Search

Co-occurrence of depression and a substance use disorder (SUD) in patients who present dual diagnoses has been long recognized as an important consideration in clinical practice. This review synthesizes the evidence of pharmacological and psychosocial interventions for comorbid depressive disorders and SUDs while providing clinical recommendations about the best interventions to address these patients. The best evidence from randomized controlled trials was used to evaluate treatment options. The strength of recommendations was described using the GRADE approach. Our results suggest that 1) In patients with depression and alcohol consumption, the administration of non-selective serotonin reuptake inhibitor (SSRI) antidepressants instead of SSRI is recommended for improvement of depressive symptoms (strong recommendation). Neither SSRI (strong recommendation) nor non-SSRI (weak recommendation) antidepressants are recommended for reduction in alcohol consumption. 2) In patients with depression and cannabis use, the use of venlafaxine is not recommended (weak recommendation). 3) In patients with depression and cocaine consumption, the use of SSRI antidepressants for improving depressive symptoms (weak recommendation) or to reduce cocaine use is not recommended (strong recommendation). The use of non-SSRI antidepressants is only recommended for improving depressive symptoms (strong recommendation). 4) The administration of bupropion to reduce nicotine consumption is not recommended (strong recommendation). 5) Regarding psychological treatment, in patients with depression and co-occurring alcohol disorder, both pharmacotherapy and cognitive behavioural therapy have positive effects on internalizing symptoms and in reducing alcohol consumption (weak recommendation). Our review suggests the need for more research in this area and for larger, multisite, randomized studies to provide more definite evidence La concurrencia de depresión y un trastorno por uso de sustancias (TUS) en pacientes que presentan patología dual ha sido reconocida desde hace mucho tiempo como una consideración importante en la práctica clínica. Esta revisión sintetiza la evidencia de intervenciones farmacológicas y psicosociales para trastornos comórbidos de depresión y uso de sustancias y además proporciona recomendaciones clínicas respecto de las mejores intervenciones para tratar a estos pacientes. Se utilizó la mejor evidencia de ensayos controlados aleatorizados para evaluar las opciones de tratamiento. La fuerza de las recomendaciones se describió mediante el enfoque GRADE. Nuestros resultados sugieren que: 1) en pacientes con depresión y consumo de alcohol, se recomienda la administración de antidepresivos inhibidores de la recaptación de serotonina (ISRS) no selectivos en lugar de los ISRS para mejorar los síntomas depresivos (recomendación fuerte). No se recomiendan antidepresivos ISRS (recomendación fuerte) ni antidepresivos no ISRS (recomendación débil) para reducir el consumo de alcohol; 2) en pacientes con depresión y consumo de cannabis, no se recomienda el uso de venlafaxina (recomendación débil); 3) en pacientes con depresión y consumo de cocaína, no se recomienda el uso de antidepresivos ISRS para mejorar los síntomas depresivos (recomendación débil) o para reducir el consumo de cocaína (recomendación fuerte). El uso de antidepresivos no ISRS solo se recomienda para mejorar los síntomas depresivos (recomendación fuerte); 4) no se recomienda la administración de bupropión para reducir el consumo de nicotina (recomendación fuerte), y 5) en cuanto al tratamiento psicológico, en pacientes con depresión y trastorno de alcohol concurrente, tanto la farmacoterapia como la terapia cognitivoconductual tienen efectos positivos en la internalización de los síntomas y en la reducción del consumo de alcohol (recomendación débil). Nuestra revisión sugiere la necesidad de realizar más investigaciones en esta área y de estudios aleatorizados, multisitio y más grandes para proporcionar más evidencia definitiva SI

