Terapia de Aceitação e Compromisso para a Cessação Tabágica: Uma Revisão Sistemática
DOI:
https://doi.org/10.51338/rppsm.596Palavras-chave:
Terapia de Aceitação e Compromisso, Cessação do Hábito de FumarResumo
Introdução: O tabagismo tem uma elevada prevalência na população e as taxas de abstinência bem-sucedida são baixas. Esta revisão sistemática pretende analisar a eficácia da terapia de aceitação e compromisso (ACT) – que promove padrões de comportamento em linha com os valores pessoais - na cessação tabágica, tendo em conta medidas de abstinência, aceitação dos cravings e a quantidade de tabaco consumido.
Metodologia: Foi realizada uma revisão sistemática da literatura recorrendo às bases de dados PubMed®, EBSCO®, SciELO, SCOPUS® e Web of Science.
Resultados: Os resultados sugerem algum benefício da ACT relativamente a medidas de aceitação dos cravings e de uma associação entre o aumento da aceitação dos cravings e a abstinência. O benefício da ACT não parece comprovar-se quanto a medidas de abstinência e de quantidade de tabaco consumido (quando não alcançada a abstinência).
Conclusão: Sugere-se a realização de mais estudos para compreender o alcance do benefício da ACT na cessação tabágica.
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Referências
Heffner JL, Watson NL, Serfozo E, Kelly MM, Reilly ED, Kim D, et al. An Avatar-Led Digital Smoking Cessation Program for Sexual and Gender Minority Young Adults: Intervention Development and Results of a Single-Arm Pilot Trial. JMIR Form Res. 2021;5:e30241. doi: 10.2196/30241.
O'Connor M, Whelan R, Bricker J, McHugh L. Randomized Controlled Trial of a Smartphone Application as an Adjunct to Acceptance and Commitment Therapy for Smoking Cessation. Behav Ther. 2020;51:162-77. doi: 10.1016/j.beth.2019.06.003.
Heffner JL, McClure JB, Mull KE, Anthenelli RM, Bricker JB. Acceptance and Commitment Therapy and nicotine patch for smokers with bipolar disorder: preliminary evaluation of in-person and telephone-delivered treatment. Bipolar Disord. 2015;17:560-6. doi: 10.1111/bdi.12300.
Zeng EY, Heffner JL, Copeland WK, Mull KE, Bricker JB. Get with the program: Adherence to a smartphone app for smoking cessation. Addict Behav. 2016;63:120-4. doi: 10.1016/j.addbeh.2016.07.007.
Singh S, Starkey NJ, Sargisson RJ. Using SmartQuit®, an Acceptance and Commitment Therapy Smartphone application, to reduce smoking intake. Digit Health. 2017;3:2055207617729535. doi: 10.1177/2055207617729535.
Bricker JB, Copeland W, Mull KE, Zeng EY, Watson NL, Akioka KJ, et al. Single-arm trial of the second version of an acceptance & commitment therapy smartphone application for smoking cessation. Drug Alcohol Depend. 2017;170:37-42. doi: 10.1016/j.drugalcdep.2016.10.029.
Santiago-Torres M, Mull KE, Sullivan BM, Kwon DM, Nez Henderson P, Nelson LA, et al. Efficacy and Utilization of Smartphone Applications for Smoking Cessation Among American Indians and Alaska Natives: Results From the iCanQuit Trial. Nicotine Tob Res. 2022;24:544-54. doi: 10.1093/ntr/ntab213.
Bricker JB, Mann SL, Marek PM, Liu J, Peterson AV. Telephone-delivered Acceptance and Commitment Therapy for adult smoking cessation: a feasibility study. Nicotine Tob Res. 2010;12:454-8. doi: 10.1093/ntr/ntq002.
McClure JB, Bricker J, Mull K, Heffner JL. Comparative Effectiveness of Group-Delivered Acceptance and Commitment Therapy versus Cognitive Behavioral Therapy for Smoking Cessation: A Randomized Controlled Trial. Nicotine Tob Res. 2020;22:354-62. doi: 10.1093/ntr/nty268.
Bricker JB, Mull KE, McClure JB, Watson NL, Heffner JL. Improving quit rates of web-delivered interventions for smoking cessation: full-scale randomized trial of WebQuit.org versus SmokeFree.gov. Addiction. 2018;113:914-23. doi: 10.1111/add.14127.
Heffner JL, Vilardaga R, Mercer LD, Kientz JA, Bricker JB. Feature-level analysis of a novel smartphone application for smoking cessation. Am J Drug Alcohol Abuse. 2015;41:68-73. doi: 10.3109/0952990.2014.977486.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. PLoS Med. 2021;18:e1003583. doi: 10.1371/journal.pmed.1003583.
Sterne JAC, Savovic J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:14898. doi: 10.1136/bmj.14898.
