<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0186-4866</journal-id>
<journal-title><![CDATA[Medicina interna de México]]></journal-title>
<abbrev-journal-title><![CDATA[Med. interna Méx.]]></abbrev-journal-title>
<issn>0186-4866</issn>
<publisher>
<publisher-name><![CDATA[Edición y Farmacia S.A. de C.V.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0186-48662017000400533</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Tratamiento de tabaquismo intenso después de un infarto agudo de miocardio]]></article-title>
<article-title xml:lang="en"><![CDATA[Treatment of severe smoking after an acute myocardial infarction]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Campollo-Rivas]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres-Delgado]]></surname>
<given-names><![CDATA[OP]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Becerra-García]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Guadalajara Centro Universitario de Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[ Jalisco]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2017</year>
</pub-date>
<volume>33</volume>
<numero>4</numero>
<fpage>533</fpage>
<lpage>539</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0186-48662017000400533&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0186-48662017000400533&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0186-48662017000400533&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: El tabaquismo es una enfermedad crónica que afecta a una quinta parte de nuestra población. No obstante, la mayoría de los fumadores no busca tratamiento de su enfermedad ni la considera tal. Algunos pacientes logran controlar la dependencia por sí solos, pero la mayoría requiere apoyo por medio de un programa médico-psicológico para lograr la abstinencia. Según la etapa de cambio de la conducta en que se encuentre el paciente, será el programa y estrategia a seguir. Se comunica el caso de un paciente de 51 años de edad con tabaquismo excesivo (80 cigarrillos al día) y antecedente de accidente vascular cerebral que padeció un infarto agudo de miocardio sometido a cateterismo cardiaco con colocación de stent, que posteriormente ingresó a un programa de tratamiento de tabaquismo. El paciente disminuyó significativamente el consumo de cigarrillos después del tratamiento, pero la dependencia a la nicotina debe considerarse una enfermedad crónica que, como tal, puede tener recaídas. Este caso es el de mayor consumo de cigarrillos que hemos estudiado y es representativo del grado de dependencia de una sustancia como la nicotina que, a pesar de las graves consecuencias por su consumo, los pacientes no pueden controlarla fácilmente.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Tobacco smoking is a chronic disease affecting one fifth of our population. Most smokers, however, are not conscious nor seek treatment for their problem. Some patients are able to reach abstinence by themselves but the majority need some kind of medical-psychological therapy. The best therapy to reach abstinence or improvement will depend on the stage of behavioral change. We present a case of extreme smoking (80 cigarettes a day) who presented a heart stroke and who was successfully treated with a stent. After he was discharged from hospital he was admitted to the smoking cessation program. He attended the program for 8 weeks and decreased his smoking by 94% at the end of the program. This case represents the clinical challenges and complexity of treatment for patients with a high degree of nicotine dependence in spite of life threatening consequences of tobacco smoking.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[tabaquismo]]></kwd>
<kwd lng="es"><![CDATA[nicotina]]></kwd>
<kwd lng="es"><![CDATA[dependencia]]></kwd>
<kwd lng="es"><![CDATA[tratamiento]]></kwd>
<kwd lng="es"><![CDATA[infarto miocardio]]></kwd>
<kwd lng="es"><![CDATA[stent]]></kwd>
<kwd lng="en"><![CDATA[heart stroke]]></kwd>
<kwd lng="en"><![CDATA[tobacco]]></kwd>
<kwd lng="en"><![CDATA[intense smoking]]></kwd>
<kwd lng="en"><![CDATA[nicotine]]></kwd>
<kwd lng="en"><![CDATA[dependence]]></kwd>
<kwd lng="en"><![CDATA[treatment]]></kwd>
<kwd lng="en"><![CDATA[stent]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="">
<collab>Instituto Nacional de Psiquiatria RFM</collab>
<collab>Instituto Nacional de Salud Pública, SSa</collab>
<source><![CDATA[Encuesta nacional de adicciones 2011]]></source>
<year>2012</year>
<publisher-loc><![CDATA[México DF, México ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<collab>Sociedad Mexicana de Neumología y Cirugía de Torax AC</collab>
<article-title xml:lang=""><![CDATA[Guías Mexicanas para el tratamiento del Tabaquismo. Un consenso nacional de expertos]]></article-title>
<source><![CDATA[Neumología y Cirugía de Torax]]></source>
<year>2005</year>
<volume>64</volume>
<numero>^s2</numero>
<issue>^s2</issue>
<supplement>2</supplement>
<page-range>S84-S112</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="confpro">
<collab>Organización Mundial de la Salud (OMS)</collab>
<source><![CDATA[Glosario de términos utilizados en el convenio y sus instrumentos]]></source>
<year></year>
<conf-name><![CDATA[ Marco de la convención de la OMS para el control del tabaco. 56 Asamblea Munidal de Salud]]></conf-name>
<conf-date>2003</conf-date>
<conf-loc> </conf-loc>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Velázquez-Monroy]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Barigarrementería]]></surname>
<given-names><![CDATA[FS]]></given-names>
</name>
<name>
<surname><![CDATA[Rubio-Guerra]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Verdejo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Méndez]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Violante]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Morbilidad y mortalidad de la enfermedad isquémica del corazón y cerebrovascular en México. 2005]]></article-title>
<source><![CDATA[Arch Cardiol Mex]]></source>
<year>2007</year>
<volume>77</volume>
<page-range>31-9</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chávez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Casanova]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La cardiopatía coronaria en México y su importancia clínica, epidemiológica y preventiva]]></article-title>
<source><![CDATA[Arch Cardiol Mex]]></source>
<year>2003</year>
<volume>73</volume>
<page-range>105-14</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ocampo-Ocampo]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Magallan-Vargas]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<source><![CDATA[Programa de cesación del tabaquismo en un hospital de tercer nivel. Terapia breve cognitivo conductual]]></source>
<year>2007</year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Secretaría de Salud]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ocampo-Ocampo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Villa-Hernández]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<source><![CDATA[Prevención, diagnóstico y tratamiento del consumo de tabaco y humo ajeno, en el primer nivel de atención, Guía CENETEC]]></source>
<year>2009</year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Secretaría de Salud]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jiménez-Silvestre]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Castillo-Vite]]></surname>
