Specific Relapse Predictors: Could Cognitive-Behavioral Treatment for Smoking Cessation Be Improved?

Abstract

Relapse remains a frequent and complex phenomenon that is not yet well understood. An under-researched area of study that may provide relevant information concerns the assessment of specific post-treatment variables, rather than the composite measures commonly used to predict smoking relapse. The current study sought to examine the effects of post-treatment smoking-related variables, including withdrawal symptomatology, abstinence self-efficacy, and smoking urgency in negative-affect situations and smoking relapse at the 3 month follow-up. The sample comprised 130 participants who achieved abstinence for at least 24 h through a cognitive-behavioral smoking cessation treatment. Regression analysis was conducted for both composite measures and specific subscales and items. Data showed that composite measures of tobacco withdrawal, self-efficacy, and smoking urgency in negative-affect situations were not significant predictors of smoking relapse. However, the analysis including subscales, and specific items showed that lower self-efficacy in negative-affect-related situations (OR = 1.36) and three withdrawal symptoms—irritability/frustration/anger (OR = 2.99), restlessness/impatience (OR = 1.87), and craving (OR = 2.31)—were significant predictors of relapse. These findings offer new insights into the role of different smoking-related post-treatment variables in short-term relapse. Considering and specifically targeting these variables after achieving abstinence may potentially contribute to reducing smoking relapse.

Sex differences in smoking cessation: a retrospective cohort study in a psychosocial care unit in Brazil

“… 39 , 40 According to these authors’ data, around half of the successful quitters in the present study should have relapsed. Generally, relapse rates range from 30 to 80% 39 , 40 during the following year. Smith et al 41 described 6-month abstinence rates as follows: bupropion = 16.8%; nicotine lozenge = 19.9%; patch = 17.7%; patch plus lozenge = 26.9%; and bupropion plus lozenge = 29.9%.…”

“…38 Unfortunately, different authors report that a significant number of smokers receiving smoking cessation treatment relapse in the subsequent weeks and months. 39,40 According to these authors' data, around half of the successful quitters in the present study should have relapsed. Generally, relapse rates range from 30 to 80% 39,40 during the following year.…”

Long-Term Outcomes of a Comprehensive Mobile Smoking Cessation Program With Nicotine Replacement Therapy in Adult Smokers: Pilot Randomized Controlled Trial

“…Finally, a higher DTQ at study entry was associated with a lower likelihood of self-reported 30-day PPA in the Pivot group and a higher likelihood in the QuitGuide group. Approaching the DTQ metric used in this study as a general proxy for self-efficacy, the literature predominantly supports the association between higher self-efficacy and a greater likelihood of cessation and between lower self-efficacy and a lower likelihood of cessation and a greater likelihood of relapse [19,[42][43][44][45][46].…”

“…Moreover, more Pivot participants ordered NRT over the course of the study, with higher mean NRT orders per person. Both higher self-efficacy and NRT use are associated with an increased likelihood of cessation [26,[42][43][44][45][46], and these factors may have contributed to the higher cessation rates in the Pivot group.…”

Examining the Relationships between Mindfulness and Tobacco Craving Factors

“…Moreover, mindfulness training may be effective for smoking cessation by decoupling the association between craving and smoking (13). As stronger tobacco craving is associated with poorer smoking cessation outcomes (14,15), there is a need to fully elucidate the potential role of mindfulness in craving attenuation in order to optimize mindfulness-based interventions for tobacco cessation. However, all the aforementioned studies assessed craving using unidimensional measures.…”