
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Néstor S, Carlos P, Cristina P, José MR, Ignacio B, Pilar S. TOBACCO USE DISORDER AND DUAL DISORDERS Joint statement by the Spanish Psychiatry Society and the Spanish Dual Disorders Society. ACTAS ESPANOLAS DE PSIQUIATRIA 2022; 50:77-138. [PMID: 35731182 PMCID: PMC11095114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Tobacco Use Disorder (TUD) is a health problem of the first order in the world population, affecting a vulnerable population, such as people with other mental disorders, whose morbidity and mortality are increased as a result.
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Affiliation(s)
- Szerman Néstor
- Instituto de Psiquiatría y Salud Mental, Hospital General Universitario Gregorio Marañón, Madrid, España. Miembro de la Sociedad Española de Patología Dual (SEPD)
| | - Parro Carlos
- Instituto de Psiquiatría y Salud Mental, Hospital General Universitario Gregorio Marañón, Madrid, España. Miembro de la Sociedad Española de Patología Dual (SEPD)
| | - Pinet Cristina
- Unidad Toxicomanías, Servicio de Psiquiatría, Hospital Sant Pau, Barcelona, España. Miembro de la Sociedad Española de Psiquiatría (SEP)
| | - Martínez-Raga José
- Departamento de Psiquiatría y Psicología Médica. Hospital Universitario Doctor Peset y Universitat de Valencia. Valencia, España. Miembro de la Sociedad Española de Patología Dual (SEPD)
| | - Basurte Ignacio
- Dirección médica de Psiquiatría y Salud Mental de la Clínica López Ibor. Madrid, España. Profesor vinculado de la Universidad Europea de Madrid. Madrid, España. Miembro de la Sociedad Española de Patología Dual (SEPD)
| | - Saiz Pilar
- Catedrática de Psiquiatría. Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Instituto de Investigación sanitaria del Principado de Asturias (ISPA), Servicio de Salud del Principado de Asturias (SESPA). Asturias, España. Miembro de la Sociedad Española de Psiquiatría (SEP)
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Kozak K, George TP. Pharmacotherapy for smoking cessation in schizophrenia: a systematic review. Expert Opin Pharmacother 2020; 21:581-590. [PMID: 32011186 DOI: 10.1080/14656566.2020.1721466] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Introduction: Rates of tobacco smoking are high in people with schizophrenia with greater difficulty of quitting smoking compared to the general population, which also relate to the increased cardiovascular and cancer risks in this co-occurring disorder. Therefore, effective smoking cessation pharmacotherapies addressing tobacco co-morbidity are imperative.Areas covered: In this review, the authors performed an extensive systematic electronic literature review examining the efficacy and safety of first-line pharmacotherapies for smoking cessation, including varenicline, sustained-release bupropion, and nicotine replacement therapies (NRT) using continuous abstinence rates over 10-12-week periods in smokers with schizophrenia. Twelve trials reporting smoking cessation outcomes using interventions in schizophrenia were included and risk ratio (RR) was used.Expert opinion: Our findings support the efficacy and safety of first-line pharmacotherapies for the treatment of tobacco use disorder in smokers with schizophrenia. Further research on the long-term effectiveness and safety of these agents in community samples is warranted. Smoking cessation pharmacotherapies may warrant the consideration of the emerging use of electronic nicotine delivery systems while neuromodulation techniques also offer promise.
