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Sigara Dışı Nikotin Bağımlılarında Fagerstrom Nikotin Bağımlılık Testi ile E-CO Ölçümünün Karşılaştırılması

Year 2021, Volume: 15 Issue: 3, 472 - 478, 10.09.2021
https://doi.org/10.21763/tjfmpc.802741

Abstract

Amaç: Nikotin Bağımlılığı için Fagerstrom Testi (FNDT) birinci basamakta sigara bıraktırma pratiğinde sık kullanılan bir testtir. Günümüzde nikotin bağımlıları klasik sigara kullanımı yanında (Klasik) diğer yöntemlerle de (e-sigara, nargile, pipo, puro, hafif sigara kullanıcıları veya sarma sigara) de (Klasik olmayan) nikotin almayı tercih etmektedirler. Bu çalışmanın amacı klasik olmayan yöntem tercih eden nikotin bağımlılarında FNDT’nin etkinliğini araştırmaktır. Gereç ve Yöntemler: 2019 yılında OMU Aile Hekimliği Anabilim Dalı Sigara Bırakma Polikliniğine başvuran 550 gönüllü iki gruba (Çalışma ve kontrol) ayrıldı. Çalışma grubunu sigara kullanmayan (Klasik olmayan) 62 (% 11,2) nikotin bağımlısı, kontrol grubunu ise sigara içen (Klasik) 488 (%88,8) nikotin bağımlısı oluşturdu. Her iki grubun FNDT ve paket yılı puanları hesaplandıktan sonra ekspirium CO (E-CO) değerleri ölçülerek birbirleri ile karşılaştırıldı. Bulgular: Katılımcıların 388'i erkekti (% 70,5) ve yaş ortalaması 39,31 ± 12,84 yıl idi. İki grup arasında ortalama E-CO ölçümleri arasında fark olmamasına rağmen (p> 0,05), paket / yıl ortalama skorları ile iki grup arasındaki FNDT skorları arasında istatistiksel olarak fark vardı (t = 1,258, t = 2.014, p <0,001). Kontrol grubunda E-CO değerleri arasında FNDT ve (r = 0,468, p <0,001) paket / yıl (r = 0,362, p <0,001) arasında korelasyon izlenirken, çalışma grubunda FNDT (r = 0,114, p = 0,06) ve paket/yıl (r= 0,098, p=0,089) arasında istatistiksel ilişki gözlenmedi. Sigara içen bağımlılarda (kontrol grubu) Lineer regresyon modelinde E-CO ile FNDT ve Paket/yıl arasında anlamlı istatistiksel ilişki izlendi (F=35,305, p<0,001).
Sonuç: FNDT klasik olarak sigara içenler için nikotin bağımlılığını değerlendirmede çok etkili bir araç olmasına rağmen, sigara dışı bir ürünle nikotin bağımlısı olan kişiler içenler için uygun olmayabilir. Birinci basamakta klasik sigara içmeyen nikotin bağımlıları için yeni değerlendirme yöntemleri tasarlamak ve araştırmak yararlı olabilir.

