Original Research ARTICLE
Cognitive, behavioral, and situational influences on relapse to smoking after group treatment for tobacco dependence
- 1Department of Health Behavior, Roswell Park Comprehensive Cancer Center, University at Buffalo, United States
- 2Community Health and Social Medicine, CUNY School of Medicine, United States
Socioeconomic disparities in treatment failures rates for evidence-based tobacco dependence treatment are well-established. Adapted cognitive behavioral treatments are extensively tailored to meet the needs of lower SES smokers and dramatically improve early treatment success, but there is little understanding of why treatment failure occurs after a longer period of abstinence than with standard treatment, why early treatment success is not sustained, and why long-term treatment failure rates are no different from standard treatments. We sought to understand the causes of treatment failure from the perspective of diverse participants who relapsed after receiving standard or adapted treatment in a randomized control trial. We used a qualitative approach and cognitive-behavioral framework to examine themes in responses to a semi-structured post-relapse telephone interview. The primary causes of relapse were familiar (i.e., habit, stress, unanticipated precipitating events). The adapted treatment appeared to improve the management of habits and stress short-term, but did not adequately prepare respondents for unanticipated events. Respondents reported that they would have benefited from continued support. New therapeutic targets might include innovative methods to reduce long-term treatment failure by delivering extended relapse prevention interventions to support early treatment success.
Keywords: relapse, smoking cessation interventions, Cognitive Behaviour Therapy, Tobacco dependence treatment, Lower socioeconomic status
Received: 19 Apr 2018;
Accepted: 20 Dec 2018.
Edited by:Andrzej Werbart, Department of Psychology, Faculty of Social Sciences, Stockholm University, Sweden
Reviewed by:Jose M. Trigo, Centre for Addiction and Mental Health (CAMH), Canada
Jonathan Greenberg, Massachusetts General Hospital, Harvard Medical School, United States
Copyright: © 2018 Sheffer, Lunden, Pittman and Prashad. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. Christine E. Sheffer, Roswell Park Comprehensive Cancer Center, University at Buffalo, Department of Health Behavior, Buffalo, United States, firstname.lastname@example.org