The DOI matches its Crossref record; 120 of the 120 references it cites were found in a registry or an index.
Relapse and maintenance issues for smoking cessation
Abstract
This article reviews short-term (6 months) and longer term (12-24 months) maintenance of cessation and relapse in adult smokers and the factors and treatments that affect these outcomes. MedLine and PsycLIT searches were done for research published in English between 1988 and 1998 meeting a defined set of criteria. Intensive intervention, telephone counseling, and use of pharmacotherapy were found to improve outcomes; however, compared with public health approaches, they reach relatively few smokers. Brief interventions during medical visits are cost-effective and could potentially reach most smokers but are not consistently delivered. Predictors of relapse include slips, younger age, nicotine dependence, low self-efficacy, weight concerns, and previous quit attempts. Potential areas for research, recommendations for longer follow-up assessments, and standard definitions for slip, relapse, and long-term maintenance are discussed.
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“Although many factors influence ongoing nicotine dependence, relapse to smoking is highly correlated with the severity of withdrawal symptoms present during abstinence (Ockene et al., 2000;Krall et al., 2002).”
From Activation of α4β2*/α6β2* nicotinic receptors alleviates anxiety during nicotine withdrawal without upregulating nicotinic receptors (2014) · cites this paper as Ockene et al., 2000
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“Among adults, the term smoking cessation refers to volitional efforts toward permanently stopping smoking behavior (Ockene et al., 2000).”
BackgroundWeight concerns as a predictor of smoking cessation according to nicotine dependence
Tuovinen, E.-L., Saarni, S. E., Kinnunen, T., Ollila, H., Ruokolainen, O., Patja, K., Männistö, S., Jousilahti, P., Kaprio, J. A., & Korhonen, T. (2018) · Nordic Studies on Alcohol and Drugs · doi:10.1177/1455072518800217 · Cited by 11
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“The negative state and dysphoria associated with nicotine withdrawal, are good predictors of smoking relapse (Ockene et al., 2000).”
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The Struggle to Quit: Barriers and Incentives to Smoking Cessation
Moffatt, J. J., Whip, R., & Moffatt, J. J. (2004) · Health Education Journal · doi:10.1177/001789690406300202 · Cited by 11
Evalution of a Smoking Cessation Psychoeducational Program for Nurses
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“Across a range of behaviors, including smoking, diet, and exercise, individuals display yo-yo patterns – initiating a behavior change only to subsequently stop the behavior change and return to previous patterns of behaviors (Kumanyika et al., 2000; Marcus et al., 2000; Ockene et al., 2000).”
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Office-based intervention for tobacco dependence
Swartz, S. H., & Hays, J. T. (2004) · Medical Clinics of North America · doi:10.1016/j.mcna.2004.07.006 · Cited by 10
“Studies show that smokers more dependent on tobacco have greater difficulty quitting than less dependent smokers [19,20].”
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Estabrooks, P. A., Gaglio, B., Morse, E. F., Smith, T. L., Edwards, A., & Glasgow, R. E. (2010) · Addictive Behaviors · doi:10.1016/j.addbeh.2010.08.006 · Cited by 9
Garey, L., Kauffman, B. Y., Neighbors, C., Schmidt, N. B., & Zvolensky, M. J. (2016) · Addictive Behaviors · doi:10.1016/j.addbeh.2016.07.018 · Cited by 9
“Although the majority of empirical work has sought to explicate smoking cessation outcomes and maintenance processes (Ockene et al., 2000), less attention has addressed ‘early problems’ in quitting (MacPherson, Stipelman, Duplinsky, Brown, & Lejuez, 2008).”
BackgroundUse of Tobacco for Weight Control across Products among Young Adults in the U.S. Military
Fahey, M. C., Little, M. A., Klesges, R. C., Talcott, G. W., Richey, P. A., Mehmet, K., & Krukowski, R. A. (2020) · Substance Use & Misuse · doi:10.1080/10826084.2020.1846196 · Cited by 9
“…gain, which is experienced by most cigarette users after cessation (Aubin et al., 2012; U.S. Department of Health and Human Services, 2014), is a commonly reported reason to not quit cigarettes (Klesges & Shumaker, 1992; Pirie et al., 1991) and has been related to relapse (Ockene et al., 2000).”
BackgroundJackson, B., & Dimmock, J. A. (2012) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2012.01.004 · Cited by 10
“…that a high level of con fi dence to regulate one ’ s actions encourages adherence to health-enhancing behaviors, including smoking cessation (e.g., Ockene et al., 2000), dietary change (e.g., Schwarzer & Renner, 2000), and physical activity maintenance (e.g., Anderson, Wojcik, Winett, &…”
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“Furthermore, a higher level of self-efficacy has effectively been shown to predict continued abstinence (Ockene et al., 2000).”
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“Many smokers, however, resume smoking within weeks or months of initiating treatment (Fiore et al., 2008; Ockene et al., 2000).”
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“Lastly, self-efficacy has been identified in a number of studies as a predictor of succeeding with quit attempts (Ockene et al., 2000; Smit, Hoving, Schelleman-Offermans, West, & de Vries, 2014), though the generalizability of these findings under different conditions remains unclear (Gwaltney, Metrik, Kahler, & Shiff…”
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“These are; Social Cognitive Theory (SCT); (Holes, 2016); Social Learning Theory (SLT) (Bandura, 1977; Ockene et al., 2000); Health Belief Model (HBM) (Glassman et al., 2018); Theory of Planned Behaviour (TPB) (Ajzen, 1991); Theory of Interpersonal Behaviour (TIB) (Ibrahim et al., 2018); and the…”
BackgroundUsing GPS to Measure the Interaction Between Individuals and Their Neighbourhood
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“the lower self-efficacy to quit and consequently the higher the risk of relapsing [44].”
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Chang, Y., Huang, W.-H., Tsai, C.-Y., & Hwang, L. (2019) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/s13011-019-0218-1 · Cited by 8
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“먼저 남성일수 록 또한 연령이 높을수록 금연성공률이 높다는 결과는 기존의 연구에서도 같은 결과를 보이고 있다 [12,13,14,15,16].”
Factors Associated with Relapse to Smoking Behavior Using Health Belief Model
Kim, H. S., & Bae, S. S. (2011) · Journal of agricultural medicine and community health · doi:10.5393/jamch.2011.36.2.087 · Cited by 8
“Ockene 등[34]은 7일 이상 연속으로 하루 한 모금 이상 흡연하거나 일정한 기간 이내에 연속 적으로 7차례 이상 흡연한 경우를 “재흡연 (relapse)”이라 정의하였다.”
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Psychosocial Characteristics of Smokers Interested in Quitting
Rayens, M. K., Hahn, E. J., & Nicholson, D. (2010) · Journal of Health Psychology · doi:10.1177/1359105310373410 · Cited by 8
“Smokers with fewer stressors are more likely to quit (Ockene et al., 2000).”
BackgroundValidity of a Functional Assessment for Smoking Treatment Recommendations Questionnaire
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Factors Associated with Six Month Quit Rate of in-hospital Smoking Program
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“로 알려져 있다.(19) 사회인구학적 요인으로는 학력이나 소 득수준이 높을수록 금연율이 높고, 니코틴의존성이 높을수 록, 흡연량이 많을수록 금연율은 감소한다.”
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Relapse Situations According to Marlatt’s Taxonomy in Smokers
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“As regards the differences found according to gender, the results are in line with those from research reporting that being male, being married and having low levels of nicotine addiction are preventive factors for smoking relapse (Ferguson et al., 2003; Ockene et al., 2000).”
