title: Early lapses in a cessation attempt: lapse contexts, cessation success, and predictors of early lapse.
abstract: BACKGROUND
  The great majority of smokers relapse when they make quit attempts. Therefore, understanding the process of relapse may guide the development of more effective smoking cessation or relapse prevention treatments. The goal of this research is to extend our understanding of the context of initial lapses that occur within 8 weeks of quitting by using more comprehensive assessments of context, a contemporary sample, and sophisticated analytic techniques.
  
  
  METHODS
  Participants from a randomized controlled smoking cessation trial completed baseline assessments of demographics and tobacco dependence, a daily smoking calendar to determine latency to lapse and relapse (7 consecutive days of smoking), and an assessment of initial lapse context (affect, location, activity, interpersonal, smoke exposure, and cigarette availability). Latent class analysis (LCA) was used to analyze the 6 early lapse (within the first 8 weeks; N = 551) context dimensions; logistic regression and Cox regression were used to relate context to cessation outcomes.
  
  
  RESULTS
  LCA revealed 5 distinct initial lapse context classes (talking, with friends, angry; social; alone; with spouse, angry; and with smoking spouse) that were differentially related to cessation outcome. The easy availability of cigarettes characterized almost 75% of lapses, but being with friends, drinking, and not being at home were associated with a lower likelihood of progression to relapse.
  
  
  CONCLUSIONS
  Early lapsing is highly related to ultimate relapse, and lapsing in frequently experienced contexts seemed most strongly linked with progression to full relapse.
authors.affiliation: Center for Tobacco Research and Intervention, University of Wisconsin-Madison;
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Deiches
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Baker
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lanza
authors.forename: Megan E
authors.initials: ME
authors.lastname: Piper
mesh_terms: D000328:Adult; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012008:Recurrence; D012907:Smoking / Q000523:psychology / Q000628:therapy; D016540:Smoking Cessation / Q000523:psychology / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy