Predictors of post-treatment relapse to smoking in successful quitters: pooled data from two phase III varenicline trials.
BACKGROUND
Identifying predictors of smoking relapse helps to elucidate the challenges of long-term smoking cessation and provides direction for improved treatment development.


METHODS
In this post hoc data analysis, we examined predictors of relapse from end-of-treatment (week 13) through 1-year follow-up (week 52) for treatment-responding participants who achieved the primary efficacy endpoint of 4-week continuous abstinence (weeks 9-12), during two phase III varenicline trials.


RESULTS
Of 626 smokers classified as treatment responders for all treatment groups across both trials, 301 (48%) relapsed during follow-up (weeks 13-52). The odds of relapsing were almost 5 times greater (odds ratio [OR]=4.92, 95% confidence interval [CI]: 2.77-8.97; p<.001) for treatment responders who did not initiate continuous abstinence until the final 4 weeks of the treatment period compared with those who initiated continuous abstinence by their quit date. Participants who reported >30 days of abstinence during the year prior to study entry were significantly more likely to relapse than those who reported 0 days of abstinence (OR=2.38, 95% CI: 1.17-5.04; p=.013).


CONCLUSIONS
Results of these analyses suggest that the ability to quit smoking on the initial quit date and maintain abstinence throughout the treatment period is a good prognostic indicator for long-term abstinence. The relationship between post-treatment relapse and longer pretreatment periods of abstinence is counterintuitive, yet not without precedence in the literature.
Heffner
Jaimee L
JL
Tri-State Tobacco and Alcohol Research Center, University of Cincinnati Genome Research Institute, 2120 E. Galbraith Rd., Bldg. A, Cincinnati, OH 45237, USA. Jaimee.Heffner@uc.edu
Lee
Theodore C
TC
Arteaga
Carmen
C
Anthenelli
Robert M
RM
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D001552:Benzazepines / Q000627:therapeutic use*; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011810:Quinoxalines / Q000627:therapeutic use*; D012008:Recurrence; D018570:Risk Assessment; D012907:Smoking / Q000523:psychology* / Q000628:therapy*; D016540:Smoking Cessation; D016896:Treatment Outcome; D000068580:Varenicline
D001552:Benzazepines; D011810:Quinoxalines; D000068580:Varenicline