Sigarayı Bırakma Tedavisinde Bilişsel Davranışçı Terapinin Etkililiği: Sistematik Bir Gözden Geçirme

Öz

Günümüzde sigara tüketimi neden olduğu ciddi hastalıklar hatta ölümler dolayısıyla dünya çapındaki önemli sorunlardan biridir. Örneklendirmek gerekirse tütün ve tütün kullanımının kanser, kalp ve damar bozuklukları ve felç gibi hastalıklara sebep olduğu bilimsel olarak kanıtlanmıştır. Bu konudaki çalışmaların artmasıyla araştırmacılar sigara tüketiminin altında yatan fizyolojik ve psikolojik bağımlılığı da keşfetmiştir. Sigara tüketiminin tehlikeli sonuçlar doğuruyor oluşu sebebiyle birçok tedavi seçeneği mevcuttur. Bilişsel Davranışçı Terapi (BDT), sigarayı bırakma tedavisinde etkinliği kanıtlanmış bir yöntemdir. Bu sistematik gözden geçirme çalışmasında BDT’nin sigara bırakma tedavisinde etkisini inceleyen araştırmaların gözden geçirilmesi amaçlanmıştır. Bu amaçla MEDLINE, PsychArticle and PsychINFO veritabanları taranmış ve belirlenen dahil etme/dışarıda bırakma kriterlerine göre değerlendirme sırasında fiziksel veya psikiyatrik herhangi bir tanısı olmayan ve ilaç kullanmayan 18 yaşından büyük katılımcıların bulunduğu çalışmalar gözden geçirmeye dahil edilmiştir. Kiterleri karşılayan 20 çalışma detaylı olarak değerlendirilmiştir. Sonuç olarak BDT temelli müdahalelerin özellikle de ilaç ve nikotin replasman tedavisi ile birleştirildiğinde sigara bırakma tedavisinde başarılı bir seçenek olduğu görülmektedir.

Anahtar Kelimeler

• sigarayı bırakma,bilişsel-davranışçı terapi,tedavi,müdahale

Effectiveness of Cognitive Behavioral Therapy for Smoking Cessation: A Systematic Review

Abstract

Smoking has become one of the most prevalent problems worldwide that causes significant illnesses even deaths. To specify, it has been found that people suffer from cancers, heart diseases and strokes due to the use of tobacco. As soon as the investigations about this field progressed, researchers discovered the physiological and psychological dependence behind smoking. By the reason of its hazardous consequences, a variety of treatment options are now available. Cognitive Behavioral Therapy (CBT) is accepted as an effective method in treatment of smoking cessation. In this article, it is aimed to review the studies which investigate the effect of CBT on smoking cessation. For this purpose, MEDLINE, PsychINFO and PsychARTICLE databases has been searched and studies that include CBT intervention are selected based on defined inclusion and exclusion criteria. Specifically, the studies in which the participants are not diagnosed with any psychological or physiological disorder, older than 18 years, and does not use any kind of medication were included to the review. 20 studies fitting the including criteria are assessed in detail. As a result, CBT-based treatments can be accepted as a successful method for smoking cessation, especially when combined with medication and NRT.

Keywords

• smoking cessation,cognitive-behavioral therapy,treatment,intervention

Kaynakça

1. Alterman AI, Gariti P, Mulvaney F. (2001). Short- and long-term smoking cessation for three levels of intensity of behavioral treatment. Psychol Addict Behav, 15(3):261-264.
2. American Cancer Society. (2007). Cancer facts and figures for African Americans 2007-2008. Atlanta, GA: Author.
3. American Lung Association. (1995). Facts about nicotine addiction and cigarettes. (Brochure).
4. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.
5. Argüder E, Karalezli A, Hezer H, Kılıç H, Er M, Hasanoğlu HC. (2013). Factors affecting the success of smoking cessation. Turk Toraks Derg, 14: 81-7.
6. Beck JS. (2011). Cognitive behavior therapy: basics and beyond. 2nd ed. New York: The Guilford Press.
7. Becoña E, Vázquez FL. (1997). Does using relapse prevention increase the efficacy of a program for smoking cessation? An empirical study. Psychol Rep, 81:291–296.
8. Becoña E, Vázquez MI, Miguez MC, Fernández del Río E, López-Durán A, Martínez Ú, et al. (2013). Smoking habit profile and health-related quality of life. Psicothema, 25:421-426. http://dx.doi.org/10.7334/psicothema2013.73

