To identify predictors of attempts to stop smoking and predictors of relapse.
This study included 2431 smokers from pre-existing Internet panels in the United States,
United Kingdom, Canada, France, and Spain. These panel members are Internet users
who have registered voluntarily and agreed to participate in various online research
studies. Respondents were aged 35-65 years, smoked >or= five cigarettes per day and
intended to stop smoking in the next 3 months. They were followed every 3 months for
up to 18 months via Internet contact on measures relating to quit attempts, smoking
status, motivation to quit, nicotine cue, weight and weight concern, health-related
factors, withdrawal symptoms, and smoking cessation aids.
In this study, recent quit attempts strongly predicted future attempts, but also predicted
subsequent relapse. Motivation to quit was predictive of future attempts but not of
relapse/abstinence following the attempts. Relapse to smoking was associated with
nicotine dependence, exposure to smoking cues, craving, withdrawal symptoms, and lack
of smoking cessation aids.
The findings lend support to a model of cessation in which level of motivation to
stop generates quit attempts but plays little role in relapse. Dependence, social
smoking cues, and a recently failed quit attempt are important factors in relapse.