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Affiliation(s)
- Karolina Kozak
- Institute of Medical Science (IMS), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Tony P George
- Institute of Medical Science (IMS), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Jaén-Moreno MJ, Feu N, Redondo-Écija J, Montiel FJ, Gómez C, Del Pozo GI, Alcalá JÁ, Gutiérrez-Rojas L, Balanzá-Martinez V, Chauca GM, Carrión L, Osuna MI, Sánchez MD, Caro I, Ayora M, Valdivia F, López MS, Poyato JM, Sarramea F. Smoking cessation opportunities in severe mental illness (tobacco intensive motivational and estimate risk - TIMER-): study protocol for a randomized controlled trial. Trials 2019; 20:47. [PMID: 30642365 PMCID: PMC6332915 DOI: 10.1186/s13063-018-3139-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 12/15/2018] [Indexed: 01/19/2023] Open
Abstract
Background There is an increased risk of premature death in people with severe mental illness (SMI). Respiratory disorders and cardiovascular disease are leading causes of increased mortality rates in these patients, and tobacco consumption remains the most preventable risk factor involved. Developing new tools to motivate patients towards cessation of smoking is a high priority. Information on the motivational value of giving the lung age and prevention opportunities is unknown in this high-risk population. Methods/design This article describes in detail a protocol developed to evaluate an intensive motivational tool, based on the individual risks of pulmonary damage and prevention opportunities. It is designed as a randomized, 12-month, follow-up, multicenter study. A minimum of 204 smokers will be included, aged 40 years and older, all of whom are patients diagnosed with either schizophrenia or bipolar disorder (BD). Chronic obstructive pulmonary disease (COPD) will be evaluated using spirometry, and the diagnosis will then be validated by a pneumologist and the lung age estimated. Based on this value, a motivational message about prevention will be issued for the intervention group, which will be reinforced by individualized text messages over a period of 3 months. The efficacy of the method and the pulmonary damage variables will be evaluated: smoking cessation at the end of follow-up will be confirmed by cooximetry, and the COPD diagnosis and the severity of the staging for disease will be assessed. Discussion In the context of community care, screening and early detection of lung damage could potentially be used, together with mobile technology, in order to produce a prevention message, which may provide patients with SMI with a better chance of quitting smoking. Trial registration ClinicalTrials.gov, ID: NCT03583203. Registered on 11 July 2018. Trial status: recruitment.
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Affiliation(s)
- María José Jaén-Moreno
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Departamento de Ciencias Sociosanitarias, Radiología y Medicina Física, Universidad de Córdoba, Córdoba, Spain
| | - Nuria Feu
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Justa Redondo-Écija
- Unidad de Drogas y Adicciones, Instituto Provincial de Bienestar Social, Diputación de Córdoba, Córdoba, Spain
| | | | - Cristina Gómez
- Unidad de Gestión Clínica de Salud Mental, Complejo Hospitalario de Jaén, Córdoba, Spain
| | - Gloria I Del Pozo
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n 14014, Córdoba, Spain
| | - Jose Ángel Alcalá
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n 14014, Córdoba, Spain
| | - Luis Gutiérrez-Rojas
- Grupo de Investigación Psiquiatría y Neurociencias (CTS-549), Instituto de Neurociencias, Universidad de Granada, Granada, Spain
| | - Vicente Balanzá-Martinez
- Área de Psiquiatría y Psicología Médica. Departamento de Medicina, Servicio de Psiquiatría, Universidad de Valencia, CIBERSAM, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Geli Marie Chauca
- Unidad de Gestión Clínica de Salud Mental, Hospital Infanta Margarita, Cabra, Spain
| | - Laura Carrión
- Unidad de Gestión Clínica de Salud Mental, Hospital Infanta Margarita, Cabra, Spain
| | - Maria Isabel Osuna
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - María Dolores Sánchez
- Unidad de Gestión Clínica de Salud Mental, Complejo Hospitalario de Jaén, Córdoba, Spain
| | - Inmaculada Caro
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Miriam Ayora
- Unidad de Psiquiatría del niño y del adolescente, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Francisca Valdivia
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n 14014, Córdoba, Spain
| | - María Soledad López
- Unidad de Gestión Clínica de Salud Mental, Hospital Infanta Margarita, Cabra, Spain
| | - Jose Manuel Poyato
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n 14014, Córdoba, Spain
| | - Fernando Sarramea
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain. .,Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n 14014, Córdoba, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006, Oviedo, Spain.