[Abstract] University students, regardless of the country, have a very high prevalence of physical inactivity and health habits acquired during this period tend to remain throughout life, including those related to physical exercise. The purpose of this study was to analyse the relationship between knowledge about the recommendations on the practice of physical activity (PA), the perceived barriers towards PA and the practice of PA by higher education students. This cross-sectional study used a self-reported questionnaire with a stratified sample of university students (n = 840) from a university in Portugal. An ordinal logistic regression model was calculated to determine the predictive variables to the practice of PA. The results showed that 35.7% of the students surveyed were sedentary, the level of knowledge about PA was low, correctly answering 2.79 (SD = .090) questions in a total of 6, and lack of time was the most evident perceived barrier. The constructed model predicted that having more barriers to PA (β = -.750, p = .000) and being female decreased the likelihood of practising PA (β = .578, p = .000). The increase of PA levels of university students is a social necessity and, in this context, higher education institutions should undertake a key role in promoting student health, by implementing actions to reduce their students’ inactivity, developing the transmission of information about the health benefits related to the practice of PA. [Resumen] Los estudiantes universitarios, independientemente del país, tienen una prevalencia muy alta de inactividad física y los hábitos de salud adquiridos durante este período tienden a permanecer a lo largo de la vida, incluidos los relacionados con el ejercicio físico. El propósito de este estudio fue analizar la relación entre el conocimiento sobre las recomendaciones sobre la práctica de AF, las barreras percibidas hacia AF y la práctica de AF por estudiantes de educación superior. Este estudio transversal utilizó un cuestionario auto informado con una muestra estratificada de estudiantes universitarios (n = 840) de una universidad de Portugal. Se calculó un modelo de regresión logística ordinal para determinar las variables predictivas para la práctica de AF. Los resultados mostraron que el 35,7% de los estudiantes encuestados eran sedentarios, el nivel de conocimiento sobre AF era bajo, respondiendo correctamente 2,79 (DE = .090) preguntas en un total de 6, y la falta de tiempo era la barrera percibida más evidente. El modelo construido predijo que tener más barreras a la AF (β = -.750, p = .000) y ser mujer disminuyó la probabilidad de practicar AF (β = .578, p = .000). El aumento de los niveles de AF de los estudiantes es una necesidad social y las instituciones deben asumir un papel clave en la promoción de la salud del alumnado, mediante la implementación de acciones para reducir la inactividad de sus estudiantes, desarrollando la transmisión de información sobre los beneficios para la salud. relacionados con la práctica de la AF. Fundação para a Ciência e a Tecnologia (Portugal); SFRH / BD / 120758/201

[excerto] A exposição das crianças ao Fumo Ambiental de Tabaco (FAT) está associada a diversos problemas de saúde, tais como tosse, pieira, dispneia, maior risco de infeções agudas das vias aéreas inferiores (bronquiolite e pneumonia), infeções respiratórias de repetição, bem como indução e exacerbação de asma. O consumo de tabaco pelos pais em casa é um fator de risco para o consumo de tabaco dos filhos., Fundos nacionais através da FCT (Fundação para a Ciência e a Tecnologia) no âmbito do projeto do CIEC (Centro de Investigação em Estudos da Criança) da Universidade do Minho, com a referência UIDB/00317/2020

Background: Scientific investigations revealed that dietary habits of students attending higher education are still inadequate and below the recommended consumption of fruits and vegetables with higher consumption of foods rich in fats, salt and sugar. This study aimed to evaluate the knowledge, attitude and practice on healthy diet among Portuguese university students. Methods: A cross-sectional study was conducted among 840 university students, using a self-reported questionnaire, previously validated. The questionnaire, in addition to the sociodemographic questions, included a scale of healthy dietary knowledge, attitude and behavior. Results: The university students were shown to have low healthy dietary knowledge, moderate healthy dietary attitude and unhealthy dietary habits during the last 7 days. Regarding healthy dietary knowledge, the female students and respondents of natural sciences had the highest score. Considering healthy dietary practice, the older students and the students who changed residence at the time of entrance to higher education had the lowest score. There was a statistically significant and positive correlation between knowledge and practice, knowledge and attitude and finally between attitude and practice. Conclusion: These findings might help health educators and policy makers to promote and to develop healthy dietary attitudes and practices. Interventions targeting university students seem to be necessary to increase the knowledge on healthy dietary behaviours regarding three main topics of planning and preparing healthy meals, nutritional recommendations and food labels., Foundation for Science and Technology-FCT (Portuguese Ministry of Education and Science) (SFRH/BD/120758/2016). Portuguese national funds through the FCT (Foundation for Science and Technology) within the framework of the CIEC (Research Center for Child Studies of the University of Minho) project under the reference UIDB/00317/2020