ResultChronic Obstructive Pulmonary Disease
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Factors Related to Relapse After 6 Months of Smoking Cessation Among Men in the Republic of Korea
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A Multilevel Model Analysis on the Determinants of Smoking Cessation Success Rates
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“구들에서는 금연시도 횟수가 많을수록 금연 실패 가능성이 높았 다.(8,24) 보건소 금연클리닉 신규등록자와 재등록자 비교 연구 에서는 재등록자의 금연성공률이 신규등록자보다 높았으나, 다”
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Relationships between unfavourable health status and smoking cessation attempts in Hungary
Szántó, Z., Susánszky, É., & Kopp, M. (2005) · Sozial- und Präventivmedizin · doi:10.1007/s00038-005-3148-9 · Cited by 6
“Smokers who quit at younger ages realize greater life expectations than those who quit later (Taylor et al. 2002) but older people find it easier to stop smoking (Ockene et al. 2000).”
BackgroundDisparities in smoking cessation among U.S. adults with a history of asthma
King, G., Polednak, A. P., Gilreath, T. D., & Bendel, R. B. (2007) · Annals of Behavioral Medicine · doi:10.1007/bf02879913 · Cited by 6
“population (20) and may reflect residual confounding with SES and=or the effects of greater social support among married versus unmarried persons ( 26 ).”
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“Los resultados también indican que la utilización de la TCC de forma aislada, sin TPN, también es más efi caz como intervención clínica para dejar de fumar que la aplicación de forma aislada de la TPN, obteniendo tasas de abstinencia a largo plazo (12 meses) que casi triplican a las conseguidas con esta última (29% fr…”
BackgroundSpears, C. A., Mhende, J., Hawkins, C., Vuong, V., Hayat, M. J., Eriksen, M. P., Hedeker, D., Abroms, L. C., & Wetter, D. W. (2022) · JMIR Research Protocols · doi:10.2196/35688 · Cited by 5
“Low self-efficacy often predicts the lapse and relapse of smoking [46].”
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Patterns and Predictors of Smoking Cessation
Ditre, J. W., Zale, E. L., & Brandon, T. H. (2015) · Progress in respiratory research/Progress in research in emphysema and chronic bronchitis/Progress in respiration research · doi:10.1159/000369500 · Cited by 5
Rapid review of brief interventions and referral for smoking cessation
Stead, L., McNeill, A. D., Shahab, L., & West, R. (2006) · UCL Discovery (University College London) · Cited by 5
Predictors for Smoking Cessation with Acupuncture in a Hong Kong Population
Liu, Z., Yang, J., Wu, Y., Zhang, O., Chen, M., Huang, L., He, X.-Q., Guanyi, W., & Wang, Y. (2015) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2015/189694 · Cited by 4
New Directions for Motivational Incentive Interventions for Smoking Cessation
Coughlin, L. N., Bonar, E. E., Walton, M. A., Fernandez, A. C., Duguid, I., & Nahum-Shani, I. B. (2022) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.803301 · Cited by 6
“, percent of abstinent breath CO samples) may be used to modify the intensity and type of support delivered and to inform when the person has received an adequate dose of treatment (50, 51).”
MethodPost‐discharge tobacco cessation rates among hospitalized US veterans with and without diabetes
Duffy, S. A., Munger, A., Karvonen-Gutierrez, C. A., Piette, J. D., Kao, T. A., & the Veterans Integrated Service Network (VISN) 11 Tobacco Tactics Team (2012) · Diabetic Medicine · doi:10.1111/j.1464-5491.2012.03635.x · Cited by 4
Flexibilidad psicológica y autoabandono del tabaco
Roales-Nieto, J. G., Moreno, E., García, R. C., Romero, B. M., López, F. R. J., Luciano, A. G., Arranz, A. S., Lao, I. F., Gámez, G. G., & Hernández-López, M. (2016) · Dialnet (Universidad de la Rioja) · Cited by 4
Long-term trends and predictors of smoking behaviors among men following first-ever ischemic stroke
Hou, L., Du, X., Li, J., Zhu, P., Yan, P., Zhan, F.-Y., Zhou, M., & Zhu, C. (2017) · Journal of Huazhong University of Science and Technology [Medical Sciences] · doi:10.1007/s11596-017-1755-3 · Cited by 4
Perceived Risk, and Risk-Reduction Behaviors: A Preliminary Study
Hampson, S. E., Andrews, J. A., Barckley, M., Lichtenstein, E., & Lee, M. E. (2000) · Cited by 4
Vyas, D., Patel, M. J., Sharma, A., Chhabra, K. G., Gupta, A., & Mundra, R. (2022) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_1821_21 · Cited by 3
“Another study by Ockene JK et al.[32] reported a clear and strong link among SE and cessation end result.”
