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Análise Psicológica
Print version ISSN 0870-8231
Aná. Psicológica vol.22 no.3 Lisboa Sept. 2004
A abstenção tabágica: Reflexões sobre a recaída
MARINA PRISTA GUERRA (*)
RESUMO
Nos últimos anos tem-se dado muita ênfase à dependência de drogas duras porque provocam uma diminuição da qualidade de vida dos seus utilizadores, interferem negativamente no funcionamento e ordem social e sobretudo devido à relação com a aquisição de doenças infecciosas como a SIDA e Hepatite C. Esta preocupação crescente, concentrou a maioria das investigações nos toxicodependentes que usam drogas ilícitas e nos fenómenos de segurança social a eles associados, deixando para um segundo plano outras dependências legalmente permissivas como o abuso de fármacos (tranquilizantes e antidepressivos), álcool e o tabaco.
O uso de tabaco é no entanto reconhecido como um dos maiores problemas de saúde pública a nível mundial contribuindo segundo as estatísticas para mortes prematuras e deterioração da qualidade de vida dos fumadores, e que vem muitas vezes associado ao consumo de outras drogas. O estudo cuidadoso da influência da nicotina no ser humano a nível biológico, psicológico e social é de suma importância para a intervenção na cessação tabágica e ainda, porque a nicotina exerce a sua influência nomeadamente na absorção de outros produtos naturais ou tóxicos. O problema do tabagismo foi estudado até um passado bem recente, meramente como um hábito que era preciso “descondicionar” e que dependia quase inteiramente da vontade do próprio. Contudo as recentes descobertas da influência positiva da nicotina em determinadas doenças veio abrir caminho para outras investigações que reforçam o poder aditivo desta droga, sobretudo porque se constata, que a maioria dos ex-fumadores tem sucessivas recaídas, tornando a abstenção total a longo prazo muito difícil.
Este artigo pretende assim esclarecer aspectos psicológicos, sociais e psicofisiológicos que estão na base do insucesso da manutenção da abstenção tabágica. Enfatizaremos assim os efeitos psicofarmacológicos que proporcionam uma explicação diferente para a futura intervenção no tabagismo e que fornece novas pistas de investigação.
Palavras-chave: Tabagismo, nicotina, psicofarmacologia, abstinência, recaída.
ABSTRACT
During the last years, a lot of attention has been given to hard drugs, as they diminish the quality of life of their users, interfere negatively in the everyday activities and social order, and mainly because of their direct relation with several infectious diseases, such as AIDS and Hepatitis C. This growing preoccupations, have concentrated the majority of research efforts in the drug users and in the associated phenomena of social insecurity, leaving to a secondary stage other legally authorized addictions, such as the use of tranquillizers and antidepressants, alcohol and tobacco.
Nevertheless, tobacco use has been recognized as one of the leading worldwide public health problems and, based on the available statistics, causes deterioration of the quality of life and premature death of the smoking population, being often associated with the use of other drugs. The carefully undertaken studies of the nicotine influence in the human being at the biological, psychological and social levels are of paramount importance in the intervention for smoking cessation, reinforced by the influence of nicotine in the absorption of other products both natural and toxic. Until very recently, tobacco use was studied merely as a habit, which should be discontinued, simply dependent for that purpose almost entirely on one's will. However recent discoveries of a positive influence of nicotine in certain diseases, has open the way for other researches, reinforcing the addictive power of this drug, mainly based on the perception that the majority of former smokers have had several relapses, making long-term smoking cessation extremely difficult.
This article intends to clarify some of the psychological, social and psycho-physiological aspects related to the unsuccess of long-term smoking cessation. The psycho-pharmacological effects of smoking, leading to a different explanation for the future intervention in tobacco use, as well as to new research fields, will be also reinforced.
Key words: Smoking, nicotine, psychopharmacology, cessation, relapse.
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(*) Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto.