Relapse and maintenance issues for smoking cessation

This article reviews short-term (6 months) and longer term (12-24 months) m aintenance of cessation and relapse in adult smokers and the factors and tr eatments 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 p harmacotherapy were found to improve outcomes; however, compared with publi c 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 s lips, 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, relaps e, and long-term maintenance are discussed.