<given-names><![CDATA[NL]]></given-names>
</name>
</person-group>
<source><![CDATA[Evaluación de resultados de la clínica para dejar de fumar]]></source>
<year>2004</year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Centros de Integración Juvenil, Dirección de Investigación y Enseñanza]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Teo]]></surname>
<given-names><![CDATA[KK]]></given-names>
</name>
<name>
<surname><![CDATA[Ounpuu]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hawken]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Pandey]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
</person-group>
<collab>INTERHEART Study Investigators</collab>
<article-title xml:lang=""><![CDATA[Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>2006</year>
<volume>368</volume>
<numero>9536</numero>
<issue>9536</issue>
<page-range>647-58</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="">
<collab>Instituto Nacional de Geografía y Estadística</collab>
<source><![CDATA[Mortalidad general. Defunciones generales totales por principales causas de mortalidad]]></source>
<year>2014</year>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pipe]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
<name>
<surname><![CDATA[Eisenberg]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Gupta]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Reid]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Suskin]]></surname>
<given-names><![CDATA[NG]]></given-names>
</name>
<name>
<surname><![CDATA[Stone]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Smoking cessation and the cardiovascular specialist: Canadian Cardiovascular Society position paper]]></article-title>
<source><![CDATA[Can J Cardiol]]></source>
<year>2011</year>
<volume>27</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>132-7</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thomas]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cardiovascular benefits of smoking cessation]]></article-title>
<source><![CDATA[Presse Med]]></source>
<year>2009</year>
<volume>38</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>946-52</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bullen]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact of tobacco smoking and smoking cessation on cardiovascular risk and disease]]></article-title>
<source><![CDATA[Expert Rev Cardiovasc Ther]]></source>
<year>2008</year>
<volume>6</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>883-95</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gastaldelli]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Folli]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Maffei]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact of tobacco smoking on lipid metabolism, body weight and cardiometabolic risk]]></article-title>
<source><![CDATA[Curr Pharm Des]]></source>
<year>2010</year>
<volume>16</volume>
<numero>23</numero>
<issue>23</issue>
<page-range>2526-30</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Papathanasiou]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Mamali]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Papafloratos]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Zerva]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effects of smoking on cardiovascular function: The role of nicotine and carbon monoxide]]></article-title>
<source><![CDATA[Health Science J]]></source>
<year>2014</year>
<volume>8</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>270-90</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Habid]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Hsu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Winchell]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Daoko]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mural thrombus in the normal-appearing descending thoracic aorta of a chronic smoker]]></article-title>
<source><![CDATA[Tex Heart Inst J]]></source>
<year>2013</year>
<volume>40</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>619-22</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Regalado-Pineda]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Lara-Rivas]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Osio-Echánove]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez-Venegas]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tratamiento actual del tabaquismo]]></article-title>
<source><![CDATA[Salud Pública Méx]]></source>
<year>2007</year>
<volume>49</volume>
<numero>^s2</numero>
<issue>^s2</issue>
<supplement>2</supplement>
<page-range>S270-9</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fiore]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Jaen]]></surname>
<given-names><![CDATA[CR]]></given-names>
</name>
<name>
<surname><![CDATA[Baker]]></surname>
<given-names><![CDATA[TB]]></given-names>
</name>
</person-group>
<source><![CDATA[Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline]]></source>
<year>2008</year>
<publisher-loc><![CDATA[Rockville, MD ]]></publisher-loc>
<publisher-name><![CDATA[US Department of Health and Human Services]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ocampo]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Cicero-Sabido]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Retos de la medicina actual: los 30 años de experiencia de la clínica contra el tabaco del Hospital General de México "Dr. Eduardo Liceaga"]]></article-title>
<source><![CDATA[Rev Med Hosp Gen Mex]]></source>
<year>2012</year>
<volume>75</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>180-4</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Monteverde]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Sansores]]></surname>
<given-names><![CDATA[RH]]></given-names>
</name>
<name>
<surname><![CDATA[Oviedo]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<name>
<surname><![CDATA[Espinosa]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Modelo para la prestación de servicios en materia de tabaquismo en México]]></article-title>
<source><![CDATA[Rev Inst Nal Enf Resp Mex]]></source>
<year>2003</year>
<volume>16</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>92-102</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Campollo]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Bustos]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Performance indicators at a Mexican public smoking cessation clinic. 2009 NIDA International forum]]></source>
<year></year>
<page-range>23-4</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Eslava]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Vélez]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Modelo para la organización de los servicios de atención al tabaquismo en los tres niveles de atención]]></article-title>
<source><![CDATA[Anuario Investigación Adicciones]]></source>
<year>2005</year>
<volume>5</volume>
<numero>^s1</numero>
<issue>^s1</issue>
<supplement>1</supplement>
<page-range>44-57</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Campollo]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[PO]]></given-names>
</name>
</person-group>
<source><![CDATA[In-house outreach: strategies to promote and advertise a smoking cessation program in a Mexican University hospital]]></source>
<year>2016</year>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
