Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-12-01T03:56:08.333Z Has data issue: false hasContentIssue false
  • English
  • Français

Relapse Situations According to Marlatt’s Taxonomy in Smokers

Published online by Cambridge University Press:  12 November 2013

Bárbara Piñeiro  and
Elisardo Becoña
Bárbara Piñeiro*
Affiliation:
Universidad de Santiago de Compostela (Spain)
Elisardo Becoña
Affiliation:
Universidad de Santiago de Compostela (Spain)
*
*Correspondence concerning this article should be addressed to Bárbara Piñeiro. Smoking Cessation Unit. Department of Clinical Psychology and Psychobiology. Faculty of Psychology. Universidad de Santiago de Compostela. 15782. Santiago de Compostela. La Coruña (Spain). E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Relapse is common during the process of giving up smoking. The aim of the present study is to explore the relapse situations, according to Marlatt’s relapse taxonomy, in a sample of 428 smokers (43.9% men and 56.1% women) who participated in a cognitive-behavior psychological treatment for quitting smoking. At the end of the treatment, 221 participants were abstinent, of whom 119 (41.2% men and 58.8% women) relapsed in the course of the 12-month follow-up, the majority in the first 3 months (69.74%). Most of the relapses were attributed to intrapersonal and environmental determinants (61.33%), the most common of which were “coping with negative emotional states” (38.65%), followed by “giving in to temptations or urges” (9.24%) and “testing personal control” (8.40%). Interpersonal determinants occurred in 38.66% of relapses, this percentage being made up mostly of “social pressure”, which was the relapse situation in 34.46% of all relapses. These results, similar to those of Marlatt’s original studies and others, contribute to improving our knowledge of the relapse situations process, with a view to interventions that may help to avoid it.

Keywords

relapsetaxonomysmoking cessationsituations
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 16 , 2013 , E91
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allsop, S., & Saunders, B. (1989). Relapse and alcohol problems. In Gossop, M. (Ed.), Relapse and addictive behavior (pp. 11–40). London, UK: Routledge.Google Scholar
Baker, T. B., Piper, M. E., McCarthy, D. E., Majeskie, M. R., & Fiore, M. C. (2004). Addiction motivation reformulated: An affective processing model of negative reinforcement. Psychological Review, 111, 33–51. http://dx.doi.org/10.1037/0033-295X.111.1.33 CrossRefGoogle ScholarPubMed
Becoña, E. (1994). Evaluación de la conducta de fumar [Assessment of smoking behavior]. In Graña, J. L. (Ed.), Conductas Adictivas: Teoría, evaluación y tratamiento (pp. 403–454). Madrid, Spain: Debate.Google Scholar
Becoña, E. (2007). Programa para dejar de fumar [Smoking cessation program] . Vigo, Spain: Nova Galicia Edicións.Google Scholar
Becoña, E., Fernández del Río, E., López, A., & Míguez, M. C. (2009). La Escala del Síndrome de Dependencia de la Nicotina (NDSS) en una muestra de fumadores que demandan tratamiento para dejar de fumar [The NDDS in a sample of smokers seeking smoking cessation treatment]. Psicothema, 21, 579–584.Google Scholar
Becoña, E., López, A., Fernández del Río, E., Míguez, M. C., & Castro, J. (2010). Spanish adaptation of the NDSS (Nicotine Dependence Syndrome Scale) and assessment of nicotine-dependent individuals at Primary Care Health Centers in Spain. The Spanish Journal of Psychology, 13, 951–960. http://dx.doi.org/10.1017/S1138741600002596 Google Scholar
Becoña, E., & Míguez, M. C. (1995). El cuestionario de evaluación de la recaída/abstinencia de los cigarrillos: Primeros resultados [Questionnaire for the assessment of relapse/abstinence in smokers: First results]. Revista Española de Drogodependencias, 20, 25–40.Google Scholar
Becoña, E., Nogueiras, L., Flórez, G., Álvarez, S., & Vázquez, D. (2010). Propiedades psicométricas de la Escala del Síndrome de Dependencia de la Nicotina (NDSS) en una muestra de fumadores que solicitan tratamiento por su dependencia del alcohol [Psychometric properties of the Nicotine Dependence Syndrome Scale (NDSS) in a sample of smokers treated for their alcohol dependence]. Adicciones, 22, 37–50.CrossRefGoogle Scholar
Berlin, I., Covey, L. S., & Glassman, A. H. (2009). Smoking and depression: A comorbidity. Journal of Dual Diagnosis, 5, 149–158. http://dx.doi.org/10.1080/15504260902870129 Google Scholar
Bliss, R. E, Garvey, A. J., Heinold, J. W., & Hitchcock, J. L. (1989). The influence of situation and coping on relapse crisis outcomes after smoking cessation. Journal of Consulting and Clinical Psychology, 57, 443–449. http://dx.doi.org/10.1037/0022-006X.57.3.443 Google Scholar
Brandon, T. H., Vidrine, J. I., & Litvin, E. B. (2007). Relapse and relapse prevention. Annual Review of Clinical Psychology, 3, 257–284. http://dx.doi.org/10.1146/annurev.clinpsy.3.022806.091455 Google Scholar
Breslau, N., & Johnson, E. O. (2000). Predicting smoking cessation and major depression in nicotine-dependent smokers. American Journal of Public Health, 90, 1122–1127. http://dx.doi.org/10.2105/AJPH.90.7.1122 Google Scholar
Carroll, K. M. (1996). Relapse prevention as psychological treatment. A review of controlled clinical trials. Experimental and Clinical Psychopharmacology, 4, 46–54. http://dx.doi.org/10.1037//1064-1297.4.1.46 CrossRefGoogle Scholar
Chaney, E. F., O’Leary, M. R., & Marlatt, G. A. (1978). Skill training with alcoholics. Journal of Consulting and Clinical Psychology, 46, 1092–1104. http://dx.doi.org/10.1037//0022-006X.46.5.1092 Google Scholar
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–46. http://dx.doi.org/10.1177/001316446002000104 Google Scholar
Coleman, T., Agboola, S., Leonardi-Bee, J., Taylor, M., McEwen, A., & McNeill, A. (2010). Relapse prevention in UK Stop Smoking Services: Current practice, potential effectiveness and cost-effectiveness. Health Technology Assessment, 14(49) 1–152.CrossRefGoogle ScholarPubMed
Conklin, C. A., Perkins, K. A., Sheidow, A. J., Jones, B. L., Levine, M. D., & Marcus, M. D. (2005). The return to smoking: 1-year relapse trajectories among female smokers. Nicotine & Tobacco Research, 7, 533–540. http://dx.doi.org/10.1080/14622200500185371 CrossRefGoogle ScholarPubMed
Cummings, C., Gordon, J. R., & Marlatt, G. A. (1980). Relapse: Prevention and prediction. In Miller, W. R. (Ed.), The addictive behaviors: Treatment of alcoholism, drug abuse, smoking and obesity (pp. 291–321). New York, NY: Pergamon Press.Google Scholar
Curry, S. J., & McBride, C. M. (1994). Relapse prevention for smoking cessation: Review and evaluation of concepts and interventions. Annual Review of Public Health, 15, 345–366. http://dx.doi.org/10.1146/annurev.pu.15.050194.002021 Google Scholar
