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Vol. 15. Issue 1.
Pages 27-42 (January - February 2009)
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Vol. 15. Issue 1.
Pages 27-42 (January - February 2009)
Artigo Original/Original Article
Open Access
Asma e a nova lei do tabaco. O que mudou?
Asthma and the new anti-smoking legislation. What has changed?
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Ágata Areias1, João Duarte1, Joana Figueiredo1, Rita Lucas1, Inês Matos1, João Pires1, Ana Glória Fonseca2, José Luís Castanheira3
1 Aluno do 6.º ano do Mestrado Integrado em Medicina, Departamento de Saúde Pública, Faculdade de Ciências Médicas, Universidade Nova de Lisboa / 6th year medical students, Public Health Department, Faculty of Medical Sciences, New University of Lisbon.
2 Docente convidada do Departamento Universitário de Saúde Pública, Faculdade de Ciências Médicas, Universidade Nova de Lisboa / Guest Professor of University Department of Public Health, Faculty of Medical Sciences, New University of Lisbon
3 Coordenador do Departamento Universitário de Saúde Pública, Faculdade de Ciências Médicas, Universidade Nova de Lisboa / Coordinator of the University Department of Public Health, Faculty of Medical Sciences, New University of Lisbon
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Resumo

Em Janeiro 2008, foi implementada, em Portugal, uma nova medida legislativa que condiciona o consumo de tabaco em espaços colectivos fechados. Como a exposição passiva ao fumo do tabaco provoca a exacerbação dos sintomas de asma, tornou-se pertinente conhecer a percepção dos doentes asmáticos sobre as repercussões desta nova lei no seu bem-estar.

Foi realizado um estudo descritivo transversal, numa amostra de conveniência, constituída por 96 doentes asmáticos da consulta de Pneumologia do Hospital Pulido Valente e do Hospital de Santa Marta, de Lisboa. Os dados foram recolhidos a partir de um questionário padronizado com respostas voluntárias, anónimas e confidenciais. Para tratamento estatístico recorreu-se ao programa Epi InfoTM e foi aplicado o teste qui-quadrado para análise dos resultados (α=5%).

Dos doentes inquiridos, a percentagem dos que estiveram expostos a fumo de tabaco até Dezembro 2007 foi de 67,7%, com maior prevalência no grupo de indivíduos activos. Apesar de a maioria dos inquiridos não referir alterações no seu bem-estar, 39,6% referiu alterações positivas (melhoria na realização de actividades diárias, diminuição dos sintomas ou menor necessidade de recorrer a medicação SOS). Destes indivíduos, que indicaram alterações positivas, 81,6% deixaram de estar expostos após entrada da nova lei e 65,8% indicaram-na como factor responsável.

Os resultados deste estudo, apenas dois meses após a implementação legal, reforçam a importância da aplicação de medidas legais eficazes que evitem a exposição ao fumo de tabaco, como forma de redução da exacerbação dos sintomas e de melhoria do bem-estar dos doentes asmáticos.

Rev Port Pneumol 2009; XV (1): 27-42

Palavras-chave:
Asma
tabaco
exposição
fumo
fumo passivo
lei
Abstract

January 2008 saw new legislation implanted in Portugal restricting smoking in closed public spaces. As second-hand smoke worsens asthma symptoms, it is important to understand how asthma patients feel this new legislation impacts on their well-being.

A descriptive cross-sectional study was conducted in a convenience sample formed of 96 asthma patients who had Pulmonology appointments at the Pulido Valente and Santa Marta Hospitals. All data was collected from a standardised questionnaire with volunteer, anonymous and confidential answers. Epi InfoTM software was used for statistical processing purposes, and the results analysed using the chi-squared test (α=5%).

67.7% of the patients polled were exposed to second-hand smoke until December 2007, with a higher percentage in those currently in work. A considerable percentage (39.6%) described positive changes (measured by improved performance of daily life activities, decrease in symptoms or lesser recourse to SOS medication), even though the majority did not recognise any improvement. 81.6% of those who noted positive changes said they were no longer exposed to second-hand smoke with the passing of the new legislation, and 65.8% stated that the smoking ban was the factor responsible for those changes.

These results, only two months after the implementation of the legislative ban on smoking in public spaces, underline the importance of approving effective measures to create and enforce smoke-free environments, reducing worsening of symptoms and improving asthma patients’ well-being.

