[Causes of relapse during attempted smoking cessation using nicotine or placebo plasters]

The causes of relapses to smoking when attempting smoking cessation are not fully understood, but several factors are of importance. Addiction to nicotine is one of the most prominent factors. In order to determine predictors of outcome in smoking cessation, we performed univariate and multivariate analysis of a large smoking cessation trial comprising 289 subjects. Weight gain and withdrawal symptoms were analyzed separately as predictors. To determine the relative magnitude of self-perceived reasons for relapse we created a questionnaire, which was answered by 132 relapsers. Previous attempts to stop smoking and a low Horn-Russell scale were significantly associated with abstinence in the nicotine-treated group. A trend towards higher abstinence rates was found in males and in subjects with low smoking saliva cotinine levels. A logistic regression analysis showed higher success rates in subjects with the largest weight gain during the first week but there was a tendency towards higher relapse rates in subjects with the greatest weight gain later. Only 20% reported weight gain to be a major problem. Minor smoking was highly correlated to later relapse. The weight gain after smoking cessation should not be prevented in the first weeks after cessation. Complete abstinence should be emphasized in smoking cessation.