Donovan, D. M. (1996). Marlatt’s classification of relapse precipitants: Is the Emperor still wearing clothes? Addiction, 91, 131–138. http://dx.doi.org/10.1046/j.1360-0443.91.12s1.3.x Google Scholar
Etter, J. F., & Stapleton, J. A. (2006). Nicotine replacement therapy for long-term smoking cessation: A meta-analysis. Tobacco Control, 15, 280–285. http://dx.doi.org/10.1136/tc.2005.015487 CrossRefGoogle ScholarPubMed
European Commission (2010). Special Eurobarometer-European Commission. Tobacco. Report No.: 332/Wave 72.3. Brussels, Belgium: Author. Retrieved from http://ec.europa.eu/public_opinion/archives/ebs/ebs_332_en.pdf Google Scholar
Ferguson, J., Bauld, L., Chesterman, J., & Judge, K. (2005). The English smoking treatment services: One-year outcomes. Addiction, 100, 59–69. http://dx.doi.org/10.1111/j.1360-0443.2005.01028.x CrossRefGoogle ScholarPubMed
Ferguson, J. A., Patten, C. A., Schroeder, D. R., Offord, K. P., Eberman, K. M., & Hurt, R. D. (2003). Predictors of 6-month tobacco abstinence among 1224 cigarette smokers treated for nicotine dependence. Addictive Behaviors, 28, 1203–1218. http://dx.doi.org/10.1016/S0306-4603(02)00260-5 Google Scholar
Ferguson, S. G., & Shiffman, S. (2010). Effect of high-dose nicotine patch on the characteristics of lapse episodes. Health Psychology, 29, 358–366. http://dx.doi.org/10.1037/a0019367 CrossRefGoogle ScholarPubMed
Fiore, M. C., Jaén, C. R., Baker, T. B., Bailey, W. C., Benowitz, N. L., Curry, S. J., … Wewers, M E. (2008). Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville, MD: U. S. Department of Health and Human Services, Public Health Service.Google Scholar
Glassman, A. H., Helzer, J. E., Covey, L. S., Cottler, L. B., Stetner, F., Tipp, J. E., & Johnson, J. G. (1990). Smoking, smoking cessation, and major depression. JAMA: Journal of the American Medical Association, 264, 1546–1549. http://dx.doi.org/10.1001/jama.1990.03450120058029 Google Scholar
Hammersley, R. (1994). A digest of memory phenomena for addiction research. Addiction, 89, 283–293. http://dx.doi.org/10.1111/j.1360-0443.1994.tb00890.x Google Scholar
Heather, N., & Stallard, A. (1989). Doses the Marlatt model underestimate the importance of conditioned craving in the relapse process? In Gossop, M. (Ed.), Relapse and addictive behavior (pp. 180–208). London, UK: Routledge Google Scholar
Hodgins, D. C., el-Guebaly, N., & Armstrong, S. (1995). Prospective and retrospective reports of mood stages before relapse to substance use. Journal of Consulting and Clinical Psychology, 63, 400–407. http://dx.doi.org/10.1037//0022-006X.63.3.400 Google Scholar
Hughes, J. R., Keely, J., & Naud, S. (2004). Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction, 99, 29–38. http://dx.doi.org/10.1111/j.1360-0443.2004.00540.x CrossRefGoogle ScholarPubMed
Hunt, W. A., Barnett, L. W., & Branch, L. G. (1971). Relapse rates in addiction programs. Journal of Clinical Psychology, 27, 455–456. http://dx.doi.org/10.1002/1097-4679(197110)27:4<455::AID-JCLP2270270412>3.0.CO;2-R Google Scholar
Kadden, R. (1996). Is Marlatt’s taxonomy reliable or valid? Addiction, 91, 139–146. http://dx.doi.org/10.1046/j.1360-0443.91.12s1.4.x CrossRefGoogle ScholarPubMed
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174. http://dx.doi.org/10.2307/2529310 Google Scholar