PRISMA Checklist. (DOCX 29 kb)

Literature search strategy. (PDF 460 kb)

A exposição de crianças ao fumo ambiental do tabaco é uma realidade mundial com consequências negativas graves na saúde infantil. Este estudo pretende avaliar a eficácia a curto-prazo do programa Domicílios 100% livres de fumo, na prevenção da exposição de crianças ao fumo ambiental do tabaco. Com essa finalidade foi realizado um estudo quase experimental que incluiu um grupo experimental constituído por alunos 466 do 4º ano de escolaridade de escolas de Braga e um grupo de controlo constituído por 273 alunos do 4º ano de escolaridade de escolas da Covilhã em Portugal. Aplicou-se um questionário de auto-preenchimento utilizado como pré/pós teste a ambos os grupos, tendo o programa sido implementado somente no grupo experimental. Observou-se uma redução significativa na prevalência de mães fumadoras do grupo experimental comparativamente ao grupo de controlo. Não se verificaram, contudo, alterações no consumo de tabaco no domicílio pelos pais dos alunos após a intervenção que possam ser atribuídas ao programa, confirmando a literatura existente. Intervenções futuras deverão actuar a um nível comunitário e focar-se directamente nos pais., The exposure of children to secondhand smoke is a worldwide reality with serious negative consequences on children's health. This study aimed to evaluate the short-term efficacy of the intervention program Domicílios 100% livres de fumo, in the prevention of children's secondhand tobacco smoke exposure. The study included an experimental group of 466 4th graders students from Braga schools and a control group of 273 4th graders students from Covilhã schools in Portugal. A validated self-reported questionnaire was administered to both groups before and after the program implementation. The program was only administered to the experimental group. Results showed a significant lower prevalence of mothers who smoke in the experimental group than in the control group. However, no significant differences were found on the parents' tobacco consumption at home after the intervention, which confirms the results found in other studies. Future intervention programs should adopt a community approach and focus directly on parents, CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT), Portugal; Fundos Nacionais através da FCT (Fundação para a Ciência e a Tecnologia) e cofinanciado pelo Fundo Europeu de Desenvolvimento Regional (FEDER) através do COMPETE 2020 – Programa Operacional Competitividade e Internacionalização (POCI) no âmbito do CIEC (Centro de Investigação em Estudos da Criança, da Universidade do Minho) com a referência POCI-01-0145-FEDER-007562, info:eu-repo/semantics/publishedVersion

A exposição das crianças ao Fumo Ambiental do Tabaco (FAT) está associada a graves problemas para a sua saúde, tais como maior risco de infeções agudas das vias aéreas inferiores, maior probabilidade de infeções respiratórias de repetição, risco acrescido de infeções nos ouvidos, indução e exacerbação de asma e enfisema pulmonar. A exposição ao FAT é especialmente grave para as crianças asmáticas. Esta exposição ocorre, na maioria dos casos, quando os pais e/ou outro convivente fumam no domicílio e/ou no carro. Objetivos: 1) Determinar a prevalência de crianças expostas ao FAT, em casa e no carro; 2) Determinar a prevalência de crianças asmáticas expostas ao FAT, em casa; 3) Caracterizar o comportamento tabágico dos pais e/ou outros conviventes em casa e no carro; 4) Identificar fatores sociodemográficos associados ao consumo de tabaco em casa. Metodologia: Estudo observacional descritivo transversal: aplicação de um questionário de auto-preenchimento a 513 alunos do 4.º ano de escolaridade (8-11 anos de idade) do Concelho de Braga no ano letivo de 2010/2011. Resultados: Estão expostas ao FAT: 27,5% das crianças em casa e 25,1% das crianças que usam o carro. Fumam em casa: 69,8% das mães e 56,8% dos pais fumadores. Fumar em casa é mais frequente nos pais com menor nível socioeconómico (p < 0,01). Conclusão: A exposição das crianças ao FAT é elevada. Os pais/mães fumam frequentemente em casa e no carro, o que justifica uma intervenção preventiva eficaz, que deverá ser uma prioridade de educação para a saúde, na escola e por parte dos profissionais de saúde

Objectives: To assess the prevalence of children's exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. Methods: In 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N = 3187, mean age 9.5 ± 0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. Results: Of the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Children's exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p