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Raich A, Pinet C, Ballbè M, Mondon S, Tejedor R, Arnau A, Fernández E. Multimodal treatment for smoking cessation with varenicline in alcoholic, methadone-maintained, and psychotic patients: A one-year follow-up. Tob Induc Dis 2018; 16:58. [PMID: 31516455 PMCID: PMC6659506 DOI: 10.18332/tid/99541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Numerous studies have evaluated the efficacy and safety of varenicline for smoking cessation in smokers in the general population and, to a lesser extent, among the psychiatric population. However, few studies have evaluated varenicline in patients with other addictions. The present study was conducted to assess outcomes of a multimodal treatment for smoking cessation intervention with varenicline in a sample of alcohol and substance use disorders and patients with psychotic disorders. METHODS This was a prospective, multicenter study. The patient sample comprised alcoholics in remission, methadone-maintained patients, and patients with psychotic disorders, all of whom wanted to stop smoking. All participants received multimodal treatment for smoking cessation therapy (psychological therapy plus varenicline). Smoking abstinence and changes in the psychopathological state of patients were assessed at predefined time points during a 12-month follow-up. The probability of tobacco abstinence after one year of treatment was computed using Kaplan-Meier life tables. RESULTS The probability of abstinence at one year was 0.225 (95% CI: 0.1430-0.319). By group, the probabilities were as follows: patients with psychotic disorders 0.254 (95% CI: 0.118-0.415); alcoholics 0.237 (95% CI: 0.098-0.409); and methadone-maintained patients 0.177 (95% CI: 0.065-0.335). Patients with previous quit attempts had a higher probability of achieving abstinence at one year (p<0.01). CONCLUSIONS The results of this study support the use of multimodal treatment with varenicline in patients with alcohol addiction in remission, patients on methadone maintenance, and patients with stable psychotic disorders. Previous smoking cessation attempts were predictive of smoking cessation success in these patients.
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Affiliation(s)
- Antonia Raich
- Group of Research SAMIS, Mental Health Department, Althaia Xarxa Assistencial Universitària de Manresa, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Cristina Pinet
- Addiction Unit, Mental Health Department, Hospital de Sant Pau, Barcelona, Spain
| | - Montse Ballbè
- Addictions Unit, Psychiatry Department, Neurosciences Institute, Hospital Clínic, IDIBAPS, Barcelona, Spain.,Tobacco Control Unit, Institut Català d'Oncologia, IDIBELL, Barcelona, Spain
| | - Silvia Mondon
- Addictions Unit, Psychiatry Department, Neurosciences Institute, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Rosa Tejedor
- Group of Research SAMIS, Mental Health Department, Althaia Xarxa Assistencial Universitària de Manresa, Barcelona, Spain
| | - Anna Arnau
- Research Department, Althaia Xarxa Assistencial Universitària de Manresa, Barcelona, Spain
| | - Esteve Fernández
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.,Tobacco Control Unit, Institut Català d'Oncologia, IDIBELL, Barcelona, Spain
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Garcia-Portilla MP, Garcia-Alvarez L, Sarramea F, Galvan G, Diaz-Mesa E, Bobes-Bascaran T, Al-Halabi S, Elizagarate E, Iglesias C, Saiz Martínez PA, Bobes J. 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. Schizophr Res 2016; 176:272-280. [PMID: 27237598 DOI: 10.1016/j.schres.2016.05.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/06/2016] [Accepted: 05/17/2016] [Indexed: 01/22/2023]
Abstract
Despite the proven association between smoking and high rates of medical morbidity and reduced life expectancy in people with severe mental disorders (SMD), their smoking rates do not decline as they do in the general population. We carried out a non-randomized, open-label, prospective, 9-month follow-up multicentre trial to investigate the clinical efficacy, safety and tolerability of a 12-week smoking cessation programme for patients with SMD in the community under real-world clinical conditions. Eighty-two adult outpatients with schizophrenic/bipolar disorder smoking ≥15 cigarettes/day were assigned by shared decision between doctors and patients to transdermal nicotine patches (TNP) [36(46.2%)] or varenicline [39(50%)]. Short-term efficacy: The 12-week 