title: Shape of the relapse curve and long-term abstinence among untreated smokers.
abstract: OBJECTIVE
  To describe the relapse curve and rate of long-term prolonged abstinence among smokers who try to quit without treatment.
  
  
  METHODS
  Systematic literature review.
  
  
  METHODS
  Cochrane Reviews, Dissertation Abstracts, Excerpt Medica, Medline, Psych Abstracts and US Center for Disease Control databases plus bibliographies of articles and requests of scientists.
  
  
  METHODS
  Prospective studies of self-quitters or studies that included a no-treatment control group.
  
  
  METHODS
  Two reviewers independently extracted data in a non-blind manner.
  
  
  RESULTS
  The number of studies was too small and the data too heterogeneous for meta-analysis or other statistical techniques.
  
  
  RESULTS
  There is a paucity of studies reporting relapse curves of self-quitters. The existing eight relapse curves from two studies of self-quitters and five no-treatment control groups indicate most relapse occurs in the first 8 days. These relapse curves were heterogeneous even when the final outcome was made similar. In terms of prolonged abstinence rates, a prior summary of 10 self-quitting studies, two other studies of self-quitters and three no-treatment control groups indicate 3-5% of self-quitters achieve prolonged abstinence for 6-12 month after a given quit attempt.
  
  
  CONCLUSIONS
  More reports of relapse curves of self-quitters are needed. Smoking cessation interventions should focus on the first week of abstinence. Interventions that produce abstinence rates of 5-10% may be effective. Cessation studies should report relapse curves.
authors.affiliation: University of Vermont, Department of Psychiatry, Burlington, VT 05401-1419, USA. john.hughes@uvm.edu
authors.forename: John R
authors.initials: JR
authors.lastname: Hughes
authors.forename: Josue
authors.initials: J
authors.lastname: Keely
authors.forename: Shelly
authors.initials: S
authors.lastname: Naud
mesh_terms: D006801:Humans; D011446:Prospective Studies; D012008:Recurrence; D012648:Self Care; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D016019:Survival Analysis; D013997:Time Factors