Lasser, K., Boyd, J. W., Woolhandler, S., Himmelstein, D. U., McCormick, D., & Bor, D. H. (2000). Smoking and mental illness: A population-based prevalence study. JAMA: Journal of the American Medical Association, 284, 2606–2610. http://dx.doi.org/10.1001/jama.284.20.2606 CrossRefGoogle ScholarPubMed
Longabaugh, R., Rubin, A., Scout, R. L., Zywiak, W. H., & Lowman, C. (1996). The reliability of Marlatt’s taxonomy for classifying relapse. Addiction, 91, 73–88. http://dx.doi.org/10.1046/j.1360-0443.91.12s1.18.x Google Scholar
Lowman, C., Allen, J., Stout, R. L., & Relapse, The Research Group. (1996). Replication and extension of Marlatt’s taxonomy of relapse precipitants: Overview of procedures and results. Addiction, 91, 51–72. http://dx.doi.org/10.1046/j.1360-0443.91.12s1.16.x CrossRefGoogle ScholarPubMed
Maisto, S. A., Connors, G. J., & Zywiak, W. H. (1996). Construct validation analyses on the Marlatt typology of relapse precipitants. Addiction, 91, 89–98. http://dx.doi.org/10.1046/j.1360-0443.91.12s1.19.x Google Scholar
Marlatt, G. A. (1985). Situational determinants of relapse and skills-training interventions. In Marlatt, G. A. & Gordon, J. R. (Eds.), Relapse Prevention: Maintenance strategies in the treatment of addictive behaviors (pp. 71–127). New York, NY: Guilford Press.Google Scholar
Marlatt, G. A. (1996). Taxonomy of high-risk situations for alcohol relapse: Evolution and development of a cognitive-behavioral model. Addiction, 91, 37–49. http://dx.doi.org/10.1111/j.1360-0443.1996.tb02326.x Google Scholar
Marlatt, G. A., & Donovan, D. M. (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors (2 nd Ed.). New York, NY: Guilford Press.Google Scholar
Marlatt, G. A., & Gordon, J. R. (Eds.). (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York, NY: Guilford Press.Google Scholar
Marlatt, G. A., & Witkiewitz, K. (2005). Relapse prevention for alcohol and drug problems. In Marlatt, G. A. & Donovan, D. M. (Eds.), Relapse Prevention. Maintenance strategies in the treatment of addictive behaviors (2 nd Ed.) (pp. 1–44). New York, NY: The Guildford Press.Google Scholar
Míguez, M. C., & Becoña, E. (2008). Abstinence from smoking ten years after participation in a randomized controlled trial of a self-help program. Addictive Behaviors, 33, 1369–1374. http://dx.doi.org/10.1016/j.addbeh.2008.06.015 CrossRefGoogle Scholar
Ministerio de Sanidad y Política Social (2010). Sistema Nacional de Salud de España [Spanish Health National System] . Madrid, Spain: Author, Instituto de Información Sanitaria. Retrieved from http://www.msps.es/organizacion/sns/docs/sns2010/Principal.pdf Google Scholar
Montes, A., Pérez, M., & Gestal, J. J. (2004). Impacto del tabaquismo sobre la mortalidad en España [Impact of smoking on mortality in Spain]. Adicciones, 16, 75–82.Google Scholar
Mulder, I., Hoogenveen, R. T., Smith, H. A., & Bueno de Mesquita, H. B. (2004). Modelling future mortality reduction through smoking cessation in the European Union. European Journal of Public Health, 14, 79–85. http://dx.doi.org/10.1093/eurpub/14.1.79 Google Scholar
Ockene, J. M., Emmons, K., Mermelstein, R., Perkins, K., Bonollo, D., Voorhees, C., & Hollis, J. (2000). Relapse and maintenance issues for smoking cessation. Health Psychology, 19, 17–31. http://dx.doi.org/10.1037//0278-6133.19.Suppl1.17 CrossRefGoogle ScholarPubMed
O’Connell, K. A., & Martin, E. J. (1987). Highly tempting situations associated with abstinence, temporary lapse, and relapse among participants in smoking cessation programs. Journal of Consulting and Clinical Psychology, 55, 367–371. http://dx.doi.org/10.1037//0022-006X.55.3.367 CrossRefGoogle ScholarPubMed
