Smoking urges and relapse among lung cancer patients: findings from a preliminary retrospective study

As part of a prospective study of relapse to smoking among previously resected lung cancer patients, we conducted a retrospective survey to examine factors that may contribute to relapse.

Patients who had smoked within 3 months before surgery completed measures assessing demographic characteristics, smoking urges, depression, social support, and psychological reactance.

Of 43 participants, 19 had relapsed at some point since surgery and 13 were currently smoking. Patients were at relatively low risk of relapse immediately following hospitalization, but at greater risk beginning 2 months later. Younger age and lower educational level predicted current smoking and shorter time to relapse. Craving to smoke was measured as: Appetitive urge (anticipation of pleasure) and Aversive urge (avoidance of negative affect). Both were greater among current smokers. Aversive urge was significantly correlated with depression. Those high on both psychological reactance and Directive social support had heightened Appetitive urges.

Among lung cancer patients, relapse to smoking may be delayed several months but remains a problem. Appetitive and Aversive motivational pathways and associated urges appear useful in organizing study of the role of psychosocial factors such as depression and social support in relapse to smoking in this group.