Distintos estudios muestran que cuando se utiliza la entrevista motivacional (EM) añadida a un tratamiento estándar, con el objetivo de aumentar la motivación, mejoran los resultados del tratamiento. El objetivo del presente estudio fue analizar si los fumadores que reciben una intervención con EM antes de un tratamiento psicológico cognitivo conductual para dejar de fumar mejoran la adherencia y la eficacia del tratamiento y reducen la recaída en los seguimientos, en comparación con fumadores que únicamente reciben un tratamiento psicológico cognitivo conductual para dejar de fumar. Se comparó en 58 fumadores (46.6% hombres y 53.4% mujeres) la eficacia de añadir o no EM a un tratamiento psicológico para dejar de fumar. El grupo experimental recibió 2 sesiones de EM antes del comienzo de las 6 sesiones del tratamiento psicológico, mientras que el grupo de control recibió únicamente las 6 sesiones del tratamiento. Los resultados no mostraron diferencias estadísticamente significativas entre los 2 grupos en la adherencia al tratamiento, resultados al final del tratamiento y en los seguimientos a los 6 y 12 meses. Concluimos que la intervención con EM no produce mejores resultados en comparación con la aplicación de un tratamiento psicológico cognitivo conductual solo. Several studies show that when using motivational interviewing (MI) added to standard treatment, in order to increase motivation, treatment outcomes improve. The aim of this study was to examine whether smokers who receive an intervention with MI before a cognitive-behavioral psychological treatment to quit smoking they improve adherence and treatment effectiveness, and they reduce the risk of relapse at follow up compared with smokers who only receive cognitive-behavioral psychological treatment for smoking cessation. We compared the effectiveness of adding or not MI to a psychological treatment to quit smoking in a sample of 58 smokers (46.6% men and 53.4% women). The experimental group received 2 sessions of MI before the beginning of the 6 sessions of the psychological treatment, while the control group received only 6 sessions of treatment. The results showed no statistically significant differences between the two groups in adherence to treatment, and treatment outcomes at the end of treatment and at 6 and 12-month follow-ups. We conclude that intervention with MI does not produce better results compared to the application of cognitive-behavioral psychological treatment alone.

Apesar das ações de educação para a saúde realizadas em contexto escolar e das frequentes campanhas de consciencialização sobre os riscos para a saúde da exposição ao fumo ambiental do tabaco (FAT), a prevalência de crianças expostas ao FAT no domicílio e nos carros continua elevada no mundo inteiro. Com o objetivo de determinar a prevalência de crianças expostas ao FAT em casa e no carro, em Portugal, realizou-se um estudo observacional descritivo transversal, que consistiu na aplicação de um questionário de autopreenchimento a 3.187 alunos (8-13 anos de idade) do 4º ano de escolaridade (ano letivo 2010/2011)1. Os resultados mostraram que 32,6% das crianças estão expostas ao FAT em casa. Dos participantes, filhos de pais fumadores que costumam viajar de carro, 47,3% afirmaram estar expostos ao fumo de tabaco na viatura onde costumam ser transportados (9,2% sempre e 38,1% ocasionalmente). Os pais e/ou as mães são os principais responsáveis pela exposição. Estes dados justificam uma intervenção preventiva eficaz, que deverá ser uma prioridade de educação para a saúde na escola., Educação, Sociedade e Culturas, N.º 38 (2013): Health education: perspectives and intervention contexts

