Search

In this study, the authors prospectively evaluated the impact of a smoking lapse on relapse probability. After 4 days of smoking abstinence, 60 smokers were randomly assigned to smoke 5 nicotine-containing or 5 denicotinized cigarettes, or to remain abstinent (no lapse) during a 4-hr time period. Afterward, smoking abstinence was encouraged with monetary incentives, and smoking behavior was tracked for 6 days. Relative to the no-lapse condition, exposure to either of the cigarette types more than doubled the probability of subsequent smoking. Smoking outcomes did not differ between nicotine-containing and denicotinized cigarettes. The data suggest that stimulus factors may play an important role in lapse to relapse processes. Keywords: smoking, lapse, relapse, denicotinized, nicotine

R. Eisenberger's (1992) learned industriousness theory states that individuals display differing degrees of persistence depending on their history of reinforcement for effortful behavior. These differences may influence the development, maintenance, and cessation of addictive behaviors. In cross-sectional studies, E. P. Quinn, T. H. Brandon, and A. L. Copeland (1996) found that cigarette smokers were less persistent than nonsmokers, and R. A. Brown, C. W. Lejuez, C. W. Kahler, and D. R. Strong (2002) found that smokers who had previously abstained for 3 months were more persistent than those who had never quit. The present study extended these findings by using a prospective design. A pretreatment measure of task persistence (mirror tracing) completed by 144 smokers predicted sustained abstinence throughout 12 months of follow-up. Moreover, persistence predicted outcome independent of other significant predictors: gender, nicotine dependence, negative affect, and self-efficacy.

The balanced placebo design (BPD) was used to evaluate the independent effects of nicotine dose and smoking-related expectancies on self-reported anxiety, urge to smoke, and withdrawal symptoms. After anxious mood was induced, participants smoked either a de-nicotinized cigarette or one with standard nicotine content. Nicotine dose was crossed with instructions that the cigarette was either de-nicotinized or standard. Nicotine cigarettes produced greater anxiety reduction than de-nicotinized cigarettes. Nicotine instructions attenuated anxiety only among those who held relevant expectancies. Nicotine dose and instructional set interacted such that either nicotine cigarettes or instructions that the cigarettes contained nicotine were sufficient to reduce urge to smoke. Implications of these findings and methodological issues regarding use of the BPD with cigarettes are discussed.

Behavioral interventions often are administered in groups, yet the effects of group membership rarely have been evaluated. The current research examined 33 groups of clients (M = 5.5 clients per group, SD = 2.5) volunteering for a group smoking cessation intervention. The intervention consisted of 6 group therapy sessions over an 11-day period. Attendance at the sessions and smoking behavior during the 11-day period were the dependent variables. Hierarchical linear modeling (HLM) revealed a statistically significant (p < .05) degree of interdependence among group members (intraclass correlation = .44 and .32 for attendance and smoking, respectively). Groups were characterized disproportionately by high attendance and infrequent smoking or low attendance and relatively frequent smoking, with fewer moderate groups than would be expected by chance. Group membership effects dissipated within a month following treatment. These findings suggest the need for assessing such effects and for future research examining their causes.

Recent findings suggest that former smokers remain at risk for relapse well beyond the traditional treatment follow-up period of one year. Although progress has been made in understanding factors involved in smoking cessation and short-term maintenance, very little attention has been paid to research on the process, predictors, and treatment implications of very delayed relapse. Possible research questions are offered to stimulate further investigation in this area.

This study compared 2 minimal interventions for reducing relapse in ex-smokers. One intervention involved 12-month access to a telephone hot line. In the other intervention, 8 relapse-prevention booklets were mailed to participants over 1 year. The 2 interventions were crossed in a 2 x 2 factorial design, yielding control, hot-line-only, mailings-only, and combined conditions. The criterion of at least 1 week of abstinence at baseline was met by 584 participants, 446 of whom also completed a 12-month assessment. Repeated mailings, but not the hot line, reduced relapse for those participants who had been abstinent for less than 3 months at baseline. At follow-up, 12% of those in the mailings conditions were smoking again compared with 35% in the nonmailings conditions. As predicted, both interventions were effective at attenuating the association between depressive symptoms and poor outcome found in the control condition.