Background: the analysis in adolescent’s smokers as prevention from the medical sciences is one of the lines of the work team in the consultation of ceasing tobacco. Objective: to analyze the psychosocial intervention to prevent the tobacco in patients with Diabetes Mellitus.The investigation embraced one period from October 2018 to September 2019. Method: was carried out a study decriptive, restrospective, for sampling intentional non probabilistic and with an universe composed by 18 old adolescents of the Policlinic "José Ramón León Acosta. It gathers it of the data was carried out through the empiric method as the clinical histories, interviews structured, the questionnaire and for the analysis of the data the statistical calculation was used.   Results: the state of individual health of this group prevailed as for knowledge that will allow them to modify its lifestyle and in turn an aging very happened to the minimum of limitations. Conclusion: the difficulties are focused in the sistematic of the development psicosocial and to prevent risk factors in adolescentes with addiction.

The adolescence is essentially a time of changes in which happens the process of the boy's transformation in adult, has characteristic peculiar, and it is also a stage, of discovery of the own identity (psychological identity, sexual identity) as well as of the individual autonomy. 

The adolescence like period of the human development has been object of the social scientists' attention and of international instances who have tried to define its limits, as well as the characteristics that define this stage [1]. 

The space of the adolescents has vital importance in the formative process of the personality, propitiating that the same ones can self-teach with a clearer vision of the harmful effects that causes the tobacco and to prevent its consequences with the help of the professionals of the health but with a model function. 

The term of «prediabetes», it is applied to those cases in those that the glucemia levels you they find above the normal values, but below the levels considered for the diagnosis of diabetes mellitus [2].

The tobacco, is defined as a dysfunction caused by a substance able to produce dependence, the nicotine. It is considered a true drug diffused in the entire world. It reaches a world prevalence of 47 % in the masculine population of adults, in front of 12 % in the woman, and in the last years a more precocious beginning of the habit is observed, particularly in the beginning of the adolescence [3].   

The addiction of smoking could be immerse in the integral style of people's life, expert this as the group of individual decisions that affect the health and envelope which you could exercise certain control degree that also has an effect on the health and the behavior of those who cohabit [4].   

Almost 80 % of those more than a thousand million smokers that there is in the world lives in countries of low revenues or means, where it is bigger the mobility load and mortality associated to the tobacco [5].

At the moment Cuba occupies the fifth place in Latin America and the Caribbean as for the prevalence of the tobacco, being Chile and Republic of the Dominican Republic the countries of more incidences in our continent [6]. 

The phenomenon that exists around this real problem, conditioned the position of the following scientific problem in the present investigation: ¿How analyze the psychosocial intervention to prevent the tobacco in patients with Diabetes Mellitus?   

General objective: to analyze the psychosocial intervention to prevent the tobacco in patients with Diabetes Mellitus.

A study descriptive- retrospective, approach was carried out in adolescents patients attended from a community health area belonging to the "José Ramón León Acosta" policlinic of Santa Clara municipality, in the period from October 2021 to September 2022, with the objective of analyze the psychosocial intervention to prevent the tobacco in patients with Diabetes Mellitus. The sample was selected through the simple random sampling probabilistic technique and previously informed consent to participate in the study.

It was study object a universe constituted by 18 adolescents and in those that was identified about of the level of knowledge on the tobacco in adolescents as risks related with the Diabetes Mellitus to those which previously were requested informed consent. 

Theoretical level: 

 Synthetic analytical: It made possible the interpretation of each one of the studied texts, to conform the criterion assumed in the epigraphs and paragraphs, as well as to particularize in the data obtained in the surveys to integrate them and to establish the corresponding generalizations.

 Inductive-deductive: It facilitated going from the particular to the general in each of the analyzes carried out in the theoretical study and in the processing of the obtained information.

 Generalization: It allowed the establishment of the regularities that were revealed in the study carried out.

Empiric level:

 Open interview: Contributed to identify the level of knowledge in the adolescents patients with Diabetes Mellitus.

 Individual clinical histories: It made it possible to provide information on various personal aspects.

 Questionnaire: Contributed to identify the information on various personal aspects.

The selection was based on the following approaches: 

Inclusion approaches:   

-All the adolescents with risks of the area of health that possess favorable psychic conditions to respond the questions.   

-That they resided in the area of chosen health. 

Exclusion approaches:   

-Adolescents that emigrate of their residence place during the study.   

Exit approaches:   

-Adolescents that abandon the investigation voluntarily. 

It was used the following variables starting from the obtained data: age and sex in the tobacco, and the levels of tobacco consumption in adolescents with Diabetes Mellitus.

Authorization was requested the adolescents, belonging to the educational policlinic “José Ramón León Acosta” for the realization of the study. To these they were explained the importance of the investigation. The data were used by the specialists of the health and with investigative ends, fulfilling the principle of the confidentiality of the data. 

Collection of the information   

To begin the development of the investigation was carried out a bibliographical revision of the topic making a meticulous analysis of the most excellent aspects in the Cuban means as at international level. It was used as technical, the documental revision that included individual clinical histories and it was applied a questionnaire with the objective of obtaining information with respect to the level of tobacco consumption in adolescents with Diabetes Mellitus.

Statistical prosecution   

The information was stored in a file of data in SPSS version 21.0 and it is presented in statistical charts; for the description it was calculated the arithmetic stocking, standard deviation, absolute frequencies and percent’s. In the analysis it was used non parametric tests as Squared Chi for adjustment kindness and independence of factors. One worked with significance levels to 5 %. 

Chart 1. Analysis for sex and age

The Chart 1 show ages that are located among the 12 years and more, 14 adolescents patients is of the male sex (77,7 %) and 4 of the female sex (22,2 %). In the analysis of the total of adolescents patients the sex male prevailed with 14 cases (77,7 %), the female one represents 4 woman (22,2 %), standing out the group of 12-15 years, for the two groups (77,7 %).

Source: clinical history of health

Before the intervention, the basic consumption on tobacco addiction are not high (56 %), what is translated in possible changes of lifestyles. 

Graphic 1. Levels of consumption on the tobacco in adolescents with Diabetes Mellitus

G:1

The results of this investigation belonged together since with the world and national tendency every time it increases more the addiction in early ages. It coincides with a study carried out according to the authors [7] and with other investigations starting from authors like [8] on the tobacco in adolescents in a community in Spain, where it was reported that the half age of beginning in this habit, is located in the 13 years of age. A study in this respect having offered by another investigator as [9] they outline that the early beginning of the habit of smoking brings future problems of health and it is the entrance door for the consumption of alcohol or other drugs.   

Due to the early age in that this addiction appears, was carried out this investigation where was appreciated that the committed ages in the study are from 12 to 15 years being predominant the masculine sex, coinciding with [10-11] that argue that the biggest prevalence in the tobacco is among the adolescents of the masculine sex, standing out the enormous risk that have of smoking the adolescents whose family makes it and the fateful consequences that brings the habit of smoking for its future life. 

In Cuba the differences among the indexes of masculine and feminine adolescents' consumption are not marked, according to that referred in the National Program of Control of the Tobacco of the Ministry of Public Health outlined for [12] however doesn't behave of equal it forms study presently, where the masculine sex prevails on the feminine one. 

In spite of the present behavior patterns in these adolescents, and the permissive of the habit for some parents and tutors, the way of obtaining of the cigarettes is through friends or contemporary, followed by traveling salespersons. This coincides with that found by other authors like [14-15-16], although it is important to point out that in the study, a group of them obtains it in the schools and the practice of its habit is recurrent, that which is possible for the lack of professors' demand that facilitate the cigarette to the student in many of the cases. 

Other studies emphasize the idea that the patient prediabetic is not considered sick person and it overvalues their state of health [17-18]. 

According to authors like [19-20] they outline that it is known the influence that has the example of the parents to adopt attitudes, by what becomes precise to surround the adolescents of positive examples that redound in the prevention of the tobacco, in order to reinforce the attitudes that go against the adoption of the habit of smoking, and where the family plays a fundamental list, behaving as another factor of risk for the consumption of the tobacco in these precocious ages of the life.   

The results of this study contrast with the study of Villacrés, in patient prediabetic who detected the lack of social and family support. Other authors have demonstrated the prevalence of gender focus, they are the women those that express bigger social support [21-22].

In connection with the accessibility to the consumption of cigarettes stood out that in spite of the prohibition of sale of cigarettes to smaller than age in Cuba, 61 % of the interviewed active smokers acquires the cigarettes through the state stores or for traveling salespersons, without discarding that the road more easy of obtaining it is by means.   

These discoveries coincide with the foundations expressed by Piqueras and other, when demonstrating to the one that don't present an appropriate understanding of the illness; it can influence it in the attitude and behavior that it is assumed regarding this. There are authors that emphasize in the category happiness, but they come it as factor of risk when assuming that, probably, the patients when being happy with their situation of life, they would not be motivated to modify behaviors, for what this attitude can have negative consequences for the fellow [23-24].

The male sex prevailed in the study, where the stadium average of beginning to present addiction to the tobacco is in adolescents. The magnitude of the population's aging doesn't have precedents; it is a process without limits in the humanity's history, the number of grown-ups increases exponentially in complex and uncertain socioeconomic joints. The development of professional competitions that offer attention to the adolescents to guarantee the quality and the excellence in the attention of health, will allow potenciar an appropriate lifestyle and to prevent that becomes a crisis factor for the sanitary structure. The obtained results are notably positive on the cost of their implementation in the current socioeconomic assisting to the focus psychologic  and social in health, about the improvement of the lifestyle of this group with Diabetes Mellitus.

Conflict of interest

The author declares no conflict of interest.