title: Late relapse/sustained abstinence among former smokers: a longitudinal study.
abstract: BACKGROUND
  Relapse remains the most refractory aspect of nicotine dependence, but little is known about relapse that occurs after a period of prolonged abstinence (i.e., "late relapse").
  
  
  METHODS
  The current study examined the prevalence and predictors of late relapse/sustained abstinence in a community-based, longitudinal cohort of former smokers surveyed at baseline and again 4 years later (n = 1143).
  
  
  RESULTS
  Late relapse rates declined precipitously and sustained abstinence increased as the duration of abstinence at baseline increased. Although the risk for late relapse appeared to be small when using a point prevalence definition of smoking, that risk increased substantially if fluctuations in smoking behavior over time were considered (i.e., many former smokers relapsed and then regained abstinence during the 4-year study period). Although there were a number of significant prospective predictors of late relapse/sustained abstinence, they did not retain their predictive ability after controlling for baseline duration of abstinence.
  
  
  CONCLUSIONS
  Although late relapse rates in the general population of former smokers appear low, and particularly so for individuals who have been abstinent for long periods of time, fluctuations between abstinence and smoking over time are not uncommon. How these fluctuations influence health or sustained abstinence over time is unclear. Because late relapse rates are generally low, interventions are likely to require careful targeting of at-risk individuals if they are to be efficacious and cost-effective.
authors.affiliation: Department of Behavioral Science, M.D. Anderson Cancer Center, Houston, TX 77030, USA. dwetter@mdanderson.org
authors.forename: David W
authors.initials: DW
authors.lastname: Wetter
authors.forename: Ludmila
authors.initials: L
authors.lastname: Cofta-Gunn
authors.forename: Rachel T
authors.initials: RT
authors.lastname: Fouladi
authors.forename: Paul M
authors.initials: PM
authors.lastname: Cinciripini
authors.forename: Dawen
authors.initials: D
authors.lastname: Sui
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Gritz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012008:Recurrence; D012307:Risk Factors; D016540:Smoking Cessation / Q000191:economics / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D013997:Time Factors