Dynamic effects of self-efficacy on smoking lapse and relapse

Self-efficacy (SE) is thought to be critical to success in smoking cessatio n both as an individual difference and as a dynamic process after a quit at tempt. In this study, 214 smokers used palm-top computers to record day-to- day variations in SE during 4 weeks after quitting. SE remained at high and stable levels prior to a Ist lapse but decreased and became more variable thereafter. The authors used event history models with time-varying covaria tes to assess the effect of daily SE on lapse and relapse risk. Daily SE me asures predicted an initial lapse on the subsequent day. However, this rela tionship was accounted for by stable baseline differences in SE (assessed b y questionnaire), rather than by day-to-day dynamics in SE. Progression fro m 1st lapse to relapse was also examined. In this instance, daily SE predic ted subsequent relapse risk, even when baseline SE and concurrent smoking w ere accounted for, suggesting the importance of SE dynamics for this stage of the relapse process.