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Yong Cui, MD, MSPH1, Xu Wang, MD, PhD2, Wanqing Wen, MD, MPH1, Cynthia J. Moriarty, MD, MSPH2, and Robert S. Levine, MD2. (1) Department of Medicine, Center for Health Services Research, Vanderbilt University, 1215 21st Ave, 6th FL, Medical Center East, Nashville, TN 37232-8300, 615-778-2644, yong.cui.1@vanderbilt.edu, (2) Preventive Medicine, Meharry Medical College, 1005 DB Todd Blvd, Nashville, TN 37208
Although most smoking cessation programs are quite effective in assisting smokers to stop smoking, the majority of initial quitters relapse within a few months. This study aimed to identify risk factors for smoking relapse and to examine the effects of these factors on dynamic relapse process in a smoking cessation program for veterans. Baseline information included sociodemographics, medical co-morbidities, smoking-related environmental factors, smoking history and behaviors, nicotine dependence, depressive symptoms, motivations for smoking, and self-efficacy. The intervention involved a 4-session group therapy consisting of counseling and use of nicotine replacement to aid quitting. Initial quit rate was 84.7% (189/223) by the program completion, and abstinence rate at 6 months was 28.3%. Using the Cox Proportional Hazards model, we identified six risk factors associated with 6-month relapse post-quit. They were younger age, low income, many smoking co-workers, age at smoking initiation < 18 years, a history of schizophrenia, and number of session attendance < 3 times. We further described characteristics of the relapse curve and studied influence of the identified risk factors on the dynamic process of smoking relapse. We found that the effects of these risk factors could be categorized into two patterns. Annual income and age at smoking initiation showed a delayed action that affected relapse curve after several weeks post-quit, whereas other risk factors modified the relapse process soon after quitting. The information will be useful in targeting veteran smokers who are at high risk for relapse, choosing optimal time for post-cessation services, and developing strategies accordingly.
Learning Objectives: At the conclusion of the session, the attendees will be able to
Keywords: Smoking Cessation, Veterans' Health
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.