El objetivo del presente trabajo es desarrollar y validar un instrumento para evaluar el uso problemático de Nuevas Tecnologías (NT) en jóvenes y adolescentes. Tras el estudio piloto se desarrolló un cuestionario inicial de 35 items. Se aplicó a una muestra de 2747 estudiantes, desde 5º de primaria a 5º de licenciatura. Los resultados obtenidos en los análisis de fiabilidad (alfa de Cronbach) señalan en todos los casos (escala total y subescalas) valores superiores a .70. Se realizaron los análisis pertinentes para establecer la validez convergente, clínica y de constructo. Los resultados finales señalan la conveniencia de reducir el cuestionario a 26 ítems. La estructura factorial apunta 7 factores, uno por cada NT considerada (Internet, Videojuegos, Móvil y Televisión), más otros tres que agrupan conductas similares en las distintas NT. Se discute la idoneidad del instrumento para la identifi-cación de conductas problemáticas en el uso de NT The objective of this paper is to develop and validate an instrument to assess the problematic use of new technologies (NT) in youth and adolescents. After the pilot study, an initial questionnaire of 35 items was developed. The questionnaire was applied to a sample of 2747 students from 5th grade to 5th university degree. Results from the analysis of reliability (Cronbach Alpha) point in all cases (full scale and subscales) values higher than .70. The appropriate analyses were conducted to establish convergent, clinical and construct validity. The final results point to the convenience to reducing the questionnaire to 26 items. The factorial structure point to seven factors, one for each considered NT (Internet, video games, mobile and television), plus other three, which grouped similar behaviour in the various NT. The suitability of the questionnaire is discusses SI

BACKGROUND: Children’s exposure to Environmental Tobacco Smoke (ETS) is associated with serious health problems, such as increased risk of acute lower airway infections, greater likelihood of recurrent respiratory infections, increased risk of ear infections induction and exacerbation of asthma and pulmonary emphysema. This exposure occurs mainly at home and in the car. OBJECTIVES: To describe the prevalence of Environmental Tobacco Smoke (ETS) exposure among Portuguese children at home and in the car, by regions. METHODS: A descriptive cross-sectional study was carried out in the 2010/2011 school year on a sample comprising 2,999 4th grade students aged 9.50 ± 0.68 years old (mean ± SD). Size sample is representative of this population and includes cities in the regions of Northern Portugal, Centre, Lisbon, Alentejo, Algarve, Madeira and Azores. Data on parental smoking habits at home and in the car was gathered through a self-report questionnaire filled out at school by children. RESULTS: In the total sample, 15.8 % [IC 95 %, 14.5–17.1 %] of children are daily exposed to ETS at home and 18.1 % [IC 95 %, 16.7–19.5 %] are occasionally exposed by at least one of the inhabitants. Among children who travel by car (n = 2,810), 4.4 % [IC 95 %, 4.1–5.7 %] state their parents smoke regularly and 24.3 % [IC 95 %, 22.7–25.9 %] they smoke occasionally at car. Analysing prevalence of ETS exposure at home by region, the highest prevalence of daily exposure is found in Lisboa (21.1 % [IC 95 %, 18.5–23.7], followed by Azores (15.3 % [IC 95 %, 9.5–21.1]) and the North (14.4 % [IC 95 %, 12.4–16.4]. The lowest prevalence of daily exposure is found in Centre (8.5 % [IC 95 %, 4.2–12.8]). The highest prevalence of daily ETS exposure in the car is found in Algarve (10.1 % [IC 95 %, 3.8–16.4]) and the lowest in the North (3.7 % [IC 95 %, 2.3–5.1] and in the Centre (3.7 % [IC 95 %, 0.2–7.2]). CONCLUSION: Children exposure to the ETS in Portugal is high. Parents and other inhabitants usually smoke at home and often in the car. These data indicate that preventive interventions in this field should constitute a priority for health education in schools and for health professionals.

La familia puede actuar como factor de riesgo o de protección frente a las conductas problema que aparecen durante la adolescencia, como el consumo de drogas. El objetivo del presente estudio es analizar si hay relación entre la presencia de problemas de depresión y ansiedad rasgo en las madres, y el consumo de drogas (tabaco, alcohol, cannabis y cocaí-na) en los hijos. La muestra está formada por 594 sujetos, 297 madres y 297 hijos, que fueron seleccionados a través de un muestreo aleatorio, estratificado por sexo y edad, de la comarca del Salnés (Pontevedra). Los resultados indican que las madres cuyos hijos han consumido alguna vez cannabis y/o cocaína, y que han fumado tabaco en los 6 últimos meses, tienen más sintomatología depresiva. Además es más probable que hayan consumido alcohol (copas) alguna vez en la vida y en los últimos 6 meses, y que se hayan emborrachado, los hijos cuyas madres tienen una puntua-ción por encima de la media de la población normal en ansiedad rasgo.