BackgroundChadi, N., Diamant, É., Pérez, T., Al-Saleh, A., Sylvestre, M., O’Loughlin, J. L., Winickoff, J. P., & Drouin, O. (2023) · JMIR Research Protocols · doi:10.2196/47978 · Cited by 3
Análisis psicométrico del inventario situacional para consumidores de tabaco
Mandujano, J. L., Betanzos, F. G., Nolasco, V. M., Morales, S. E. C., & Valero, C. Z. V. (2009) · Diversitas · doi:10.15332/s1794-9998.2009.0001.05 · Cited by 3
Late smoking relapse among adolescent quitters
Peterson, A. V., & Marek, P. M. (2016) · Addictive Behaviors · doi:10.1016/j.addbeh.2016.10.024 · Cited by 3
“Late relapse after an initial substantial period of quitting has been identified as both an important scientific issue and a significant public health issue (e.g., Ockene et al., 2000; Swan & Denk, 1987; Brandon and De Michelle, 1995; Brandon, Lazev, & Juliano, 1998).”
BackgroundRisk factors for failure to quit cigarette smoking among male Saudi's in Abha City
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Risk of Psychiatric Morbidity in Patients with Tobacco Habits: A Cross-Sectional Study
Aditya, A. (2017) · JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH · doi:10.7860/jcdr/2017/26824.10172 · Cited by 3
“Some other researchers have also pointed out in previous studies that the higher frequency and longer duration of tobacco use are important clinical indices associated with tobacco addiction and play an important role in relapse and maintenance issues in tobacco cessation [18,19].”
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Effectiveness of pharmacotherapy in behavioural therapeutic smoking cessation programmes
Oostveen, R., van der Galiën, O. P., Smeets, H. M., Hollinga, A. P. D., & Bosmans, J. E. (2014) · European Journal of Public Health · doi:10.1093/eurpub/cku200 · Cited by 3
Respiratory Symptoms, Knowledge and Attitude among Male Smoker Students in Mutah University, Jordan
Alnawaiseh, N. A., Rawashdeh, A., Salahat, S., & Ajarmeh, S. (2018) · Biomedical & Pharmacology Journal · doi:10.13005/bpj/1567 · Cited by 3
Interventions for increasing health promotion practices in dental healthcare settings
Talla, P. K., Gagnon, M., Dupéré, S., Bedos, C. P., Légaré, F., & Dawson, A. B. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010955.pub2 · Cited by 2
Cigarette Smoking Relapse Among People Who Switched to E-cigarettes or Other Tobacco Products
Sun, R., Méndez, D., & Warner, K. E. (2024) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntae201 · Cited by 2
Environmental Tobacco Smoke and Children's Health
Williamson, J. M. (2010) · Eastern Economic Journal · doi:10.1057/eej.2009.27 · Cited by 2
“Recently, Pickett et al. [2006], using data from 1999–2002, reported non-smoking adults who lived in counties with extensive smoke-free laws had statistically lower levels of ETS exposure, though they do not account for price effects, so we cannot make conclusions about causal effect from their estimates.”