Rev Port Pneumol 2009; XV (1): 27-42

Key-words:
Asthma
tobacco
exposure
smoke
second-hand smoke
legislation
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Bibliografia / Bibliography
[1.]
U.I. Carvajal, M.L. Garcia, M.R. Busquets, S.V.M. Morales, N.G. Andoin, G.J. Batlles, et al.
Geographic variation in the prevalence of asthma symptoms in Spanish children and adolescents.
Arch Bronconeumologia, 41 (2005), pp. 659-666
[3.]
W.W. Masoli, D. Fabian, S. Holt, R. Beasley.
The global burden of asthma:executive summary of the GINA Dissemination Comitte report.
[4.]
R. Beasley.
The Global Burden of Asthma Report, global Initiative for Asthma, (2004),
[5.]
A.E. Williams, K.F. Rabe.
Cost of scheduled and unscheduled asthma managment in seven European countries.
European Respiratory Review, 15 (2006), pp. 4-9
[6.]
D. Ferreira, R. Duarte, A. Carvalho.
Exacerbações da asma persistente grave – Impacto do controlo de factores de risco.
Rev Port Pneumol, XIII (2007), pp. 675-689
[7.]
U.I. Carvajal, M.L. Garcia, M.R. Busquets, S.V.M. Morales, N.G. Andoin, G.J. Batlles, et al.
Geographic variation in the prevalence of asthma symptoms in Spanish children and adolescents.
Arch Bronconeumologia, 41 (2005), pp. 659-666
[8.]
Comissão de coordenação do programa de asma.
Programa Nacional de Controlo da Asma, Direcção-Geral de Saúde, (2000),
[9.]
National heart, lung and blood institute and world health organization. Global strategy for asthma management and prevention. NHLBI / WHO Workshop Report 1995.
[10.]
European Community Respiratory Health Survey.
Variations in the prevalence of respiratry symptoms, self-reported asthma attacks and use of asthma medication in the Europena Community Respiratory Health Survey.
Eur Respir J, 9 (1996), pp. 687-695
[11.]
G.W. Chalmers, K.J. Macleod, S.A. Little, L.J. Thomson, C.P. McSharry, N.C. Thomson.
Influence of ciggartte smoking on inhaled corticosteroid treatment in mild asthma.
Thorax, 57 (2002), pp. 226-230
[12.]
R. Chaudhuri, E. Livingston, A.D. McMahon, N.C. Thomson.
Cigarette smoking impairs the therapeutic response to corticosteroids in chronic asthma.
Am J Respir Crit Care Med, 168 (2003), pp. 1308-1311
[13.]
E.D. Bateman, H.A. Boushey, J. Bousquet, W.W. Busse, T.J. Clark, R.A. Pauwels, et al.
Can guideline-defined asthma control be achieved? The Gaining Optimal Asthma Control study.
Am J Respir Crit Care Med, 170 (2004), pp. 836-844
[14.]
M.D. Eisner, J. Klein, S.K. Hammond, G. Koren, G. Lactao, C. Iribarren.
Directly measured second hand smoke exposure and asthma health outcomes.
Thorax, 60 (2005), pp. 814-821
[15.]
World Health Organization Europe. Legislating for smoke free places, WHO for Europe Region, (2007),
[16.]
World Health Organization Europe. The European Tobacco Control Report 2007, WHO for Europe Region, (2007),
[17.]
D. Menzies, A. Nair, P.A. Williamson, S. Schembri, M.Z.H. Al-Khairalla, M. Barnes, et al.
Respiratory symptoms, pulmonary function and markers of inflammation among bar workers before and after a legislative ban on smoking in public places.
JAMA, 296 (2006), pp. 1742-1748
[18.]
Diário da República, 1.ª série, n.º 156. Lei n.º 37/2007.
[19.]
WHO Report on the global tobacco epidemic, 2008: The MPOWER package, World Health Organization, (2008),
[20.]
M.D. Eisner, P.P. Katz, E.H. Yelin, S.K. Hammond, P.D. Blanc.
Measurement of environmental tobacco smoke exposure among adults with asthma.
Environ Health Perspect, 109 (2001), pp. 809-814
[21.]
M.D. Eisner, E.H. Yelin, J. Henke, S.C. Shiboski, P.D. Blanc.
Environmental tobacco smoke and adult asthma: the impact of changing exposure on health outcomes.
Am J Respir Crit Care Med, 158 (1998), pp. 170-175
[22.]
S.K. Jindal, D. Gupta, A. Singh.
Indices of Morbidity and control of asthma in adult patients exposed to environmental tobacco smoke.
Chest, 106 (1994), pp. 746-749
[23.]
G. Dubois.
Prevention of air pollution by indoor tobacco smoke in France.
Bull Acad Natl Med, 189 (2005), pp. 803-812
[24.]
B. Hermann, J. Born, P. Novak, V. Wanek.
Smoking behavior and attitude toward smoking regulations and passive smoking in the workplace.
Prev Med, 26 (1997), pp. 138-143
[25.]
M. Nebot, M.J. López, G. Gorini, M. Neuberger, S. Axelsson, M. Pilali, et al.
Environmental tobacco smoke exposure in public places of European cities.
Tob Control, 14 (2005), pp. 60-63
[26.]
D. Shelley, R. Yerneni, D. Hung, D. Das, M. Fahs.
The relative effect of household and workplace smoking restriction on health status among Chinese Americans living in New York City.
J Urban Healt, 84 (2007), pp. 360-371
[27.]
J.R. Greer, D.E. Abbey, R.J. Burchette.
Asthma related to occupational and ambient air pollutants in non-smokers.
J Occup Med, 35 (1993), pp. 909-915
[28.]
M. Wakefield, L. Trotter, M. Cameron, A. Woodward, G. Inglis, D. Hill.
Association between exposure to workplace secondhand smoke and reported respiratory and sensory symptoms: cross-sectional study.
J Occup Environ Med, 45 (2003), pp. 622-627
[29.]
C.W. Noonan, T.J. Ward.
Environmental tobacco smoke, woodstove heating and risk of asthma symptoms.
J Asthma, 44 (2007), pp. 735-738
[30.]
European Commission.
Attitudes of Europeans towards tobacco, pp. 239
Copyright © 2009. Sociedade Portuguesa de Pneumologia/SPP
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