Piasecki, T. M. (2006). Relapse to smoking. Clinical Psychology Review, 26, 196–215. http://dx.doi.org/10.1016/j.cpr.2005.11.007 CrossRefGoogle ScholarPubMed
Piasecki, T. M., Fiore, M. C., McCarthy, D. E., & Baker, T. B. (2002). Have we lost our way? The need for dynamic formulations of smoking relapse proneness. Addiction, 97, 1093–1108. http://dx.doi.org/10.1046/j.1360-0443.2002.00216.x Google Scholar
Powell, J., Dawkins, L., West, R., Powell, J., & Pickering, A. (2010). Relapse to smoking during unaided cessation: Clinical, cognitive and motivational predictors. Psychopharmacology, 212, 537–549. http://dx.doi.org/10.1007/s00213-010-1975-8 Google Scholar
Shiffman, S. (2006). Reflections on smoking relapse research. Drug and Alcohol Review, 25, 15–20. http://dx.doi.org/10.1080/09595230500459479 Google Scholar
Shiffman, S., Hufford, M., Hickcox, M., Paty, J. A., Gnys, M., & Kassel, J. D. (1997). Remember that? A comparison of real-time versus retrospective recall of smoking lapses. Journal of consulting and Clinical Psychology, 65, 292–300. http://dx.doi.org/10.1037/0022-006X.65.2.292.a Google Scholar
Shiffman, S. M., Paty, J. A., Gnys, M., Kassel, J. A., & Hickcox, M. (1996). First lapses to smoking: Within-subjects analysis of real-time reports. Journal of Consulting and Clinical Psychology, 64, 366–379. http://dx.doi.org/10.1037//0022-006X.64.2.366 Google Scholar
Shiffman, S., Waters, A. J., & Hickcox, M. (2004). The nicotine dependence syndrome scale: A multidimensional measure of nicotine dependence. Nicotine and Tobacco Research, 6, 327–348. http://dx.doi.org/10.1080/1462220042000202481 Google Scholar
Stone, A. A., & Shiffman, S. (1994). Ecological momentary assessment (EMA) in behavioral medicine. Annals of Behavioral Medicine, 16, 199–202.CrossRefGoogle Scholar
Stout, R. L., Longabaugh, R., & Rubin, A. (1996). Predictive validity of Marlatt’s taxonomy versus a more general relapse code. Addiction, 91, 99–110. http://dx.doi.org/10.1046/j.1360-0443.91.12s1.20.x CrossRefGoogle ScholarPubMed
U. S. Department of Health and Human Services (2010). How tobacco smoke causes disease: The biology and behavioral basis for smoking-attributable disease. A report of the Surgeon General. Rockville, MD: Author, Public Health Service, Office of Surgeon General.Google Scholar
Velicer, W. F., Prochaska, J. O., Rossi, J. S., & Snow, M. G. (1992). Assessing outcome in smoking cessation studies. Psychological Bulletin, 111, 23–41. http://dx.doi.org/10.1037//0033-2909.111.1.23 CrossRefGoogle ScholarPubMed
West, R., Hajek, P., Stead, L., & Stapleton, J. (2005). Outcome criteria in smoking cessation trials: Proposal for a common standard. Addiction, 100, 299–303. http://dx.doi.org/10.1111/j.1360-0443.2004.00995.x Google Scholar
Witkiewitz, K., & Marlatt, G. A. (2004). Relapse prevention for alcohol and drug problems: That was Zen, this is Tao. American Psychologist, 59, 224–235. http://dx.doi.org/10.1037/0003-066X.59.4.224 CrossRefGoogle ScholarPubMed
Zhou, X., Nonnemaker, J., Sherrill, B., Gilsenan, A., Coste, F., & West, R. (2009). Attempts to quit smoking and relapse: Factors associated with success or failure from the ATTEMPT cohort study. Addictive Behaviors, 34, 365–373. http://dx.doi.org/10.1016/j.addbeh.2008.11.013 Google Scholar