INVESTIGATING FACTORS INVOLVED IN SMOKING LAPSE TO RELAPSE PROGRESSION: A LABORATORY MODEL

Pharmacological and cognitive-behavioral interventions have improved initial smoking cessation rates; however, long-term abstinence is only achieved by 10-20% of quitters. The present study examined the effect of an experimentally controlled smoking lapse on relapse probability and explored baseline and post-abstinence predictors of self-initiated smoking. After two days of biologically confirmed abstinence, eighty smokers were randomly assigned to a programmed smoking lapse or a no lapse control condition. For the next three days, participants received monetary incentives to encourage abstinence and returned to the laboratory daily for brief assessments. The smoking lapse increased the risk of returning to smoking in the first 24 hours by more than two fold. Baseline negative affect moderated the effect of the experimental manipulation on time to self-initiated smoking such that for those with high levels of negative affect at baseline the risk of self-initiated smoking was about 8 times higher if they were exposed to a programmed lapse compared to the control group. Similarly, pre-manipulation self-efficacy moderated the effect of the programmed lapse on progression to self-initiated smoking such that smokers low in self-efficacy had an exponentially higher risk to return to smoking if they experienced a lapse. Furthermore, pre-manipulation self-efficacy, recovery self-efficacy, and several measures of negative affect predicted progression to self-initiated smoking in the lapse group. Additional research on factors involved in relapse processes is needed and brief laboratory models offer a cost- and time-effective framework to investigate such factors.