A new study highlights that ex-smokers often relapse not due to cravings or lack of confidence, but because of exhaustion from the continuous effort to stay smoke-free.
In a breakthrough that sheds new light on smoking cessation, researchers have determined that the most reliable predictor of relapse among ex-smokers is not craving for cigarettes or lack of confidence but rather cessation fatigue — a weariness from the ongoing effort to remain tobacco-free.
This insight comes from a new study published in the journal Addiction.
“Smoking is notoriously hard to quit. About 95% of unassisted attempts to quit ultimately end in relapse, and even when evidence-based treatments like nicotine patches are used, relapse rates are still high,” lead author Hua Yong, of Deakin University in Australia, said in a news release.
The study, which followed nearly 2,000 ex-smokers across Australia, Canada, England and the United States, delved into the participants’ experiences over two years.
The researchers found that 9.2% of the ex-smokers had relapsed within this period. What stood out was that those reporting high levels of cessation fatigue were 1.64 times more likely to relapse compared to those with low fatigue.
This fatigue remains a factor regardless of how long someone has been smoke-free or whether they use vaping as a nicotine substitute. Even after overcoming withdrawal symptoms and conditioned responses, the mental and emotional effort to maintain a smoke-free life can accumulate, ultimately overwhelming an individual’s coping mechanisms and motivation.
The implications of these findings are profound. Public health strategies could be vastly improved by incorporating regular assessments of cessation fatigue during medical check-ups. By doing so, health care providers can identify those at higher risk of relapse and offer targeted support timely.
“Our research suggests that ‘tiredness with efforts to remain not smoking’ can be a useful screening tool to catch ex-smokers who are at higher risk of relapse and give them support when they need it,” Yong added. “We could incorporate assessment of cessation fatigue in routine health checks and be ready to provide relapse prevention interventions where needed. Ex-smokers might also be advised to seek more help when they begin to experience fatigue.”
Given that nearly one in 10 ex-smokers relapsed due to cessation fatigue, this study underscores the necessity of ongoing support for individuals post-quitting.