Turkiye Klinikleri Journal of Internal Medicine

.: REVIEW
Anksiyete, Depresyon ve Sigara Bağımlılığı
Anxiety, Depression and Cigarette Addiction
Leyla DOĞANa, Vildan MEVSİMb
aKayseri İncesu İlçe Devlet Hastanesi, Aile Hekimliği Kliniği, Kayseri, TÜRKİYE
bDokuz Eylül Üniversitesi Tıp Fakültesi, Aile Hekimliği ABD, İzmir, TÜRKİYE
Turkiye Klinikleri J Intern Med. 2020;5(1):22-6
doi: 10.5336/intermed.2019-70326
Article Language: TR
Full Text
ÖZET
Sigara bağımlılığı, önemli ve önlenebilir küresel bir sağlık problemidir. Dünyada yaklaşık 1,3 milyar kişi sigara içicisidir. Kadınlarda sigara içme oranı daha düşük olmakla birlikte, geçtiğimiz senelerde bu oranda artma olduğu da bilinmektedir. Hindistan, Endonezya ve Çin gibi Asya ülkeleri bu sayının büyük kısmını oluşturmakta ve toplam sigara içicilerinin dörtte üçlük bölümü Türkiye'nin de aralarında bulunduğu 10 ülkede yaşamaktadır. Türkiye'de 16 milyon insan sigara içicisidir ve yılda 100.000 kişi sigaraya bağlı sağlık problemlerinden dolayı ölmektedir. Sigara içen bireylerde nikotin bağımlılığı düzeyini, anksiyete ve depresyon düzeyini belirlemek önem teşkil eder. Çünkü sigara bırakma sürecini daha da zorlaştıran faktörler arasında bulunan bağımlılık derecesi ve eşlik eden psikiyatrik hastalıkların varlığı; hem tedavi şekline karar vermede hem de bireyin rahatsızlığını anlama boyutunda belirleyicidir. Bağımlılığı ele alırsak, Fagerström Testi bilinen en iyi ve en yaygın değerlendirme aracıdır ve sigara içen kişiye uygulandığında aldığı puana göre kişinin bağımlılık seviyesi çok düşük, düşük, orta, yüksek ve çok yüksek şeklinde gruplandırılır. Sigara bırakma programlarında bağımlılığının değerlendirilmesi, motivasyonel görüşme, farmakolojik, nonfarmakolojik terapiler ve düzenli takip önerilmektedir. Ayrıca anksiyete, depresyon ve bağımlılık düzeyinin sigara bırakma üzerine olan etkisi araştırılmakta olan bir konudur. Bu çalışma, sigara bırakma sürecinde, sigara içenlerde sigara içme durumu ile bağımlılık düzeyi ve psikolojik/psikiyatrik bozukluklar arasındaki ilişkiyi dikkate alarak tasarlanmıştır. Temel amaç, bırakma programlarının eylem planlamasını desteklemeyi ve optimize etmeyi amaçlayan sigara bırakma durumu ile nikotin bağımlılık düzeyi, depresyon ve kaygı düzeyleri arasındaki ilişkiyi incelemektir.

Anahtar Kelimeler: Sigara; anksiyete; depresyon; bağımlılık düzeyi
ABSTRACT
Cigarette addiction is an important and preventable global health problem. About 1.3 billion people in the world are smokers. Although the smoking rate in women is less than in men, it is known that this rate has increased in recent years. Asian countries such as India, Indonesia and China make up the majority of this number and three quarters of total smokers live in 10 countries including Turkey. 16 million people are smokers in Turkey and 100.000 people die annually due to smoking-related diseases. It is important to detect the level of nicotine dependence, anxiety and depression in smokers. Because the factors that make the smoking cessation process more difficult are the level of dependence and the presence of psychiatric disorders such as anxiety and depression. In terms of addiction, the Fagerström Test is the best and most widely known assessment tool and when administered to a smoker, the level of dependence of the individual is grouped as very low, low, medium, high and very high. In smoking cessation programs, assessment of addiction, motivational interviewing, pharmacological, non-pharmacological therapies and regular follow-up are recommended. In addition, the effect of anxiety, depression and dependence on smoking cessation is a subject under investigation. This study was designed by taking into consideration the relationship between smoking status, addiction level and psychological/ psychiatric disorders in smokers during the cessation process. The main objective is to investigate the relationship between smoking cessation and nicotine dependence, depression and anxiety levels, which aim to support and optimize action planning of quitting programs.

Keywords: Smoking; anxiety; depression; addiction
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