Assessment of smoking relapse

Abstract

Using a random assignment, prospective design, this study tested a model of smoking relapse by examining the effects of a programmed cue exposure on subsequent relapse latency and withdrawal among recently abstinent smokers. Seventy-two subjects were required to quit smoking for a period of 4 days and were then randomly assigned to either a cue exposure or control condition. In the cue exposure condition, subjects were required to smoke five cigarettes between a morning and mid day session in their natural environment, the control subjects were required to maintain abstinence through the mid day session. Following the exposure session, subjects subsequent smoking behavior and relapse latency, withdrawal symptoms, and psychological correlates of re-exposure (i.e. guilt, cravings, desire to smoke) were examined by means of questionnaires. Physiological measures of re-exposure, such as heart rate, carbon monoxide levels, blood pressure, etc., were also examined. Behavioral analysis indicated that all subjects experimentally exposed to nicotine (i.e. smoking) after the required 4 day abstinence period returned to smoking by the end of the study, whereas eighteen percent of the subjects randomly assigned to the non-smoking condition were able to maintain abstinence. Further, this behavioral effect was seen in spite of significant decreases in desire to smoke and cravings, as well as significant increases in drowsiness and guilt. It was also shown that withdrawal symptoms did not reliably influence the relapse process. Further research on experimental re-exposure using diverse smoking populations is recommended.