Rationalizations and identity conflict following smoking relapse: a thematic analysis

Lei Hum Wee,Azlyn Azmainie Binti Ithnin,Robert West,Nihayah Mohammad,Caryn Mei Hsien Chan,Siti Saadiah Hasan Nudin

doi:10.3109/14659891.2016.1143045

Abstract

Introduction: Little is known about how smokers respond cognitively and emotionally to the experience of “late” relapse after the acute withdrawal phase. This study assessed the kinds of thoughts and feelings that emerge in order to provide a basis for quantitative research assessing prevalence of different types of response and implications for future quit attempts.Methods: Face-to-face in-depth interviews were conducted among 14 people attending a quit smoking clinic in Malaysia who had relapsed after at least 6 weeks of abstinence. Transcripts were analyzed using thematic analysis to enable emergence of important aspects of the experience.Results: Following relapse, smokers often engaged in rationalizations and activities to minimize worry about the harmful effects of smoking by switching to a lower-tar cigarette, reducing the number of cigarette smoked, attempting to reduce cigarette smoke inhalation, comparing themselves with other smokers, and minimizing the health risks associated with smoking. In some cases, smokers retained a “non-smoker” identity despite having relapsed.Conclusion: Smoking relapsers rationalize their failure to quit and minimize their health risk in order to protect their image as non-smokers while it remains a source of identity conflict.

Highlights

Little is known about how smokers respond cognitively and emotionally to the experience of “late” relapse after the acute withdrawal phase
Even after the acute withdrawal phase lasting around 4 weeks, relapse rates are high
Smokers’ appeared to reduce the dissonance associated with resumption of smoking by (a) noting that they had switched to a “lower-tar” cigarette, (b) noting that they had reduced the number of cigarettes smoked, (c) comparing themselves with heavier smokers, (d) minimizing the health risks associated with smoking, and (e) noting that they were reducing cigarette smoke inhalation

Summary

Introduction

Little is known about how smokers respond cognitively and emotionally to the experience of “late” relapse after the acute withdrawal phase. Conclusion: Smoking relapsers rationalize their failure to quit and minimize their health risk in order to protect their image as non-smokers while it remains a source of identity conflict. It is possible that the way people react cognitively and emotionally to this “late” relapse could influence future quitting. The transition from lapse to relapse (an initial violation of the no-smoking rule to abandonment of the quit attempt) has been found to follow a variety of trajectories, from relatively rapid re-establishing of smoking to a process of continued struggle that takes place over weeks or even months (Wee et al, 2013; West, 2009)

Methods

Results

Conclusion