Relación entre el consumo de tabaco, salud mental y malestares físicos en hombres trabajadores de una empresa textil mexicana

Resumen

SUMMARYIntroductionTobacco use is considered a worldwide public health problem becauseof the amount of death and disease it causes. The WHO reports that30% of the adult population in the world are cigarette smokers, andthat nearly five million of these will die within one year. Prospectivestudies performed by the WHO show that if current tobacco usecontinues, in 2020 there will be 8.4 million deaths due to tobacco-related diseases every year; seven out of 10 of these deaths will occurin emergent countries, like Mexico. More than 53000 tobacco usersdie every year in Mexico because of tobacco-related diseases, and atleast 147 of these die daily. Data from the National Addictions Survey(NAS) 2002 showed that 26.4% of the people between 12 and 65years old were active tobacco consumers; this amounted to nearly 14million individuals. Of these, 7.1% were under 18 years old. Thenumber of tobacco consumers in Mexico has increased from ninemillion in 1988 to 14 million in 2002. According to the NAS, 52% ofthe users smoke on a daily basis, and 61.4% of them began smokingwhen they were minors. To know the actual consumption levels, it isimportant to consider some factors: the number of cigarettes a personsmokes, the different situations where a person smokes, and the socialand physical consequences of smoking. Thus, it would be possible todevelop a consumer classification (i. e. soft consumers, mildconsumers, and hard consumers). There may be numerous causesfor a person to be ill. When speaking about the harmful effects oftobacco use, the literature is clear in stating that these begin with thefirst cigarette smoked. However, it can take up to 30 years for aconsumer to notice the damage on his health after his/her consumptionbegan; but within the first ten years there are problems in lung functionand in physical endurance. When a person starts smoking there areacute and unpleasant side effects that are rarely associated withsmoked tobacco use. Consumption creates a tolerance which makesunpleasant effects to stop or fade away, giving place to pleasantsensations produced by nicotine; concentration improves andpsychomotor skills, alert, and activation get better and there is areduction in anxiety and stress. The relationship between tobacco useand mental health is evident at the level of the emotional outcomes ofsuffering a chronic illness, such as lung cancer.On the other hand, nicotine use has been related to a reductionin the severity of depression. Chemical alternatives for reducingconsumption, based on the substance physical effects that promoteaddiction, have not proven to be effective so far. There is also evidencethat consumers that fail in quitting smoking or people that havedependence problems with nicotine show a high prevalence of mayordepression when compared to non-dependent consumers. Thisassociation was direct with the severity of nicotine dependence. It alsohas been observed that smoking interferes often with psychologicallearning tools, mainly when consumption starts at very early ages.Emotional distress can produce low self-esteem and a lack of self-confidence. Therefore, the chances to begin tobacco consumptionincrease when it is used as a crutch to cope with social pressure andacceptance. Since tobacco use is a conduct that has shown to haveserious repercussions on physical health and an important relationshipwith mental health in human beings, and is therefore a growing publichealth problem, the objective of this study is to explore a possible linkamong smoked tobacco consumption, mental health and physicalproblems in male workers from a textile factory.MethodA non-probabilistic convenience sample was used in the study. Subjectsvoluntarily agreed to complete the questionnaire: 279 male workerswere interviewed; 54% were between 18 and 27 years old and 23%were between 28 and 37. Most of them had studied junior high schoolor higher (74%) and 65% were in a serious relationship (married orliving with a couple).Data about tobacco use were collected using a questionnairewith questions from the NAS 2002. To explore mental health the five-item Mental Health Inventory was used (MHI-5). As it is a self-answeredscreening test, it does not give a diagnosis, but it does allowestablishing if subjects have symptoms of a probable mental healthproblem. Information about physical distress was collected through an11-item somatization sub-scale from the Symptoms Check List-90 (SCL-90). The number of physical troubles that subjects reported during the