HEALTH PSYCHOLOGY, 1992,11(5), 331-334
Copyright © 1992, Lawrence Erlbaum Associates, Inc.
Smoking Cessation Among Self-Quitters
John R. Hughes
Departments ofPsychiatry, Psychology, and Family Practice
University of Vermont
Suzy B. Gulliver
University of Vermont
James W. Fenwick
Department ofMedical Biostatistics
University of Vermont
William A. Valliere, Kevin Cruser, Sara Pepper, and Pam Shea
Department ofPsychiatry
University of Vermont
Laura J. Solomon
University of Vermont
Brian S. Flynn
Office on Health Promotion Research
University of Vermont
We examined cessation among 630 smokers who quit abruptly on their own. Continuous, complete abstinence rates were
33% at 2 days, 24% at 7 days, 22% at 14 days, 19% at 1 month, 11% at 3 months, 8% at 6 months postcessation, and 3%
at 6 months with biochemical verification. Slipping (smoking an average of less than 1 cigarette/day) was common (9%
to 15% of subjects) and was a strong predictor of relapse; however, 23% of long-term abstainers slipped at some point.
These results challenge beliefs that most smokers can initially stop smoking and that most relapse occurs later on
postcessation.
Key words: nicotine, relapse, self-quitters, smoking
Much of the research in smoking has focused on relapse following
initial cessation (Hunt, Barnett, & Branch, 1971; Marlatt & Gordon,
1985). This emphasis has arisen, in part, because much of the
existing literature on smoking cessation has been acquired from the
fewer than 5% of smokers who received formal behavioral or drug
treatments. Initial cessation rates in these studies are often quite high
(e.g., 50% to 75%) because subjects are typically highly motivated
and received an intensive therapy.
Several prospective studies of the 95% of smokers who quit on
their own have reported much lower long-term abstinence rates than
in clinic attendees (Cohen et al., 1989; Fiore et al., 1990; Schacter,
1982). Initial cessation rates in these studies have not been well
described, as the earliest follow-up in most was 1 month postcessa-
tion. The purpose of this article is to provide a description of
abstinence rates in self-quitters very early on (i.e., 2, 7, 14 and 30
days postcessation).
Requests for reprints should be sent to John R. Hughes, Human Behavioral
Pharmacology Lab, Department of Psychiatry, Ira Allen School, University
of Vermont, 38 Fletcher Place, Burlington, VT 05401.
METHOD
This article reports the abstinence and relapse outcomes for a study
of self-quitters. Other papers will report the withdrawal (Hughes, in
press) and prediction-of-relapse analyses.
Subjects
Smokers about to quit "on their own" were recruited through news-
paper and radio ads. Subjects were compensated at a rate of $10 for
15 min of interview time. We were able to reach 1,396 (60%) of the
2,349 individuals we called.
The major focus of the study was on withdrawal symptoms in
self-quitters who stopped abruptly (Hughes, in press); thus, several
exclusion criteria were used to select a sample who would be likely
to stop abruptly on their own. These criteria excluded 671 smokers
(48% of 1,396). The reasons for exclusion were reduced number of
cigarettes in past 2 weeks (28% of the 671 excluded subjects), rated
motivation to quit less than 5 on a 10-point scale (19%), not presently
smoking daily (19%), planned an extended vacation in next few
months (13%), recently switched to low-nicotine cigarette in the past
2 weeks (8%), had a quit date more than 100 days from interview
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