title: Adherence to treatment to help quit smoking: effects of task performance and coping with withdrawal symptoms.
abstract: BACKGROUND
  Currently the combined cognitive-behavioral and pharmacological treatment is the best option to quit smoking, although success rates remain moderate. This study aimed to identify predictors of continuous abstinence in an assisted smoking cessation program using combined treatment. In particular, we analyzed the effects of socio-demographic, smoking-, and treatment-related variables. In addition, we analyzed the effect of several risk factors on abstinence, and estimated a model of risk for smoking relapse.
  
  
  METHODS
  Participants were 125 workers at the University of Granada (50 males), with an average age of 46.91 years (SD = 8.15). They were recruited between 2009 and 2013 at an occupational health clinic providing smoking cessation treatment. Baseline measures included socio-demographic data, preferred brand of cigarettes, number of years smoking, use of alcohol and/or tranquilizers, past attempts to quit, Fargerström Test for Nicotine Dependence, Smoking Processes of Change Scale, and Coping with Withdrawal Symptoms Interview. Participants were invited to a face-to-face assessment of smoking abstinence using self-report and cooximetry hemoglobin measures at 3, 6, and 12 months follow-up. The main outcome was smoking status coded as "relapse" versus "abstinence" at each follow-up. Kaplan-Meier survival analysis was performed to estimate the probability of continued abstinence during 12 months and log-rank tests were used to analyze differences in continued abstinence as a function of socio-demographic, smoking-, and treatment-related variables. Cox regression was used to analyze the simultaneous effect of several risk factors on abstinence.
  
  
  RESULTS
  Using alcohol and/or tranquilizers was related to shorter abstinence. Physical exercise, the number of treatment sessions, performance of treatment tasks, and coping with withdrawal symptoms were related to prolonged abstinence. In particular, failure to perform the treatment tasks tripled the risk of relapse, while lack of coping doubled it.
  
  
  CONCLUSIONS
  Our results show that physical exercise, performance of treatment-related tasks, and effective coping with withdrawal symptoms can prolong abstinence from smoking. Programs designed to help quit smoking can benefit from the inclusion of these factors.
authors.affiliation: Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Centro de Investigación Cuerpo Cerebro Comportamiento (CIMCYC), Universidad de Granada, Campus Universitario de Cartuja s/n, 18071 Granada, España. fcalopez@ugr.es.
authors.forename: Francisca
authors.initials: F
authors.lastname: López-Torrecillas
authors.forename: Maria Mar
authors.initials: MM
authors.lastname: Rueda
authors.forename: Eva María
authors.initials: EM
authors.lastname: López-Quirantes
authors.forename: Javier Machado
authors.initials: JM
authors.lastname: Santiago
authors.forename: Reyes Rodríguez
authors.initials: RR
authors.lastname: Tapioles
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D015444:Exercise / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data*; D012307:Risk Factors; D012907:Smoking / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013030:Spain; D013375:Substance Withdrawal Syndrome / Q000523:psychology*; D013647:Task Performance and Analysis; D014029:Tobacco Use Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy