Predictors of relapse among smokers: transtheoretical effort variables, demographics, and smoking severity

Abstract

The present longitudinal study investigates baseline assessments of static and dynamic variables, including demographic characteristics, smoking severity, and Transtheoretical Model of Behavior Change (TTM) effort variables (Decisional Balance (i.e. Pros and Cons), Situational Temptations, and Processes of Change) of relapse among individuals who were abstinent at 12months. The study sample (N=521) was derived from an integrated dataset of four population-based smoking cessation interventions. Several key findings included: Participants who were aged 25-44 and 45-64 (OR=.43, p=.01 and OR=.40, p=.01, respectively) compared to being aged 18-24 were less likely to relapse at follow-up. Participants in the control group were more than twice as likely to relapse (OR=2.17, p=.00) at follow-up compared to participants in the treatment group. Participants who reported higher Habit Strength scores were more likely to relapse (OR=1.05, p=.02). Participants who had higher scores of Reinforcement Management (OR=1.05, p=.04) and Self-Reevaluation (OR=1.08, p=.01) were more likely to relapse. Findings add to one assumption that relapsers tend to relapse not solely due to smoking addiction severity, but due to immediate precursor factors such as emotional distress. One approach would be to provide additional expert guidance on how smokers can manage stress effectively when they enroll in treatment at any stage of change.

Keywords: Maintenance; Relapse; Smoking; Stage of change; Transtheoretical model.