References

  • 1. Türkiye Halk Sağlığı Kurumu. Küresel Yetişkin Tütün Araştırması Türkiye 2012. ” “Sağlık Bakanlığı yayın no:948, Ankara: 2014;4-6.
  • 2. Türkiye hastalık yükü çalışması 2004. Sağlık Bakanlığı, Refik Saydam Hıfzıssıhha Merkezi Başkanlığı, Hıfzıssıhha Mektebi Müdürlüğü, Sağlık Bakanlığı yayın no: 701 Ankara: Aydoğdu Ofset Matbaacılık, 2007;27.
  • 3. WHO. Quitting tobacco. Tobacco Free Initiative (TFI). https://www.who.int/tobacco/quitting/summary_data/en (Last updated at:01/02/2019)
  • 4. Siahpush M et al. Association between duration of use of pharmacotherapy and smoking cessation: findings from a national survey. BMJ Open 2015;5(1):e006229. DOI: 10.1136/bmjopen-2014-006229
  • 5. Fritz M, Wallner R, Grohs U, Kemmler G, Saria , Zernig G. Comparable sensitivities of urine cotinine and breath carbon monoxide at follow-up time points of three months or more in a smoking cessation trial. Pharmacology 2010;85:234-40. DOI: 10.1159/000280435
  • 6. Jarvıs MJ, Tunstall-Pedoe H, Feyerabend C, Vesey C, Saloojee Y. Comparison of Tests Used to Distinguish Smokers from Nonsmokers. Am J Public Health 1987; 77:1435-8. DOI: 10.2105/ajph.77.11.1435
  • 7. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict 1991; 86: 1119-27. DOI: 10.1111/j.1360-0443.1991.tb01879.x
  • 8. Kozlowski LT, Porter CQ, Orleans CT, Pope MA, Heathertone T. Predicting smoking cessation with self-reported measures of nicotine dependence: FTQ, FTND, and HSI. Drug and Alcohol Dependence 1994; 34 (3): 211–6. DOI: 10.1016/0376-8716(94)90158-9
  • 9. Cahill, K., Stevens, S., Perera, R., Lancaster, T., 2013. Pharmacological interventions for smoking cessation: An overview and network meta-analysis. Cochrane Database Syst. Rev. 31, 5:CD009329. doi: 10.1002/14651858.CD009329.pub2.
  • 10. Yalcin BM, Unal M, Pirdal H, Karahan TF. Effects of an anger management and stress control program on smoking cessation: a randomized controlled trial. J Am Board Fam Med. 2014;27(5):645-60. DOI: 10.3122/jabfm.2014.05.140083
  • 11. Uysal et. Al. Fagerstrom test for nicotine dependence: Reliability in Turkish sample and factor analysis. Tüberküloz ve Toraks Dergisi 2004;52(2):115-21
  • 12. Andersson MF, Moller AM. Assessment of carbon monoxide values in smokers: a comparison of carbon monoxide in expired air and carboxyhaemoglobin in arterial blood. Eur J Anaesthesiol 2010; 27:812–8. DOI: 10.1097/EJA.0b013e32833a55ea
  • 13. Jarvis MJ, Belcher M, Vessey C, Hutchison DCS. Low cost carbon monoxide monitors in smoking assessment. Thorax 1986;41:886–7. DOI: 10.1136/thx.41.11.886
  • 14. Benowitz NL, Jacob P. Effects of cigarette smoking and carbon monoxide on nicotine and cotinine metabolism. Clin Pharmacol Ther. 2000;67(6):653-9. DOI: 10.1067/mcp.2000.107086
  • 15. American Cancer Society Medical and Editorial Content Team. (2019). What do we know about e-cigarettes? http://cancer.org/cancer/cancer-causes/tobacco-and-cancer/e-cigarettes.html (Last update at:09/09/2020 )
  • 16. Uysal MA, Turan A. Can Fagerstrom test for nicotine dependence be used to evaluate the nicotine dependence in electronic cigarette users? Turk Thoracj. 2019; 110
  • 17. Cattamanchi A, Jewell T. Healthline. How much nicotine is in a cigarette and other tobacco products? https://www.healthline.com/health/how-much-nicotine-is-in-a-cigarette) (Last updated at: 01/05/2019)
  • 18. Guan NC, Ann AY. Exhaled carbon monoxide levels among Malaysian male smokers with nicotine dependence. South Asian J Trop Med Pubklic Health. 2012; 43: 212-6. PMID: 23082572
  • 19. Babaoğlu E, Karalezli A, Er M, Hasanoğlu HC, Öztuna D. Exhaled carbon monoxide is a marker of heavy nicotine dependence. Turk J Med Sci, 2016;46:1677-81. DOI:10.3906/sag-1601-140

Comparison of Exhaled Carbon Monoxide and Fagerstrom Test for Nicotine Dependency in Non-Cigarette Nicotine Addicts

Year 2021, Volume: 15 Issue: 3, 472 - 478, 10.09.2021
https://doi.org/10.21763/tjfmpc.802741

Abstract

Introduction/Aim: Fagerstrom test for Nicotine Dependency (FNDT) is one of the most frequent tools used to assess the nicotine dependency in primary care. Today, apart from classical cigarette smoking many nicotine addicts may prefer other methods (e-cigarette, hookah, pipe, cigars, light cigarette users or directly tobacco users) to gather nicotine. The main aim of this study is to evaluate the effectiveness of FNDT in this non-classical nicotine addicts. Material and Methods: Among 550 volunteered patients who have administered to the OMU Family Medicine Departments smoking cessation clinic in 2019 have been divided into two groups (Study and control). The study group consisted of 62 (11.2%) nicotine addicts who don’t smoke cigarette (Non-classical) and 488 (88.8%) cigarette smoker (classical) nicotine addict. Both groups’ FNDT scores, their package year scores are calculated and their exhaled CO (E-CO) is measured. Then these results have been analyzed. Results: Among all of the subjects 388 were men (70.5%). The mean age of the participants was 39,31±12,84 years. Although there is no difference between the E-CO measurements between two groups (p>0,05), there was statistically difference between the mean scores of package/year and FNDT scores between the two groups (t=1.258, t=2.014, p<0.001 respectively). There was a strong correlation between FNDT (r=0,468) and package/year (r=0,362) with E-CO in control group (p<0,001) while there was no statistical significance between FNDT (r=0.114) and package/ year (r=0.098) in study group (p=0.06). There was a statistically significant relation between E-CO with FNDT and package/year was observed in cigarette smokers (Control Group) (F=35.305, p<0.001).
Conclusion: Although FNDT is a very effective tool for assessing nicotine dependency for classical smokers, it may be not suited for all of the nicotine addicts. It may be useful to design and search new assessment methods for nicotine dependence in non-conventional smokers in primary care.