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, 5. Art. No.:CD009329. DOI:10.1002/14651858.CD009329.pub2.
10. Cavallo DA, Cooney JL, Duhig A., Smith AE, Liss TB, McFedridge AK, et al. (2007). Combining cognitive behavioral therapy with contingency management for smoking cessation in adolescent smokers: a preliminary comparison of two different CBT formats. Am J Addict, 16:469-474.
11. Centers for Disease Control and Prevention. (2008). Smoking-attributable mortality, years of potential life lost, and productivity losses—United States, 2000–2004. MMWR Recomm Rep, 57:1226– 1228.
12. Cinciripini PM, Lapitsky LG, Wallfisch A, Mace R, Nezami E, Vunakis HV. (1994). An evaluation of a multicomponent treatment program involved scheduled smoking and relapse prevention procedures: initial findings. Addict Behav, 19(1):13-22.
13. Cinciripini PM, Cinciripini LG, Wallfisch A, Haque W, Vunakis HV (1996). Behavior therapy and the transdermal nicotine patch: Effects on cessation outcome, affect and coping. J Consult Clin Psychol, 64(2):314-323.
14. Dziegielewski SF, Eater JA. (2000). Smoking cessation: Increasing practice understanding and time-limited intervention strategy. Fam Soc, 81(3):246-255.
15. Fiore MC, Jaén CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service.
16. Guimaraes FMCL, Nardi AE, Cardoso A, Valenca AM, da Conceicao EG, King ALS. (2014). Cognitive-behavioral therapy treatment for smoking alcoholics in outpatients. Medical Express, 1(6):336-340.
17. Hall SM, Munoz RF, Reus VI. (1994). Cognitive-behavioral intervention increases abstinence rates for depressive-history smokers. J Consult Clin Psychol, 62, 141-146.
18. Hall SM, Reus VI, Munoz RF, Sees KL, Humfleet GL, Hartz DT, et al. (1998). Nortriptyline and cognitive-behavioral therapy in the treatment of cigarette smoking. Arch Gen Psychiatry, 55:683-690.
19. Hall SM, Humfleet GL, Munoz RF, Reus VI, Robbins JA, Prochaska JJ. (2009). Extended treatment of older cigarette smokers. Addiction, 104:1043-1052.
20. Hall SM, Humfleet GL, Munoz RF, Reus VI, Prochaska JJ, Robbins JA. (2011). Using extended cognitive behavioral treatment and medication to treat dependent smokers. Am J Public Health, 101(12):2349-2356.
21. Hendriks PS, Delucchi KL, Hall SM. (2010). Mechanisms of change in extended cognitive behavioral treatment for tobacco dependence. Drug Alcohol Depend, 109:114-119.
22. Hernandez-Lopez M, Luciano MC, Bricker JB, Roales-Nieto JG, Montesinos F.(2009). Acceptance and commitment therapy for smoking cessation: a preliminary study of its effectiveness in comparison with cognitive behavioral therapy. Psychol Addict Behavs, 23(4):723-730.
23. Hollon SD, Beck AT. (2004). Cognitive and cognitive behavioral therapies. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (5th ed., pp. 447–492). Hoboken, NJ: Wiley
24. Kılınç O. (2010). Sigara Bırakma Tedavisinde Davranışçı ve Bilişsel Yöntemler. In: Tütün ve Tütün Kontrolü, 2nd ed. (Eds Aytemur ZA, Akçay Ş, Elbek O):479-484. Ankara, Toraks kitapları yayın kurulu, Aves yayıncılık.
25. Lee M, Miller SM, Wen KY, Azor Hui S, Roussi P, Hernandez E. (2015). Cognitive behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women. J Behav Med, 38:932-943.
26. Lichtenstein E, Glasgow RE. (1992). Smoking cessation: What we have learned over the last decade? J Consult Clin Psychol, 60(4):518-527.
27. Lindson‐Hawley N, Thompson T, Begh R. (2015). Motivational interviewing for smoking cessation. Cochrane Database of Syst Rev, 3. Art. No.:CD006936. DOI: 10.1002/14651858.CD006936.pub3.
28. López-Núñez C, Alonso-Pérez F, Pedrosa I, Secades-Villa R. (2016a). Cost effectiveness of a voucher-based intervention for smoking cessation. Am J Drug Alcohol Abuse, 42(3):296-305.
29. López-Núñez C, Martinez-Loredo V, Weidberg S, Pericot-Valverde I, Secades-Villa R. (2016b). Voucher-based contingency management and in-treatment behaviors in smoking cessation treatment. Int J Clin Health Psychol, 16:30-38.
30. Marlatt GA, Gordon JR. (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York: Guilford.O’Brien CP, McLellan AT. (1996). Myths about the treatment of addiction. Lancet, 347:237–40.
31. Orleans C, Rimer B, Telepchak J, Fleisher L, Keintz M, Boyd N, et al. (1997). Clear Horizons: A Quit Smoking Guide for Smokers Aged 50 and Older. Fox Chase Cancer Center, Philadelphia, PA.
32. Park CB, Choi JS, Park SM, Lee JY, Jung HY, Seol JM, et al. (2014). Comparison of the effectiveness of virtual cue exposure therapy and cognitive behavioral therapy for nicotine dependence. Cyberpsychol Behav Soc Netw, 17(4):262-267.
33. Pollak KI, Oncken CA, Lipkus IM, Lyna P, Swamy GK, Pletsch PK, et al. (2007). Nicotine replacement and behavioral therapy for smoking cessation in pregnancy. Am J Prev Med, 33(4):297 -305.
34. Rovina N, Nikoloutsou I, Katsani G, Dima E, Fransis K, Roussos C, et al. (2009). Effectiveness of pharmacotherapy and behavioral interventions for smoking cessation in actual clinical practice. Ther Adv Respir Dis, 3(6):279-287.
35. Rüther T, Kiss A, Eberhardt K, Linhardt A, Kröger C, Pogarell O. (2017). Evaluation of the cognitive behavioral smoking reduction program “Smoke_less”: a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci. doi:10.1007/s00406 017-0818-6
36. Schmitz JM, Stotts AL, Mooney ME, DeLaune KA, Moeller FG. (2007). Bupropion and cognitive-behavioral therapy for smoking cessation in women. Nicotine Tob Res, 9(6):699-709.
37. Secades-Villa R, Alonso-Pérez F, García-Rodríguez O, Fernández-Hermida JR. (2009). Effectiveness of three intensities of smoking cessation treatment in primary care. Psychol Rep, 105:747–758.
38. Secades-Villa R, García-Rodríguez O, López-Núnez C, Alonso-Pérez F, Fernández Hermida JR. (2014). Contingency management for smoking cessation among treatment-seeking patients in a community setting. Drug Alcohol Depend, 140:63-68.
39. Sheffer CE, Bickel WK, Franck CT, Panissidi L, Pittman JC, Stayna H, et al. (2017). Improving tobacco dependence treatment outcomes for smokers of lower socioeconomic status: a randomized clinical trial. Drug Alcohol Depend, 181:177-185.
40. Somers J. (2007). Cognitive behavioural therapy. Core information document. British Columbia Ministry of Health. Available from: http://www.health.gov.bc.ca/library/publications/year/2007/MHA_CognitiveBehaviouralTherapy.pdf. Accessed April 28 2016.
41. Stead LF, Hartmann‐Boyce J, Perera R, Lancaster T. (2013). Telephone counseling for smoking cessation. Cochrane Database Syst Rev, 8. Art. No.:CD002850. DOI: 10.1002/14651858.CD002850.pub3.
42. Şengezer T. (2016). Tütün bağımlılığında bilişsel-davranışçı tedavi yöntemleri. Güncel Göğüs Hastalıkları Serisi, 4(1):97-103.
43. Weidberg S, Landes RD, López-Núñez C, Pericot-Valverde I, González-Roz A, Yoon JH, et al. (2015). Contingency management effects on delay discounting among patients receiving smoking cessation treatment. Psicothema, 27(4):309-316.
44. Wittchen H, Hoch E, Klotsche J, Muehlig S. (2011). Smoking cessation in primary care - a randomized controlled trial of bupropione, nicotine replacements, CBT and a minimal intervention. Int J Methods Psychiatr Res. 20(1):28-39.
45. Yalcin BM, Unal M, Pirdal, H, Karahan TF. (2014). Effects of an anger management and stress control program on smoking cessation: a randomized controlled trial. J Am Board Fam Med, 27(5):645-660.
46. Yeşildal A, Oğuz G, Güven M, Sungur MZ, Üstünuçar I. (2014). Sigara bağımlılığı tedavisinde bilişsel davranışçı grup tedavisi. Bağımlılık Dergisi, 15(2):76-84.