Tratamientos para dejar de fumar financiados por la Seguridad Social


Escribimos este post para informaros de los tratamientos para dejar de fumar financiados por la Seguridad Social. Así sabréis en qué condiciones está indicado su uso. 

No todos los pacientes que quieren dejar de fumar van a necesitar estos fármacos. No debemos olvidar que el proceso de dejar de fumar es un proceso lento, que requiere constancia y mucha fuerza de voluntad. Los fármacos ayudan, pero no van a dejar de fumar por tí. Con estos fármacos, según varios estudios, la abstinencia al año es de un 21,2% con vareniclina y de un 13,9% con bupropión. 
¿Los fármacos financiados por la Seguridad Social son gratuitos? ¿Cuál es su precio?
No, los fármacos financiados no son gratuitos. Que un fármaco esté financiado por la Seguridad Social significa que sólo vas a tener que pagar una parte del coste del medicamento. 
Como ocurre con todos los medicamentos financiados, dependiendo de tu nivel de ingresos, pagarás un porcentaje de lo que cuesta. Esto quiere decir que hay gente que pagará más y otros que pagarán menos. 
El tratamiento con bupropion (Zyntabac) oscilará desde los 0 euros en el caso los pacientes cuya aportación es del 0% hasta los 37,5 euros en el caso de los pacientes de pagan el máximo (60%). 
El tratamiento con Vareniclina (Champix) varía desde los 0 euros en el caso de la aportación mínima hasta los 172,12 euros para los que tienen la aportación máxima. 
¿Todos los pacientes que quieren dejar de fumar van a necesitar tratamiento farmacológico?
No. Lo primero, debes estar convencido de que quieres dejar de fumar. En caso contrario, el fracaso en el abandono del tabaco está garantizado. 
Si estás decidido a dejar de fumar, debes pedir cita en tu médico. En la primera visita tu médico te hará unas preguntas para valorar si necesitas tomar medicación o  no. Todos los fármacos tienen sus contraindicaciones y sus efectos adversos. Por ello, si no es necesario tomar fármacos que te ayuden a dejar de fumar, no te prescribirán nada.
¿Estos tratamientos son nuevos?
No. Estos tratamientos son los mismos que os explicamos en un post previo hace tiempo (pulse aquí para acceder a él) y no han cambiado. Lo único que ha cambiado es que ahora alguno de ellos está financiado por la Seguridad Social. 
¿Cuáles son los efectos secundarios más frecuentes?
En el caso del bupropion, es un fármaco que a pesar de tener muchas interacciones medicamentosas y más contraindicaciones que la vanericlina, se tolera algo mejor que ésta. Los principales efectos secundarios que puede dar son sequedad de boca, náuseas, vómitos, estreñimiento, dolor abdominal, insomnio, erupciones exantemáticas, picores y sudoración. 
La vareniclina se tolera algo peor que el bupropion. Da reacciones adversas muy frecuentes como náuseas, vómitos, estreñimiento, diarrea, dolor abdominal, gases , sequedad de boca, reflujo, insomnio y cefalea. 
¿Puedo fumar y beber durante el tratamiento con bupropion o vareniclina?
No. Con ninguno de estos tratamientos se puede beber porque pueden interaccionar con el alcohol y generar más sensibilidad al alcohol. Esta mayor sensibilidad puede generar entre otras cosas conductas agresivas con el alcohol y amnesia temporal.
Con ambos tratamientos se puede fumar las primeras 1-2 semanas pero se recomienda abandonar por completo el tabaco al terminar la segunda semana desde que se inició el tratamiento. 
¿Qué necesito para dejar de fumar?
Fuerza de voluntad y querer dejarlo. Debes estar convencido de que quieres dejar de fumar por el bien de tu salud. El tabaco es una droga, eres adicto y estás enganchado a ella. Si no vences esa tentación, nada ni nadie lo va a hacer por tí. 
Si te propones dejar de fumar, haz una lista con los pros y contras de fumar. Haz otra lista con tus motivos para dejar de fumar y ve pensando una fecha importante para tí para dejarlo. Todo ello te dará fuerzas para superar el proceso. No olvidemos que la preparación forma parte del proceso de dejar de fumar. Si pasamos a la acción sin prepararnos, es mucho más probable que fracasemos. 
¿Cómo decide mi médico si necesito medicación para dejar de fumar?
Cuando vayas a consulta, tu médico te hará una serie de preguntas. Con estas preguntas, valorará si cumples criterios para usar medicación para fumar. 
¿Cuáles son los criterios de financiación de medicación para dejar de fumar?
Cada caso es diferente. Hay que analizar cada situación por separado para decidir el tratamiento que te conviene. Deben tenerse en cuenta las contraindicaciones de cada fármaco y los efectos adversos, así como la situación personal de cada uno, para sopesar el tratamiento más adecuado a cada persona.
En general, para valorar el tratamiento farmacológico debe cumplirse lo siguiente: 

  • Estar dispuesto a dejar de fumar en un periodo de tiempo próximo
  • Fumar más de 10 cigarrillos al día 
  • Dependencia alta 
  • Tener un intento previo de dejar de fumar en el año anterior que ha fracasado

¿Cuánto dura el tratamiento con fármacos?
Para considerar a una persona como ex-fumadora, deben pasar 12 meses sin fumar. El tratamiento farmacológico forma parte de la fase de acción dentro del proceso de abandono del tabaco. La duración del tratamiento farmacológico será de 9 semanas si usamos como tratamiento el bupropion y 12 semanas si optamos por la vareniclina.
¿Cuántos intentos de abandono del tabaco están financiados?
Dentro del proceso de abandono del tabaco hay que contemplar la recaída. Puedes intentar dejar de fumar siempre que te lo propongas y se pueden hacer varios intentos al año con tratamientos farmacológicos pero la Seguridad Social sólo financiará un tratamiento farmacológico al año. 
No olvidéis que estos no son los únicos tratamientos que existen para dejar de fumar. En este post os hemos hablado de los financiados por la Seguridad Socia pero en el post “fármacos para dejar de fumar” os explicamos cada uno de ellos por separado. Ánimo, haz lo mejor para tu salud y abandona el tabaco. Nosotros te ayudamos, con o sin fármacos puedes vencer al tabaco.  


Marta  Cano Pazos

Médica familiar y comunitaria, Laguna de Duero, Valladolid

 
Revisado: Enero 2020.

489 comentarios en “Tratamientos para dejar de fumar financiados por la Seguridad Social”

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