AVALIAO DO FUMANTE: HISTRIA DO TABAGISMO

1. DADOS GERAIS
Nome: _________________________________________________________ Idade: ______ Sexo: _______
Data da Entrevista: _________________.
2. ROTEIRO DA ENTREVISTA DE AVALIAO
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Incio do consumo
Desenvolvimento do consumo at o nvel atual
Qual o maior nvel de consumo estvel
Qual o menor nvel de consumo estvel
Qual o nvel de consumo atual: mnimo consumido e o mximo consumido
Tentativas prvias de interromper o uso
Resultados das tentativas prvias
Fatores de sucesso
Fatores de recada
Circunstncias que modulam o consumo
Presena de outros fumantes em casa ou no trabalho
Restries do uso do cigarro em casa ou no trabalho
Variaes do consumo ao longo da semana
Circunstncias de vida: estresse psicolgico, ansiedade, depresso...
Escalas objetivas de ansiedade e depresso
Sintomas de abstinncia: listar sintomas e pedir paciente escolher
Teste de dependncias de nicotina
Uso/abuso/dependncia de outras substncias psicoativas: lcool, caf, medicamentos e drogas ilcitas
Preocupaes com peso (patolgicas ou no): paciente deve ser orientado a no se preocupar demasiadamente com o
peso, o foco do tratamento deve ser o abandono do tabagismo, no entanto, o paciente deve procurar nutricionista e
exerccios fsicos: pesquisas apontam aumento de apetite por no mximo seis meses depois (em dependentes) do
abandono do tabagismo e ganho de at 5kg no mximo em mdia.
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