Reasons for smoking relapse according to time since quit attempt.

OBJECTIVE: To investigate the primary reasons for smoking relapse and examine how they vary according to the time elapsed between abstinence and relapse. METHODS: This was a cross-sectional study analyzing 1,305 adult smokers who sought treatment at a smoking cessation center in Brazil between January of 2018 and December of 2020. All participants had previously attempted to quit smoking. On the basis of the longest duration of abstinence achieved, participants were divided into two groups: early relapse (within six months) and late relapse (after six months). The main reasons for relapse were assessed for the overall population and compared between the two groups. RESULTS: The most frequently reported reasons for relapse were chemical dependence, anxiety, stress due to everyday problems, and irritability/anger. In comparison with individuals with late relapse, those with early relapse more commonly cited chemical dependence (45.0% vs. 20.5%; p < 0.001), anxiety (39.2% vs. 27.3%; p < 0.001), and irritability (20.5% vs. 13.4%; p = 0.001). In contrast, late relapse was more often associated with stress due to everyday problems (35.5% vs. 23.1%; p < 0.001), exposure to high-risk situations (19.6% vs. 9.2%; p < 0.001), and interacting with smokers outside the home (10.7% vs. 5.6%; p = 0.001). CONCLUSIONS: Reasons for smoking relapse vary over time. Early relapse is more frequently associated with chemical dependence, anxiety, and irritability, whereas late relapse is more commonly associated with stress, exposure to high-risk situations, and social exposure to smokers. These findings may guide tailored interventions based on the timing of relapse.