In a companion paper, Herd, Borland, and Hyland (2009) were able to demonstrate that only some of these beliefs, expectations, and experiences assessed postquitting predict subsequent relapse. Frequency of urges to smoke and low-abstinence self-efficacy selleck products were both strong predictors of relapse, and both of these factors mediated the positive relationships between perceived benefits of smoking and relapse. They also found that the predictive effect of urges to smoke really only emerged after a couple of weeks after quitting, suggesting that it is less important in the period of withdrawal than later on. They found that some experienced losses from quitting predicted relapse, but expectations about health gains from staying quit and reported overall quality of life since quitting did not predict relapse.

In an effort to identify additional predictors of relapse, we sought to extend this work (Herd & Borland, 2009; Herd et al., 2009) by examining other measures of experiences and expectations of quitters using data from a partially overlapping sample collected at subsequent waves of the ITC-4 country project. Our sample did not include data from Waves 1 and 2 as our measures of interest, not considered by Herd et al., were only asked from Wave 3 onwards, and we also had an additional wave (Wave 6) not included in Herd et al. Specifically, our study aimed to explore the extent and predictive value for relapse/quit maintenance of (a) reported changes in capacity to enjoy life��s simple pleasures, (b) ability to cope with stress and control negative emotions, and (c) reported concerns about future smoking related illness despite having quit.

Based on the findings of Herd et al., we hypothesized that reported postquitting gains in life enjoyment and coping with either stress or negative emotions would be associated with sustained abstinence. We did not have any clear prediction for reported concerns about future health, although we suspected that these would be associated with increased relapse risk if they were an indication of ongoing concern that the damage has already been done, and therefore, it is too late to lessen the impact on future health rather than as a continuing motivation to stay quit.

Method Cilengitide The International Tobacco Control Four Country Survey (ITC-4) is a prospective cohort study of a broadly representative sample of over 2,000 adult smokers (18 years and older who reported smoking at least 100 cigarettes in lifetime) conducted in each of four countries: Canada, the United States, the United Kingdom, and Australia. Participants were recruited via random digit dialing telephone interviews and followed up annually. Additional participants were recruited yearly to replace those lost to attrition. A detailed description of the aims and methods of the ITC Project can be found in Thompson et al. (2006).