El consumo de tabaco y alcohol conlleva importantes problemas de salud pública. Además, constituyen las drogas de acceso al consumo de otras sustancias. Por ello resulta esencial detectar su presencia a edades tempranas. Este estudio tiene como objetivo evaluar en una muestra de escolares gallegos la prevalencia de consumo de alcohol y tabaco, y si existe relación entre ambos consumos. Se realizó una encuesta en 17 centros educativos a una muestra representativa de escolares de enseñanza obligatoria (N= 1.447). Su media de edad fue de 12.8 años (DT= 1.2). El cuestionario utilizado, de tipo autoadministrado, recogía datos s1ociodemográficos y sobre consumo de alcohol y tabaco.El 27.4% (n= 397) indica haber fumado en alguna ocasión, y el 7.3% (n= 105) consume alcohol semanalmente. Para las diferentes sustancias, el consumo se inicia a edades similares. La edad media a la que afirman haber probado el primer cigarrillo y la primera cerveza fue a los 10.7 años, el vino a los 9.7, y las bebidas de alta graduación a los 11.2 años. Asimismo, se halla un porcentaje significativamente superior de consumidores de alcohol entre los fumadores, tanto a nivel general (27.2% vs. 6.1%) (?2 (1) = 50.51, p > 0.001), como en cada una de las bebidas evaluadas. En cuanto a la frecuencia de consumo de cigarrillos, se observa un porcentaje significativamente superior de consumidores de alcohol entre los que afirman fumar a diario, con respecto a los que lo hacen de forma esporádica. Los resultados obtenidos en este estudio resultan de interés a nivel preventivo, pues nos indican que ambas problemáticas deben ser abordadas al mismo tiempo antes de los 10 años.

The self-help smoking programs have demonstrated to be effective so that many people stop smoking. In the present paper we describe the origin, foundations, characteristic and results of a psychological program to stop smoking through the postal mail, named “Programa 2001 para dejar de fumar” [“Program 2001 to stop smoking”] (Becoña, 1996). This program can be combined with phone advice, write feedback or additional support by email. This treatment is an adaptation in format of self-help of the cognitive-behavioural psychological treatment “Programa para dejar de fumar” [“Program to stop smoking”] (Becoña, 1993) that has shown a good efficacy and cost-effectiveness. The “Program 2001 to stop smoking” was applied in Spain, at national level, from the year 1995. In this years have already participated in it more than 4.500 smokers. Your cost-effectiveness is excellent (until 27% of abstinence at 12 month follow-up) in relation with other clinical treatments, such psychological as pharmacological.

In the last years, different studies have found a clear relationship between the consumption of tobacco and the presence of other psychopathological disorders, such as depression, anxiety disorders, other addictive disorders (alcoholism, cannabis dependence, cocaine dependence, etc.), attention deficit disorder with hiperactivity and schizophrenia. In this article these relationships are revised and some of the possible explanations to the same ones. We concludes that the presence of psychiatric comorbidity in the smokers supposes a fact of great relevance, as its treatment as for the development of preventive programs. This relevance it will be more important in next years, if it is decreased the number of smokers in the general population. When happening this more difficult to smoking cessation in the smokers with psychopathological disorders. When the smoker don´t have psychopathological disorders they stop more easily to smoke. En los últimos años, distintos estudios han encontrado una clara relación entre el consumo de tabaco y la presencia de otros trastornos psicopatológicos, tales como depresión, trastornos de ansiedad, otros trastornos adictivos (dependencia del alcohol, cannabis, cocaína, etc.), trastorno de déficit de atención con hiperactividad y esquizofrenia. En este artículo se revisan estas relaciones y algunas de las posibles explicaciones a las mismas. Se concluye que la presencia de comorbilidad psiquiátrica en los fumadores supone un dato de gran relevancia, tanto para su tratamiento como para el desarrollo de programas preventivos. Esta relevancia será mayor en los próximos años, conforme disminuye el número de fumadores en la población general. Al ocurrir esto se incrementará esta relación al serle más difícil dejar de fumar a los fumadores que tienen estos trastornos psicopatológicos. Los que no los tienen dejan más fácilmente de fumar.

