The importance of nutrition in smoking cessation in women
The importance of nutrition in smoking cessation in women
MARCOS HS NASCIMENTO 2
- Masters Degree in Nutritional Safety at Federal University of Paraná – UFPR – Brazil
- Medical Editor of PULMAOSA Website
The strategy in stimulating smoking cessation in women should be priorized ahead of the growing exposure to tobacco promotional campaigns associated with the tobacco industry for this population group.
Smoking nowadays is the leading cause of preventable death in the world, and is considered a disease with its own ICD (International Classification of Diseases) to designate it: the F17.2. Smoking by itself, is capable of generating 50 other diseases, being the huge star among the non communicating diseases, as it is responsible by 30% of all cancer deaths, including lung cancer that presents a clear link with smoking and is the current leader of deaths from this disease in both men and women in the United States and also in Brazil (1).
Data obtained from the World Health Organization (WHO), attributed approximately 5.4 million deaths per year to tobacco, with Brazil accounting for 200,000 of these deaths (2,3).
Although the prevalence of smoking in Brazil have declined over the past years (17.5% of adults (over 15 years), 22% male and 13% female), however, in the main cities of the Southern region of the country presented high prevalence of smoking among women, with 17.5% in Porto Alegre (Rio Grande do Sul State); 15.5% in Curitiba (Paraná); and Florianópolis (Santa Catarina) 15.3%. This may indicate a need to prioritize health promotion and tobacco control focuses primarily on women (4.5).
The control and reduction of smoking prevalence are of fundamental importance since it can provide gains in both health and in financial resources (6). About this context, the Brazilian Thorax Society guidelines for smoking cessation (BTS) suggested that the presence of a dietitian in the multidisciplinary team is of great importance (7).
Regarding specifically to women and their body image, this fact represents a significant issue in this group’s behave, where the fear of weight gain is the great factor relationed with women’s noncompliance about smoking cessation treatment, even when the health benefits are known, and also combined with other factors such as stress relief and anxiety (8).
It is crucial that the frequent eating habits or acquired ones be rating after such treatment, as well as monitoring body weight, ir order to be establish behaviors that contribute for the real success of smoking quit process. The weight gain factor is responsible by non-adherence for the treatment to quit tobacco derivatives and cigarettes, just because the large variation in weight gain and its mechanism constitute the major cause for the increased caloric intake and decreased resting metabolic rate (9).
There is evidence that nicotine causes an increase in energy expenditure. This is explained by the fact that consumption of a single cigarette induce about 3% increase in energy expenditure of the organism of in a period of 30 minutes. Concomitantly nicotine promotes an apetite decrease, caused by the rapid arrival of smoke nicotine in the brain (about 6 to 10 seconds). It allows some increase in the concentration of neurotransmitters, such as dopamine and serotonin, which are inhibitors intake food. It would explain the fact that smokers tend to have lower body weight when compared to nonsmokers, instituting a belief that smoking is an efficient way to control body weight (10,11).
Therefore obtain better results in tobacco control policies, aimed at women, duty would consider the influence of body weight control appropriate and compulsory through nutritional intervention assertive. The objectives of this strategy is to achieve higher success rates in smoking cessation, justifying the control of food intake, that more than an addendum to the treatment, it must be presented as a condition “si ne qua non” in the process of smoking cessation treatment for women.
- NASCIMENTO, M.H.S. Doenças Crônicas: Pedágio caro para o Brasil, os USA e o Mundo. Available from: https://pulmaosarss.wordpress.com/2012/03/16/doencas-cronicas pedágio-caro-para-o-brasil-os-usa-e-o-mundo/.Acesso em 12/03/2012.
- World Health Organization (WHO). The World Health Report 2002: Reducing risks, promoting healthy lifestyles. Geneva: WHO, 2002.
- Instituto Nacional do Câncer (INCA). Tabagismo no Brasil:
Dados e Numéricos. Brasilia: Ministério da Saúde, INCA. Available from: http://www.inca.gov.br/tabagismo/index.as.Acesso em 20/03/2012.
- Instituto Brasileiro de Geografia e Estatística (IBGE).Global Adult Tobacco Survey(GATS):Brasil,2008.IBGE;2009.
- Ministério da Saúde. Secretaria de Vigilância em Saúde; Secretaria de Atenção à Saúde. Diretrizes e Recomendações para o Cuidado Integral de Doenças Crônicas Não-Transmissíveis: Promoção da Saúde, Vigilância, Prevenção e Assistência. Brasília,2008.
- PISINGER, C.; GODTFREDSEN,N.S. Is there a health benefit of reduced tobacco consumption? A systematic review. Nicotine To Res.9(6):631-46, 2007.
- REICHERT,J.et al ,Diretrizes para cessação do tabagismo, Sociedade Brasileira de Pneumologia e Tisiologia (SBPT). J Bras Pneumol. 34(10):845-880, 2008.
- SCARINCI,I.C.et al.Sociocultural factors associated with cigarette smoking among women in Brazilian worksites:a qualitative study.Health Promotion international,v.22,n.2,p.146-154,2007.
- FILOZOF,C.;FERNANDEZ,P.M.C.;FERNANDEZ,C.A. Smoking cessation and weight gain. Obes Rev,5:95-103, 2004.
- CHIOLERO,A., FAETH.D., PACAUD, F., CORNUZ, J. Consequences of smoking for body weight, body fat distribution, and insulin resistance. Am J Clin Nutr ;87:801–9,2008.