Temptations to smoke after quitting: A comparison of lapsers and maintainers
Abstract
This study addresses whether characteristics of temptations to smoke differ for participants who quit smoking and maintain abstinence compared to those who quit and then lapse. Participants used hand-held computers to record temptations and were beeped at random for base-rate assessments. We used generalized estimating equations to compare 1,851 temptation episodes and 5,192 random assessments recorded by 151 participants (116 lapsers, 35 maintainers) over 1-23 days of abstinence. Compared to randomly sampled occasions, temptations were marked by greater negative affect, restlessness, attention disturbance, and exposure to smoking cues; participants were also more likely to be eating or drinking during temptations. Temptations reported by lapsers and maintainers did not differ in any respect, including their reported coping. The results highlight situational variance over individual differences.
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When relapse was defined according to the Shiffman et al. (1996) definition, the pattern of findings yielded by the current model was slightly different.
“When relapse was defi ned according to the Shiffman et al. (1996) defi nition (i.e., smoking at least 5 cigarettes/day on at least three consecutive days following the quit day; Shiffman et al., 1996 ), the pattern of fi ndings yielded by the current model was slightly different.”
From Anxiety sensitivity and anxiety and depressive symptoms in the prediction of early smoking lapse and relapse during smoking cessation treatment (2009) · cites this paper as Shiffman et al., 1996
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“In addition to the pharmacological rewards from nicotine administration, smoking is also maintained by the associations of the pharmacological action of nicotine with cues such as the sight of favored cigarette pack or lighter and the sight or smell of cigarette smoke (6).”
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Bolman, C. A. W., Verboon, P., Thewissen, V., Boonen, V., Soons, K., & Jacobs, N. (2017) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000365 · Cited by 26 · see citing works
“In addition, quitters are more likely to lapse when smoking is permitted, when cigarettes are available, and when other smokers are present (Shiffman et al., 1996b, 2007).”
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“It has been suggested that these positive changes in smoking behaviours are maintained, in part, by reductions in smoking-related cues (e.g., the smell of cigarettes, observing others smoking) (Shiffman et al., 1996).”
BackgroundMotivation in Tobacco Use Cessation Research
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“In addition, greater temptation for smoking has been shown to follow negative affect (Shiffman et al., 1996).”
BackgroundThe mobile assistance for regulating smoking (MARS) micro-randomized trial design protocol
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“Both cognitive (e.g., cognitive avoidance, self-talk) and behavioral (e.g., relaxation, stimulus substitution) strategies predict cessation success (Shiffman, 1984; Shiffman et al., 1996a,b).”
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A Clinical Overview of Nicotine Dependence and Withdrawal
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Self-citationBrief psycho-education affects circadian variability in nicotine craving during cessation
Nosen, E., & Woody, S. R. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.02.017 · Cited by 15 · see citing works
Ho, J., Kraemer, W. J., Volek, J. S., Vingren, J. L., Fragala, M. S., Flanagan, S. D., Maladouangdock, J., Szivak, T. K., Hatfield, D. L., Comstock, B. A., et al. (2013) · Addictive Behaviors · doi:10.1016/j.addbeh.2013.10.027 · Cited by 14 · see citing works
“Since stressful environments can compound the stress created by abstinence (Shiffman et al., 1996), the mental challenge session may have promoted higher stress levels when combined with resistance exercise.”
BackgroundVersace, F., Stevens, E. M., Robinson, J. D., Cui, Y., Deweese, M. M., Engelmann, J. M., Green, C. E., Karam‐Hage, M., Lam, C. Y., Minnix, J. A., et al. (2017) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntx264 · Cited by 14 · see citing works
Burris, R. F., & O’Connell, K. A. (2003) · Research in Nursing & Health · doi:10.1002/nur.10096 · Cited by 14 · see citing works
Anesthesia is a risk factor for drug and alcohol craving and relapse in ex-abusers
Sadeghi, P., & Zacny, J. P. (1999) · Medical Hypotheses · doi:10.1054/mehy.1999.0797 · Cited by 14 · see citing works
Begh, R. A., Smith, M. C., Ferguson, S. G., Shiffman, S. M., Munafo, M. R., & Aveyard, P. N. (2016) · Psychology of Addictive Behaviors · doi:10.1037/adb0000231 · Cited by 14 · see citing works
Self-citationOno, M., Kochiyama, T., Fujino, J., Sozu, T., Kawada, R., Yokoyama, N., Sugihara, G., Murai, T., & Takahashi, H. (2018) · Addiction Biology · doi:10.1111/adb.12555 · Cited by 11 · see citing works
“(Shiffman et al. 1996).”
Genetic Variability of Smoking Persistence in African Americans
Hamidovic, A., Kasberger, J. L., Young, T., et al. (2011) · Cancer Prevention Research · doi:10.1158/1940-6207.capr-10-0362 · Cited by 12 · see citing works
“This may be relevant in tobacco addiction as relapse episodes occur following exposure to smoking cues because previously neutral stimuli acquire incentive motivational value when repeatedly paired with nicotine (18, 19).”