BackgroundThe impact of smoking on infertility, pregnancy outcomes and fetal development
Hamad, M. F., Refaat, K. M., Fischer‐Hammadeh, C., & Hammadeh, M. E. (2012) · Teratology Studies · doi:10.4081/ts.2012.e1 · Cited by 2
Kwon, E., & Nah, E. (2018) · Daehan imsang geon-gang jeungjin hakoeji/Daehan imsang geon'gang jeungjin haghoeji · doi:10.15384/kjhp.2018.18.3.138 · Cited by 2
Conley, C. C., Ryba, M. M., & Andersen, B. L. (2018) · Springer eBooks · doi:10.1007/978-3-319-93003-9_14 · Cited by 2
Factors related to the smoking relapse of out-of-school adolescents
Bae, J. E., Kim, C.-W., Lee, S. E., Im, H.-B., Kim, I. Y., Lee, T., Lee, S., & Jang, M. (2021) · 보건교육·건강증진학회지 · doi:10.14367/kjhep.2021.38.3.13 · Cited by 2
Prenatal Smoking Cessation among Black and White Women in Eastern North Carolina
Orr, S. T., Newton, E. R., & Weismiller, D. G. (2007) · American Journal of Health Promotion · doi:10.4278/0890-1171-21.3.192 · Cited by 2
Panos, M. E. (2018) · University of Minnesota Digital Conservancy (University of Minnesota) · Cited by 2
Interventions for increasing health promotion practices in dental healthcare settings
Talla, P. K., Gagnon, M., Dupéré, S., Bedos, C. P., Légaré, F., & Dawson, A. B. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010955 · Cited by 2
RetractedSmit, E. S. (2012) · Research Publications (Maastricht University) · doi:10.26481/dis.20121003es · Cited by 2
Effect of Tocopheryl Acetate on Maternal Cigarette Smoke Exposed Swiss Albino Mice Inbred Fetus
Chaudhary, J. (2016) · JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH · doi:10.7860/jcdr/2016/20304.8608 · Cited by 1
Nigusie, A., Azale, T., Yitayal, M., & Gezie, L. D. (2024) · Pan African Medical Journal · doi:10.11604/pamj.2024.48.16.37504 · Cited by 1
“Models of behavior change help to guide strategies to promote healthy behaviors and facilitate effective adaptation to and coping with illness [31,32].”
BackgroundA phenomenological analysis of relapse among adults with substance abuse
Mehari, A., Melese, H., & Reshid, M. (2026) · Scientific Reports · doi:10.1038/s41598-026-39291-z · Cited by 5
“The close proximity of these treatment locations to establishments where substances were accessible created a cyclical pattern of recovery and relapse, significantly impeding my rehabilitation progress (Interviewee 9, Sep 18, 2024).”
Self-change among gamblers and cigarette smokers
Klingemann, H., Sobell, L. C., Barker, J., Blomqvist, J., Cloud, W., Ellinstad, T., Finfgeld, D. L., Granfield, R., Hodgins, D. C., Hunt, G. P., et al. (2001) · Springer eBooks · doi:10.1007/978-94-010-0922-5_5 · Cited by 1
Surgery is unlikely to be enough for a patient to stop smoking 24 h prior to hospital admission
Marinho, I. M., Carmona, M. J. C., Benseñor, F. E. M., Hertel, J. M., de Moraes, M. F. B., Santos, P. C. J. L., Vane, M. F., & Issa, J. S. (2018) · Brazilian Journal of Anesthesiology (English Edition) · doi:10.1016/j.bjane.2017.12.004 · Cited by 1
Marinho, I. M., Carmona, M. J. C., Benseñor, F. E. M., Hertel, J. M., de Moraes, M. F. B., Santos, P. C. J. L., Vane, M. F., & Issa, J. S. (2018) · Brazilian Journal of Anesthesiology · doi:10.1016/j.bjan.2017.12.007 · Cited by 1
Buitenhuis, A. H., Hagedoorn, M., & Tuinman, M. A. (2021) · Psychology and Health · doi:10.1080/08870446.2021.1978443 · Cited by 1
“, 2019) and more successful long-term (>6 months) smoking cessation (Ockene et al., 2000).”
