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Published on: November 11, 2013
Relapse dynamics during smoking cessation: recurrent abstinence violation effects and lapse-relapse progression
Thomas R Kirchner1, Saul Shiffman, E Paul Wileyto
1Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC 20036, USA. tkirchner@americanlegacy.org
Journal of Abnormal Psychology
|July 27, 2011
Summary
Understanding smoking cessation requires examining responses to lapses. Declines in self-efficacy accelerate further lapses, while self-blame offers protection. Nicotine patches help initially but their effect wanes with guilt.
Area of Science:
- Behavioral Psychology
- Addiction Research
- Public Health
Background:
- Smoking cessation is a complex process with frequent lapses.
- The Abstinence Violation Effect (AVE) framework explains responses to lapses.
- Understanding how AVE components influence continued smoking is crucial.
Purpose of the Study:
- To investigate the dynamic relationship between AVE responses to lapses and subsequent lapse-relapse progression.
- To examine the predictive power of internal attribution, abstinence self-efficacy, and guilt on smoking lapse progression.
- To assess the impact of nicotine patch treatment on recurrent lapse progression.
Main Methods:
- Parametric recurrent event survival analyses were used.
- 203 smokers who achieved abstinence provided data on 1,001 lapse episodes.
- Participants reported on internal attribution, abstinence self-efficacy, and guilt after each lapse.
Main Results:
- Responses to the first lapse did not predict relapse.
- Subsequent lapses were predicted by changes in AVE components: decreased self-efficacy accelerated progression, while increased self-blame protected against further lapses.
- Nicotine patch treatment initially slowed lapse progression but this effect diminished over time and was influenced by guilt levels.
Conclusions:
- Self-efficacy is a key predictor of lapse progression in smoking cessation.
- Attributions of self-blame and guilt have complex, sometimes counterintuitive, effects on smoking lapse dynamics.
- The effectiveness of interventions like nicotine patches may vary depending on individual responses to lapses.
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