Factors Related to Relapse After 6 Months of Smoking Cessation Among Men in the Republic of Korea

Abstract

We identified factors associated with relapse after 6 months of smoking cessation (late relapse) among males of the Republic of Korea. Of the 222,707 smokers who visited public health center-based smoking cessation clinics (SCCs) between January 1, 2009 and mid-December 2009, we included 1720 individuals who successfully completed a 6-month smoking cessation program at an SCC. These participants were selected via a random stratified sampling design and completed an SCC user satisfaction survey between December 31, 2009 and January 6, 2010. Multiple logistic regression was used to identify factors associated with late relapse, and path analysis was employed to explore relationships among these factors. The frequency of late relapse was 21.6% (n = 372). Residence in a metropolitan area, low socioeconomic status, and the use of nicotine replacement therapy (NRT) were associated with statistically significant increases in late relapse, whereas greater access to counseling and more satisfaction with the SCC were associated with reduced late relapse. The path analysis showed that a greater number of cigarettes smoked daily and a younger age at smoking initiation exerted significant indirect effects on late relapse when NRT was employed. Residence in a metropolitan area indirectly prevented late relapse as counseling frequency increased. NRT use, counseling frequency, and SCC user satisfaction were affected by both smoking behavior and socioeconomic status. Relapse prevention efforts should concentrate on increasing both counseling frequency and SCC user satisfaction. Future studies should focus on the effect of NRT on the maintenance of long-term cessation at the population level in real-world settings.

Reasons for and Scenarios Associated with Failure to Cease Smoking: Results from a Qualitative Study Among Polish Smokers Who Had Unsuccessfully Attempted to Quit

“…Previous studies have highlighted the significant influence of the smoking environment on the occurrence of relapses to smoking, particularly among former smokers with lower education levels and lower income. 30 , 32 , 57 …”

“…Previous studies have highlighted the significant influence of the smoking environment on the occurrence of relapses to smoking, particularly among former smokers with lower education levels and lower income. 30,32,57 The participants frequently emphasized that the attitude of their close social circle to smoking abstinence was a significant factor. Unfortunately, they had negative experiences in this regard, as having a spouse who smoked had a similar influence as spending time with other smokers -they were a source of stimuli to smoke.…”

Uncertainty Analysis in Intervention Impact on Health Inequality for Resource Allocation Decisions

“…For example, socioeconomic variation in relapse rate was not considered. Evidence from South Korea suggests that relapse may be higher in more deprived groups, 36 which would make the interventions even less effective in the more deprived groups and lead to less favorable results in terms of the potential for the smoking cessation services to reduce inequalities. In the comparison between the 2 active interventions, we used the same socioeconomic pattern in uptake, but there is some evidence that variation in intervention uptake is associated with the type of intervention.…”

Reasons for and Scenarios Associated With Failure to Cease Smoking: Results From a Qualitative Study Among Smokers Who Had Unsuccessfully Attempted to Quit

“…People with lower education levels and who have lower socio-economic status are more likely to smoke, meaning former smokers from these social groups are more frequently exposed to smoking cues. Previous studies have highlighted the signi cant in uence of the smoking environment on the occurrence of relapses to smoking, particularly among former smokers with lower education levels and lower income [27,29,53].…”