title: [ETAP: A smoking scale for Primary Health Care].
abstract: OBJECTIVE
  To obtain a scale of tobacco exposure to address smoking cessation.
  
  
  METHODS
  Follow-up of a cohort. Scale validation.
  
  
  METHODS
  Primary Care Research Unit. Tenerife.
  
  
  METHODS
  A total of 6729 participants from the "CDC de Canarias" cohort.
  
  
  METHODS
  A scale was constructed under the assumption that the time of exposure to tobacco is the key factor to express accumulated risk. Discriminant validity was tested on prevalent cases of acute myocardial infarction (AMI; n=171), and its best cut-off for preventive screening was obtained. Its predictive validity was tested with incident cases of AMI (n=46), comparing the predictive power with markers (age, sex) and classic risk factors of AMI (hypertension, diabetes, dyslipidaemia), including the pack-years index (PYI).
  
  
  RESULTS
  The scale obtained was the sum of three times the years that they had smoked plus years exposed to smoking at home and at work. The frequency of AMI increased with the values of the scale, with the value 20 years of exposure being the most appropriate cut-off for preventive action, as it provided adequate predictive values for incident AMI. The scale surpassed PYI in predicting AMI, and competed with the known markers and risk factors.
  
  
  CONCLUSIONS
  The proposed scale allows a valid measurement of exposure to smoking and provides a useful and simple approach that can help promote a willingness to change, as well as prevention. It still needs to demonstrate its validity, taking as reference other problems associated with smoking.
authors.affiliation: Servicio de Urgencias, Hospital Universitario NS de Candelaria, Sta. Cruz de Tenerife, España.
authors.forename: Pilar María
authors.initials: PM
authors.lastname: González Romero
authors.affiliation: Centro de Salud Barranco Grande, Universidad de La Laguna, Sta. Cruz de Tenerife, España.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Cuevas Fernández
authors.affiliation: Unidad de Investigación Atención Primaria, Hospital Universitario NS de Candelaria, Sta. Cruz de Tenerife, España.
authors.forename: Itahisa
authors.initials: I
authors.lastname: Marcelino Rodríguez
authors.affiliation: Unidad de Investigación Atención Primaria, Hospital Universitario NS de Candelaria, Sta. Cruz de Tenerife, España.
authors.forename: María Del Cristo
authors.initials: Mdel C
authors.lastname: Rodríguez Pérez
authors.affiliation: Dirección del Servicio Canario de la Salud, Área de Medicina Preventiva de la Universidad de La Laguna, Sta. Cruz de Tenerife, España. Electronic address: acableo@gobiernodecanarias.org.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cabrera de León
authors.affiliation: Unidad de Investigación Atención Primaria, Hospital Universitario NS de Candelaria, Sta. Cruz de Tenerife, España.
authors.forename: Armando
authors.initials: A
authors.lastname: Aguirre-Jaime
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D012907:Smoking / Q000453:epidemiology*; D013997:Time Factors
keywords: Atención primaria; Cardiopatía isquémica; Escala; Ischaemic heart disease; Prevención; Prevention; Primary care; Scale; Smoking; Tabaquismo