BackgroundMohanty, D. P., Rout, T., Shankar, K. V., Nag, R., Agrawala, S. K., & Mishra, S. N. (2022) · Journal of Associated Medical Sciences · doi:10.12982/jams.2023.014 · Cited by 1
Mental Illness and Tobacco Usage
Asharani, P. V., & Subramaniam, M. (2022) · Springer eBooks · doi:10.1007/978-3-030-92392-1_41 · Cited by 1
Approaches to Smoking Cessation in a Cardiovascular Population
Sohn, M., Shishani, K., Okada, A., & Froelicher, E. S. (2012) · Springer eBooks · doi:10.1007/978-1-4419-5650-7_15 · Cited by 1
Życińska, J. (2009) · Polish Psychological Bulletin · doi:10.2478/s10059-009-0005-3 · Cited by 1
Addiction Neuroscience and Tobacco Control
GARTNER, C. E., & Partridge, B. (2011) · Elsevier eBooks · doi:10.1016/b978-0-12-385973-0.00004-1 · Cited by 1
Chang, E., Dove, M. S., Saw, A., Tsoh, J. Y., Fung, L., & Tong, E. K. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147682 · Cited by 1
“Behaviors included smoker quit attempt in the past year, smoker quit intent within the next 30 days, and smoking intensity (cigarettes consumed per day, smoker NNAL level), as higher smoking intensity may reflect degree of addiction [24].”
BackgroundA comprehensive assessment of distress tolerance as a predictor of early smoking lapse
Stipelman, B. A. (2008) · University Libraries (University of Maryland) · Cited by 1
Self-Change in a Broader Context: Beyond Alcohol and Drugs
Flöter, S., Kröger, C. B., Toneatto, T., Nett, J. C., Polivy, J., Takala, J.-P., & Finn, P. (2007) · Springer eBooks · doi:10.1007/978-0-387-71287-1_6 · Cited by 1
Het verschil in gedragsdeterminanten van tijdelijke en succesvolle pogingen om met roken te stoppen
ten Berg, B., van den Putte, B., Yzer, M. C., & Willemsen, M. C. (2006) · gedrag en gezondheid · doi:10.1007/bf03071145 · Cited by 1
Smoking, Smoking Cessation, and Lung Cancer Screening in the NELSON Trial
van der Aalst, C. M. (2011) · EUR Research Repository (Erasmus University Rotterdam) · Cited by 1
Perez, L. A. B., Ehrminger, M., & Romo, L. (2021) · Preprints.org · doi:10.20944/preprints202109.0245.v1
Development of the self-efficacy for medication adherence - buprenorphine (SEMA-B) assessment
Krug, M. J. (2012) · e-Publications@Marquette (Marquette University)
朋子, 木., 正和, 中., 一郎, 水., & 明, 大. (2004) · doi:10.11236/jph.51.5_357
Crone, M. R., & van Kesteren, N. M. C. (2007) · TNO Repository
Metadata
- Authors
- Ockene, J. K., Mermelstein, R. J., Bonollo, D. S., Emmons, K. M., Perkins, K. A., Voorhees, C. C., & Hollis, J. F.
- Affiliations
- University of Massachusetts Chan Medical School (US)
- University of Massachusetts Boston (US)
- Harvard University (US)
- University of Pittsburgh (US)
- National Cancer Institute (US)
- Kaiser Permanente (US)
- Venue
- Health Psychology
- Published
- 2000-01
- Volume
- 19
- Issue
- 1, Suppl
- Pages
- 17-31
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- OpenAlex
- W2096002727
- Cited by
- 337
- References
- 117
- Citations by year
- 2026: 3 · 2024: 2 · 2023: 4 · 2022: 11 · 2021: 15 · 2020: 6 · 2019: 9 · 2018: 17 · 2017: 8 · 2016: 9 · 2015: 14 · 2014: 17 · 2013: 14 · 2012: 22
- FWCI
- 6.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- smoking cessation, relapse, long-term maintenance, nicotine dependence, self-efficacy, slip, telephone counseling, pharmacotherapy, brief intervention, public health approach, predictors of relapse, cost-effectiveness
- MeSH terms
- Adult, Cardiovascular Diseases, Counseling, Follow-Up Studies, Health Promotion, Humans, Life Style, Outcome and Process Assessment, Health Care, Recurrence, Health Behavior, Smoking Cessation
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