BackgroundThe effect of anticipatory strategies on the first day of smoking cessation.
O’Connell, K. A., Gerkovich, M. M., Bott, M. J., Cook, M. R., & Shiffman, S. S. (2002) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.16.2.150 · Cited by 11 · see citing works
Self-citationCigarette tax rates, behavioral disengagement, and quit ratios among daily smokers
Ferrer, R. A., Orehek, E., Scheier, M. F., & O'Connell, M. E. (2018) · Journal of Economic Psychology · doi:10.1016/j.joep.2018.03.005 · Cited by 10 · see citing works
Coping with temptations and adolescent smoking cessation: An initial investigation
Myers, M. G., & MacPherson, L. (2009) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntp089 · Cited by 10 · see citing works
MacLean, R. R., Sofuoglu, M., & Waters, A. J. (2020) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2020.107892 · Cited by 9 · see citing works
Does the reaction of abstaining smokers to the smell of other people's cigarettes predict relapse?
McRobbie, H. J., Hájek, P., & Locker, J. (2008) · Addiction · doi:10.1111/j.1360-0443.2008.02340.x · Cited by 9 · see citing works
Lam, C. Y., Robinson, J. D., Carter, B. L., Wetter, D. W., Minnix, J. A., & Cinciripini, P. M. (2008) · Addictive Behaviors · doi:10.1016/j.addbeh.2008.07.006 · Cited by 9 · see citing works
“Smoking and negative affective cues often precipitate smoking (Shiffman et al., 2002), a lapse after quitting (Shiffman et al., 1996a; Shiffman et al., 1996b), and relapse (Shiffman, 1982).”
BackgroundShiffman, S. S., Fant, R. V., Gitchell, J. G., Cone, E. J., Henningfield, J. E., & m, K. F. (2003) · American Journal of Drug Delivery · doi:10.2165/00137696-200301020-00003 · Cited by 9 · see citing works
Self-citationRoom, R. (2005) · Addiction · doi:10.1111/j.1360-0443.2005.01153.x · Cited by 8 · see citing works
Using ecological measures of smoking trigger exposure to predict smoking cessation milestones.
Minami, H., Tran, L. T., & McCarthy, D. E. (2014) · Psychology of Addictive Behaviors · doi:10.1037/adb0000017 · Cited by 8 · see citing works
Russell, C., & Davies, J. B. (2009) · Current Psychology · doi:10.1007/s12144-009-9057-y · Cited by 7 · see citing works
“Shiffman et al. (1996b) found that temptations to smoke reported by 35 maintainers (reporting 625 temptation episodes) were indistinguishable from those reported by 116 lapsers (reporting 1,126 temptation episodes) in terms of their intensity, triggering stimuli, and duration.”
ResultPost-traumatic Stress Disorder and Substance Use Disorders
Roberts, M. E., Moore, S. D., & Beckham, J. C. (2007) · Elsevier eBooks · doi:10.1016/b978-012370632-4/50019-x · Cited by 5 · see citing works
Ren, J.-J., & Shi, Y. (2024) · Annals of the Institute of Statistical Mathematics · doi:10.1007/s10463-024-00899-5 · Cited by 4 · see citing works
“In a smoking cessation study (Shiffman et al. 1996), 151 smokers who had quit for at least 24 h were considered, and T i is time to the first lapse, which is subject to right censoring (4) due to drop-outs and the end time of study.”
Effects of smoking and nicotine withdrawal on prospective memory
Rash, C. J. (2007) · doi:10.31390/gradschool_dissertations.3448 · Cited by 4 · see citing works
“Long-term abstinence rates among exsmokers wanting to quit are low, ranging from 20 to 40% for treatment programs, and only 5% for those quitting without the aid of a treatment program (CDC, 2002; Hughes, Keely, & Naud, 2004; Shiffman et al., 1996; Stitzer, 1998).”
Contextual Factors Associated With Temptations and Lapses Among Smokers Trying to Quit
Elling, J. M., de Vries, H., Candel, M. J. J. M., & Crutzen, R. (2023) · Zeitschrift für Psychologie · doi:10.1027/2151-2604/a000536 · Cited by 2 · see citing works
- Authors
- Shiffman, S., Gnys, M., Richards, T. J., Paty, J. A., Hickcox, M., & Kassel, J. D.
- Affiliations
- University of Pittsburgh (US)
- Venue
- Health Psychology
- Published
- 1996
- Volume
- 15
- Issue
- 6
- Pages
- 455-461
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- OpenAlex
- W1965171696
- Cited by
- 149
- References
- 0
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 1 · 2020: 8 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 5 · 2015: 1 · 2014: 3 · 2013: 6 · 2012: 7
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Drug Abuse (DA 06084, R01DA006084)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- smoking relapse, smoking abstinence, negative affect, restlessness, attention deficits, smoking cues, coping, smoking cessation
- MeSH terms
- Smoking Prevention, Adaptation, Psychological, Adult, Behavior Therapy, Cues, Female, Follow-Up Studies, Humans, Male, Recurrence, Risk Factors, Smoking, Smoking Cessation, Behavior, Addictive
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