OJMP  Vol.1 No.3 , July 2012
Identifying Distinct Quitting Trajectories after an Unassisted Smoking Cessation Attempt: An Ecological Momentary Assessment Study
ABSTRACT
Objectives: This study aimed at identifying distinct quitting trajectories over 29 days after an unassisted smoking ces- sation attempt by ecological momentary assessment (EMA). In order to validate these trajectories we tested if they predict smoking frequency up to six months later. Methods: EMA via mobile phones was used to collect real time data on smoking (yes/no) after an unassisted quit attempt over 29 days. Smoking frequency one, three and six months after the quit attempt was assessed with online questionnaires. Latent class growth modeling was used to analyze the data of 230 self-quitters. Results: Four different quitting trajectories emerged: quitter (43.9%), late quitter (11.3%), returner (17%) and persistent smoker (27.8%). The quitting trajectories predicted smoking frequency one, three and six months after the quit attempt (all p < 0.001). Conclusions: Outcome after a smoking cessation attempt is better described by four distinct trajectories instead of a binary variable for abstinence or relapse. In line with the relapse model by Marlatt and Gordon, late quitter may have learned how to cope with lapses during one month after the quitting attempt. This group would have been allocated to the relapse group in traditional outcome studies.

Cite this paper
M. Bachmann, H. Znoj and J. Brodbeck, "Identifying Distinct Quitting Trajectories after an Unassisted Smoking Cessation Attempt: An Ecological Momentary Assessment Study," Open Journal of Medical Psychology, Vol. 1 No. 3, 2012, pp. 44-50. doi: 10.4236/ojmp.2012.13008.
References
[1]   N. Knoll, U. Scholz and N. Rieckmann, “?Introduction into Health Psychology? Einführung in Die Gesundheitspsychologie,” Ernst Reinhardt Verlag, München, 2005.

[2]   G. A. Marlatt, “Relapse Prevention: Theoretical Rationale and Overview of the Model,” In: G. A. Marlatt and J. R. Gordon, Eds., Relapse Prevention, Guilford Press, New York, 1985, pp. 3-70.

[3]   S. Shiffman, “Reflections on Smoking Relapse Research,” Drug and Alcohol Review, Vol. 25, No. 1, 2006, pp. 15-20. doi:10.1080/09595230500459479

[4]   I. Elfeddali, C. Bolman, M. J. J. M. Candel, R. W. Wiers and H. De Vries, “The Role of Self-Efficacy, Recovery Self-Efficacy, and Preparatory Planning in Predicting Short-Term Smoking Relapse,” British Journal of Health Psychology, Vol. 17, No. 1, 2012, pp. 185-201. doi:10.1111/j.2044-8287.2011.02032.x

[5]   T. Kinnunen, K. Doherty, F. S. Militello and A. J. Garvey, “Depression and Smoking Cessation: Characteristics of Depressed Smokers and Effects of Nicotine Replacement,” Journal of Consulting and Clinical Psychology, Vol. 64, No. 4, 1996, pp. 791-798. doi:10.1037/0022-006X.64.4.791

[6]   J. L. Westmaas and K. Langsam, “Unaided Smoking Cessation and Predictors of Failure to Quit in a Community Sample: Effects of Gender,” Addictive Behaviors, Vol. 30, No. 7, 2005, pp. 1405-1424. doi:10.1016/j.addbeh.2005.03.001

[7]   A. Hyland, Q. Li, J. E. Bauer, G. A. Giovino, C. Steger and K. M. Cummings, “Predictors of Cessation in a Cohort of Current and Former Smokers Followed over 13 Years,” Nicotine & Tobacco Research, Vol. 6, No. 6, 2004, pp. 363-369. doi:10.1080/14622200412331320761

[8]   K. M. Menninga, A. Dijkstra and W. A. Gebhardt, “Mixed Feelings: Ambivalence as a Predictor of Relapse in Ex-Smokers,” British Journal of Health Psychology, Vol. 16, No. 3, 2011, pp. 580-591. doi:10.1348/135910710X533219

[9]   I. Berlin and L. S. Covey, “Pre-Cessation Depressive Mood Predicts Failure to Quit Smoking: The Role of Coping and Personality Traits,” Addiction, Vol. 101, No. 12, 2006, pp. 1814-1821. doi:10.1111/j.1360-0443.2006.01616.x