El porcentaje de mujeres fumadoras está todavía aumentando en España. Si persisten los patrones actuales de fumar entre las mujeres, el número de muertes continuará creciendo de modo acusado en el próximo siglo. Es posible que en un futuro cercano fumen más mujeres que hombres entre la población adulta española. En esta revisión se actualiza lo que se conoce sobre el impacto que tiene fumar cigarrillos en la salud de las mujeres, los patrones de consumo actuales entre las mismas, los factores especiales que influyen en que fumen y las dificultades que tienen cuando consideran e intentan dejar de fumar. También sugerimos formas en las cuales el consejo mínimo, la terapia de conducta y los productos sustitutivos de la nicotina se pueden incorporar como estrategias de tratamiento adaptadas a las necesidades especiales de las mujeres que fuman. The percentage of women smokers is still on the rise in Spain. If the current smoking patterns among women continue, the number of deaths will continue rising sharply over the next hundred years. There may be more female smokers than male smokers in the adult population in Spain in the near future. This review provides an update of current knowledge as to the impact cigarette smoking has on women’s health, the current patterns of use among them, the special factors which have a baring on their smoking and the difficulties they have when they are considering the possibility of or trying to quit smoking. We also suggest ways in which a minimum degree of counseling, behavior therapy and nicotine substitute can be incorporated as treatment strategies suited to the special needs of women smokers.

De acordo com o último relatório do ESPAD (2012), 74% dos adolescentes portugueses reportaram ter consumido bebidas alcoólicas no último ano, 52% no último mês e 22% reportaram binge drinking . O consumo de álcool é um problema grave e prevalente entre os jovens, sendo indispensável identificar fatores associados a este consumo, por forma a desenvolver estratégias preventivas eficazes. Objetivos: Descrever as perceções sobre os fatores de risco e protetores associados à experimentação e ao consumo regular de álcool na adolescência, de acordo com o género. Metodologia: Recorreu-se à técnica de grupos focais, através da metodologia World Café . Organizaram-se nove grupos de estudantes (n=243): 2 grupos masculinos, 2 femininos, 4 mistos (de consumidores de álcool) e 1 grupo misto de jovens abstémicos. Os dados foram transcritos e analisados de acordo com a metodologia de análise de conteúdo. Resultados: Os participantes identificaram fatores de risco associados à experimentação (ex. atitudes da família face ao consumo) e ao consumo regular de bebidas alcoólicas (ex. gestão de emoções negativas). Foram encontradas diferenças de género na experimentação; as atitudes dos familiares face ao consumo surgem como mais relevantes para os rapazes, enquanto nas raparigas, a influência dos pares parece ter um papel mais preponderante. Conclusões: Os dados revelam diferentes fatores associados ao consumo de álcool na adolescência e identificam diferenças entre géneros. Os programas preventivos devem ter em conta estas diferenças e desenvolver ações suportadas pelas mesmas. Concomitantemente, revela-se importante que estes envolvam os pais, consciencializando-os para a influência dos seus comportamentos nos filhos., According to the last ESPAD Report (2012), 74% of Portuguese adolescents reported to have used alcohol in the last year, with 52% using it in the last month and 22% reporting binge drinking. Alcohol consumption is a severe and prevalent problem among adolescents; therefore it is very important to identify factors associated with this consumption in order to develop effective preventive strategies. Objectives: To describe the perceptions about the risk and protective factors associated with experimentation and regular alcohol consumption in adolescence, by gender. Methods: A focus group technique was used trough a World Café methodology. Nine groups of students were organized (n=243): 2 male groups, 2 female groups, 4 mixed groups (boys and girls who used alcohol) and 1 group of abstinent students. Data was transcribed and analyzed through a content analysis methodology. Results: Participants identified risk factors associated with experimentation (e.g.: family attitudes towards alcohol consumption) and regular alcohol consumption (e.g.: way of dealing with negative emotions). Gender differences were also identified in experimentation; family attitude towards alcohol consumption seems to be more relevant to boys, while peer’s influence seems to play a predominant role to girls. Conclusions: Data reveals several factors associated with alcohol consumption in adolescents and identify gender differences. Preventive programs should take these differences into account and develop actions supported by those. At the same time, it is important that they involve parents, raising awareness to their influence in children’s behaviors., CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT)