Avaliação da efetividade de orientação para controle de peso no tratamento de mulheres fumantes.

Abstract

This doctoral thesis evaluated the effectiveness of the incorporation of guidance for weight control of women assisted in the Smoking Control Program. This is a cluster-randomized clinical trial conducted with women smokers 18 years of age or older who were attended by the Smoking Control Program in treatment groups of health units in the planning area 5.2 (AP 5.2) of the Municipal Health Department of Rio de Janeiro (SMSRJ), recruited from October 2015 to October 2017 and accompanied by 6 months. Eight health units (51 treatment groups with 205 participants) were randomized, of which four were for the intervention group (24 treatment groups with 77 participants) and four for the control group (27 treatment groups with 128 participants). To verify the rate of variation of weight over time according to the allocation group, intention-to-treat analysis was performed through mixed linear generalized models. The rate of change in weight at 3 months was not different between groups (p = 0.82); and the mean weight gain was 0.9kg in the intervention group and in the control group 1.1kg. The cessation rates found were 19.5% in the intervention group; and 10.1% in the control group at 6 months. The means of cessation time were 97.5 days (SD 84.6) in the intervention group and 106.6 days (SD 82.5) in the control group at six months. The cessation time did not differ between groups by the Log-rank test (p = 0.40). The mean time to relapse was 117.5 days (SD 57.0) in the intervention group and 92.1 days (DP 55.5) in the control group at 6 months. Although they were larger in the control group, the KM curves did not differ by the log-rank test (p = 0.07). This study suggests that providing weight-management guidance during treatment for tobacco dependence in women is likely to increase the cessation rate and reduce weight gain. Cessation strategies should take into account gender differences. Assessment studies need to be done to support and improve tobacco control policy in the country.