References

  • 1. Türkiye Halk Sağlığı Kurumu. Küresel Yetişkin Tütün Araştırması Türkiye 2012. ” “Sağlık Bakanlığı yayın no:948, Ankara: 2014;4-6.
  • 2. Türkiye hastalık yükü çalışması 2004. Sağlık Bakanlığı, Refik Saydam Hıfzıssıhha Merkezi Başkanlığı, Hıfzıssıhha Mektebi Müdürlüğü, Sağlık Bakanlığı yayın no: 701 Ankara: Aydoğdu Ofset Matbaacılık, 2007;27.
  • 3. WHO. Quitting tobacco. Tobacco Free Initiative (TFI). https://www.who.int/tobacco/quitting/summary_data/en (Last updated at:01/02/2019)
  • 4. Siahpush M et al. Association between duration of use of pharmacotherapy and smoking cessation: findings from a national survey. BMJ Open 2015;5(1):e006229. DOI: 10.1136/bmjopen-2014-006229
  • 5. Fritz M, Wallner R, Grohs U, Kemmler G, Saria , Zernig G. Comparable sensitivities of urine cotinine and breath carbon monoxide at follow-up time points of three months or more in a smoking cessation trial. Pharmacology 2010;85:234-40. DOI: 10.1159/000280435
  • 6. Jarvıs MJ, Tunstall-Pedoe H, Feyerabend C, Vesey C, Saloojee Y. Comparison of Tests Used to Distinguish Smokers from Nonsmokers. Am J Public Health 1987; 77:1435-8. DOI: 10.2105/ajph.77.11.1435
  • 7. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict 1991; 86: 1119-27. DOI: 10.1111/j.1360-0443.1991.tb01879.x
  • 8. Kozlowski LT, Porter CQ, Orleans CT, Pope MA, Heathertone T. Predicting smoking cessation with self-reported measures of nicotine dependence: FTQ, FTND, and HSI. Drug and Alcohol Dependence 1994; 34 (3): 211–6. DOI: 10.1016/0376-8716(94)90158-9
  • 9. Cahill, K., Stevens, S., Perera, R., Lancaster, T., 2013. Pharmacological interventions for smoking cessation: An overview and network meta-analysis. Cochrane Database Syst. Rev. 31, 5:CD009329. doi: 10.1002/14651858.CD009329.pub2.
  • 10. Yalcin BM, Unal M, Pirdal H, Karahan TF. Effects of an anger management and stress control program on smoking cessation: a randomized controlled trial. J Am Board Fam Med. 2014;27(5):645-60. DOI: 10.3122/jabfm.2014.05.140083
  • 11. Uysal et. Al. Fagerstrom test for nicotine dependence: Reliability in Turkish sample and factor analysis. Tüberküloz ve Toraks Dergisi 2004;52(2):115-21
  • 12. Andersson MF, Moller AM. Assessment of carbon monoxide values in smokers: a comparison of carbon monoxide in expired air and carboxyhaemoglobin in arterial blood. Eur J Anaesthesiol 2010; 27:812–8. DOI: 10.1097/EJA.0b013e32833a55ea
  • 13. Jarvis MJ, Belcher M, Vessey C, Hutchison DCS. Low cost carbon monoxide monitors in smoking assessment. Thorax 1986;41:886–7. DOI: 10.1136/thx.41.11.886
  • 14. Benowitz NL, Jacob P. Effects of cigarette smoking and carbon monoxide on nicotine and cotinine metabolism. Clin Pharmacol Ther. 2000;67(6):653-9. DOI: 10.1067/mcp.2000.107086
  • 15. American Cancer Society Medical and Editorial Content Team. (2019). What do we know about e-cigarettes? http://cancer.org/cancer/cancer-causes/tobacco-and-cancer/e-cigarettes.html (Last update at:09/09/2020 )
  • 16. Uysal MA, Turan A. Can Fagerstrom test for nicotine dependence be used to evaluate the nicotine dependence in electronic cigarette users? Turk Thoracj. 2019; 110
  • 17. Cattamanchi A, Jewell T. Healthline. How much nicotine is in a cigarette and other tobacco products? https://www.healthline.com/health/how-much-nicotine-is-in-a-cigarette) (Last updated at: 01/05/2019)
  • 18. Guan NC, Ann AY. Exhaled carbon monoxide levels among Malaysian male smokers with nicotine dependence. South Asian J Trop Med Pubklic Health. 2012; 43: 212-6. PMID: 23082572
  • 19. Babaoğlu E, Karalezli A, Er M, Hasanoğlu HC, Öztuna D. Exhaled carbon monoxide is a marker of heavy nicotine dependence. Turk J Med Sci, 2016;46:1677-81. DOI:10.3906/sag-1601-140
There are 19 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Orijinal Articles
Authors

Bektaş Yalçın 0000-0003-4065-6293

Esra Yalçın This is me 0000-0003-3208-5769

T.fikret Karahan 0000-0002-1260-1239

Publication Date September 10, 2021
Submission Date October 12, 2020
Published in Issue Year 2021 Volume: 15 Issue: 3

Cite

Vancouver Yalçın B, Yalçın E, Karahan T. Comparison of Exhaled Carbon Monoxide and Fagerstrom Test for Nicotine Dependency in Non-Cigarette Nicotine Addicts. TJFMPC. 2021;15(3):472-8.

English or Turkish manuscripts from authors with new knowledge to contribute to understanding and improving health and primary care are welcome.