7-day smoking cessation (self-reported cigarettes/day=0 and breath carbon monoxide levels≤9ppm) prevalence was 49.3%, without statistically significant differences between medications (TNP 50.0% vs varenicline 48.6%, chi-square=0.015, p=1.000). Long-term efficacy: At weeks 24 and 36, 41.3 and 37.3% of patients were abstinent, with no statistically significant differences between treatments. Safety and Tolerability: no patients made suicide attempts/required hospitalization. There was no worsening on the psychometric scales. Patients significantly increased weight [TNP 1.1(2.8) vs varenicline 2.5(3.3), p=0.063], without significant changes in vital signs/laboratory results, except significant decreases in alkaline phosphatase and low-density lipoprotein-cholesterol levels in the varenicline group. Patients under varenicline more frequently presented nausea/vomiting (p<0.0005), patients under TNP experienced skin reactions more frequently (p=0.002). Three patients under varenicline had elevated liver enzymes. In conclusion, we have demonstrated that in real-world clinical settings it is feasible and safe to help patients with stabilized severe mental disorders to quit smoking.
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Affiliation(s)
- Maria P Garcia-Portilla
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain.
| | | | - Fernando Sarramea
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain; UGC Salud Mental, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Gonzalo Galvan
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain
| | - Eva Diaz-Mesa
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain
| | - Teresa Bobes-Bascaran
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 46010, Valencia, Spain
| | - Susana Al-Halabi
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain
| | - Edorta Elizagarate
- Unidad de Psicosis Refractarias, Hospital Psiquiátrico de Álava, 01006 Vitoria, Spain
| | - Celso Iglesias
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain
| | - Pilar A Saiz Martínez
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain
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Stubbs B, Vancampfort D, Bobes J, De Hert M, Mitchell AJ. How can we promote smoking cessation in people with schizophrenia in practice? A clinical overview. Acta Psychiatr Scand 2015; 132:122-30. [PMID: 25754402 DOI: 10.1111/acps.12412] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVE High rates of smoking and nicotine dependence are associated with increased physical comorbidity and premature death in people with schizophrenia. We conducted a clinical overview to establish how smoking cessation should be promoted in practice. METHOD Systematic clinical review of major electronic databases from inception till November 2014. RESULTS A growing body of evidence supports pharmacological interventions to assist smoking cessation. The most promising evidence is for bupropion with several meta-analyses demonstrating its effectiveness. Currently, there is limited evidence demonstrating the effectiveness of nicotine replacement therapy (NRT) and varenicline, although this is likely to be due to the paucity of research. There are no consistent data to suggest that pharmacological interventions increase adverse events. Behavioural and psychosocial interventions also demonstrate promise, particularly when combined with pharmacotherapy. Careful monitoring of antipsychotic levels (in particular clozapine) is essential, and the promotion of physical activity may be useful to negate potential weight gain and diabetes risk following smoking cessation. CONCLUSION Evidence from systematic reviews and meta-analyses suggests that smoking cessation interventions are effective in people with schizophrenia, although more long-term research is required. Promoting smoking cessation should be given utmost priority in clinical practice, and we offer practical strategies to facilitate this.
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Affiliation(s)
- B Stubbs
- School of Health and Social Care, University of Greenwich, Eltham, London, UK
| | - D Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - J Bobes
- Department of Psychiatry, University of Oviedo - CIBERSAM, Oviedo, Spain
| | - M De Hert
- KU Leuven Department of Neurosciences, UPC KU Leuven, Kortenberg, Belgium
| | - A J Mitchell
- Department of Cancer and Molecular Medicine, University of Leicester, Leicester, UK
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