[10]   S. Shiffman and A. J. Waters, “Negative Affect and Smoking Lapses: A Prospective Analysis,” Journal of Consulting and Clinical Psychology, Vol. 72, No. 2, 2004, pp. 192-201. doi:10.1037/0022-006X.72.2.192

[11]   L. Cofta-Woerpel, J. B. McClure, Y. Li, D. Urbauer, P. M. Cinciripini and D. W. Wetter, “Early Cessation Success or Failure among Women Attempting to Quit Smoking: Trajectories and Volatility of Urge and Negative Mood during the First Postcessation Week,” Journal of Abnormal Psychology, Vol. 120, No. 3, 2011, pp. 596-606. doi:10.1037/a0023755

[12]   T. M. Piasecki, D. E. Jorenby, S.S. Smith, M. C. Fiore and T. B. Baker, “Smoking Withdrawal Dynamics: I. Abstinence Distress in Lapsers and Abstainers,” Journal of Abnormal Psychology, Vol. 112, No. 1, 2003, pp. 3-13. doi:10.1037//0021-843X.112.1.3

[13]   R. M. Van Zundert, S. G. Ferguson, S. Shiffman and R. Engels, “Dynamic Effects of Craving and Negative Affect on Adolescents Smoking Relapse,” Health Psychology, Advance Online Publication, 2011. doi:10.1037/a0025204

[14]   C. A. Conklin, K. A. Perkins, A. J. Sheidow, B. L. Jones, M. D. Levine and M. D. Marcus, “The Return to Smoking: 1-Year Relapse Trajectories among Female Smokers,” Nicotine & Tobacco Research, Vol. 7, No. 4, 2005, pp. 533-540. doi:10.1080/14622200500185371

[15]   D. C. N. Wong, S. S. C. Chan, D. Y. T. Fong, A. Y. M. Leung, D. O. B. Lam and T.-H. Lam, “Quitting Trajectories of Chinese Youth Smokers Following Telephone Smoking Cessation Counseling: A Longitudinal Study,” Nicotine & Tobacco Research, Vol. 13, No. 9, 2011, pp. 848-879. doi:10.1093/ntr/ntr086

[16]   B. B. Hoeppner, M. S. Goodwin, W. F. Velicer, M. E. Mooney and D. K. Hatsukami, “Detecting Longitudinal Patterns of Daily Smoking Following Drastic Cigarette Reduction,” Addictive Behaviors, Vol. 33, No. 5, 2008, pp. 623-639. doi:10.1016/j.addbeh.2007.11.005

[17]   R. Keller, T. Radke, H. Krebs and R. Hornung, “[Tobacco Consumption in the Swiss Population between 2001 and 2010] Der Tabakkonsum in der Schweizer Bev?lkerung in den Jahren 2001 bis 2010,” Universit?t Zürich, Psychologisches Institut, Sozial-und Gesundheitspsychologie , Zürich, 2011.

[18]   L. K. Muthén and B.O. Muthén, “Mplus User’s Guide,” Muthén & Muthén, Los Angeles, 1998-2011.

[19]   J. R. Hughes, J. Keely and S. Naud, “Shape of the Relapse Curve and Long-Term Abstinence among Untreated Smokers,” Addiction, Vol. 99, No. 1, 2004, pp. 29-36. doi:10.1111/j.1360-0443.2004.00540.x

[20]   S. J. Japuntich, A. M. Leventhal, M. E. Piper, D. M. Bolt, L. J. Roberts, M. C. Fiore and T. B. Baker, “Smoker Characteristics and Smoking-Cessation Milestones,” American Journal of Preventive Medicine, Vol. 40, No. 3, 2011, pp. 286-294. doi:10.1016/j.amepre.2010.11.016

[21]   J. K. Ockene, K. M. Emmons, R. J. Mermelstein, K. A. Perkins, D. S. Bonollo, C. C. Voorhees and J. F. Hollis, “Relapse and Maintenance Issues for Smoking Cessation,” Health Psychology, Vol. 19, No. 1S, 2000, pp. 17-31. doi:10.1037//0278-6133.19.Suppl1.17

[22]   S. Shiffman, S. E. Brockwell, J. L. Pillitteri and J. G. Gitchell, “Individual Differences in Adoption of Treatment for Smoking Cessation: Demographic and Smoking History Characteristics,” Drug and Alcohol Dependence, Vol. 93, No. 1-2, 2008, pp. 121-131. doi:10.1016/j.drugalcdep.2007.09.005

 
 
Top