Reflections on smoking relapse research

This paper presents personal reflections on the history, current status and the future of research on smoking relapse. Relapse was traditionally viewed primarily as an outcome, to be reduced with increased treatment. In the 1980s, relapse research was invigorated by a focus on the process of relapse, focusing on the specific situations in which lapses to smoking occurred, and on the processes that mediated progression from a lapse to a relapse. This line of research had substantial influence on treatment, but has currently been displaced by a return to a pure outcomes-focus, driven in part by the practical need to find treatments that work and to package them for dissemination. At the same time, technological and methodological developments have enabled detailed monitoring of experience and behaviour throughout the relapse process, and progression of these developments will make monitoring of relapse process compelling in the future. The need to understand how interventions work will also drive a resurgence of research on the relapse process. Finally, the same technological and conceptual developments that enable detailed monitoring of behaviour will spawn the development of just-in-time interventions that are offered and implemented as needed, rather than being addressed in the abstract in advance of the need.