Clinical predictors of tobacco dependence relapses

Abstract

Introduction

So far, the smoking relapses after quitting have not been studied clinically. Psychological research emphasizes the role of stress and mood disorders in tobacco dependence relapse.

Our investigations showed that not only emotional changes but some clinico-psychopatological factors (signs) of tobacco dependence are very important in predicting the smoking relapses.

Methods

165 tobacco dependent patients, age 47–76, 105 women, 60 men, smoking period more than 25 years, were examined and anamnestically investigated from their first attempts to start smoking. All of them had therapy resistance appeared after several successful quittings.

Factor analysis was made to find out the prognostic signs for smoking recidives.

Results

100% patients had at least 2–3 “unfull” therapy remissions after smoking cessations with the persistence of ideatory component of craving for tobacco: the impossibility to control the mental ideas of smoking.

The less meaningful factors were, such as:

1. • depressive mood at the time of remission with anxiety and sensibility in women (73%) and disphoria and irritability in men (89%);

2. • indifferent attitude towards tobacco smoke smell (72%);

3. • indifferent attitude to own health condition (56% women, 93% men);

4. • short time quitting periods before relapses in smoking anamnesis ;

5. • passive smoking in family (at work) (72 women, 43%men);

6. • slowly disappearing symptoms of smoking cessation at the process of treatment (86% both sexes).

Conclusions

These data have preventive and prognostic benefit for diagnosis and planning therapy intervention.