Bricker J, Wyszynski C, Comstock B, Heffner JL. Pilot randomized controlled trial of web-based acceptance and commitment therapy for smoking cessation. Nicotine Tob Res. 2013;15:1756-64. doi: 10.1093/ntr/ntt056.
Bricker JB, Bush T, Zbikowski SM, Mercer LD, Heffner JL. Randomized trial of telephone-delivered acceptance and commitment therapy versus cognitive behavioral therapy for smoking cessation: a pilot study. Nicotine Tob Res. 2014;16:1446-54. doi: 10.1093/ntr/ntu102.
Bricker JB, Mull KE, Kientz JA, Vilardaga R, Mercer LD, Akioka KJ, et al. Randomized, controlled pilot trial of a smartphone app for smoking cessation using acceptance and commitment therapy. Drug Alcohol Depend. 2014;143:87-94. doi: 10.1016/j.drugalcdep.2014.07.006.
Bricker JB, Watson NL, Mull KE, Sullivan BM, Heffner JL. Efficacy of Smartphone Applications for Smoking Cessation: A Randomized Clinical Trial. JAMA Intern Med. 2020;180:1472-80. doi: 10.1001/jamanternmed.2020.4055.
Davoudi M, Omidi A, Sehat M, Sepehrmanesh Z. The Effects of Acceptance and Commitment Therapy on Man Smokers' Comorbid Depression and Anxiety Symptoms and Smoking Cessation: A Randomized Controlled Trial. Addict Health. 2017;9:129-38.
Gifford EV, Kohlenberg BS, Hayes SC, Pierson HM, Piasecki MP, Antonuccio DO, et al. Does acceptance and relationship focused behavior therapy contribute to bupropion outcomes? A randomized controlled trial of functional analytic psychotherapy and acceptance and commitment therapy for smoking cessation. Behav Ther. 2011;42:700-15. doi: 10.1016/j.beth.2011.03.002.
Mak YW, Leung DYP, Loke AY. Effectiveness of an individual acceptance and commitment therapy for smoking cessation, delivered face-to-face and by telephone to adults recruited in primary health care settings: a randomized controlled trial. BMC Public Health. 2020;20:1719. doi: 10.1186/s12889-020-09820-0.
Mak YW, Loke AY, Leung DY. Acceptance and Commitment Therapy versus Social Support for Smoking Cessation for People with Schizophrenia: A Randomized Controlled Trial. J Clin Med. 2021;10:4304. doi: 10.3390/jcm10194304.
Gifford EV, Kohlenberg BS, Hayes SC, Antonuccio DO, Piasecki MM, Rasmussen-Hall ML, et al. Acceptance-Based Treatment for Smoking Cessation. Behav Ther. 2004;35:689-705.
Heffner JL, Kelly MM, Waxmonsky J, Mattocks K, Serfozo E, Bricker JB, et al. Pilot Randomized Controlled Trial of Web-Delivered Acceptance and Commitment Therapy Versus Smokefree.gov for Smokers With Bipolar Disorder. Nicotine Tob Res. 2020;22:1543-52. doi: 10.1093/ntr/ntz242.
Jones HA, Heffner JL, Mercer L, Wyszynski CM, Vilardaga R, Bricker JB. Web-based acceptance and commitment therapy smoking cessation treatment for smokers with depressive symptoms. J Dual Diagn. 2015;11:56-62. doi: 10.1080/15504263.2014.992588.
Litvin EB, Kovacs MA, Hayes PL, Brandon TH. Responding to tobacco craving: experimental test of acceptance versus suppression. Psychol Addict Behav. 2012;26:830-7. doi: 10.1037/a0030351.
Lombardero A. Smoking cessation for patients in multidisciplinary pain treatment settings: A preliminary test of acceptance and commitment therapy. ProQuest Information Learning. 2017; 77.
Hernández-López M, Luciano MC, Bricker JB, Roales-Nieto JG, Montesinos F. Acceptance and commitment therapy for smoking cessation: a preliminary study of its effectiveness in comparison with cognitive behavioral therapy. Psychol Addict Behav. 2009;23:723-30. doi: 10.1037/a0017632.
Karekla M, Savvides SN, Gloster A. An Avatar-Led Intervention Promotes Smoking Cessation in Young Adults: A Pilot Randomized Clinical Trial. Ann Behav Med. 2020;54:747-60. doi: 10.1093/abm/kaaa013.
Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. J Consult Clin Psychol. 2007;75:336-43. doi: 10.1037/0022-006X.75.2.336.
Kelson J, Rollin A, Ridout B, Campbell A. Internet-Delivered Acceptance and Commitment Therapy for Anxiety Treatment: Systematic Review. J Med Internet Res. 2019;21:e12530. doi: 10.2196/12530.
Prevedini AB, Presti G, Rabitti E, Miselli G, Moderato P. Acceptance and commitment therapy (ACT): the foundation of the therapeutic model and an overview of its contribution to the treatment of patients with chronic physical diseases. G Ital Med Lav Ergon. 2011;33(1 Suppl A):A53-63.





