Life adversity is associated with smoking relapse after a quit attempt

Andrine M Lemieux, Leif Olson, Motohiro Nakajima, Lauren Schulberg, Mustafa N al'Absi

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Multiple cross-sectional studies have linked adverse childhood events and adult adversities to current smoking, lifetime smoking, and former smoking. To date, however, there have been no direct observational studies assessing the influence of adversities on smoking relapse. We prospectively followed 123 participants, 86 of whom were habitual smokers, from pre-quit ad libitum smoking to four weeks post-quit. Thirty-seven non-smokers were also tested in parallel as a comparison group. Subjects provided biological samples for confirmation of abstinence status and self-report history of adversities such as abuse, neglect, family dysfunction, incarceration, and child-parent separation. They also completed mood and smoking withdrawal symptom measures. The results indicated that within non-smokers and smokers who relapsed within the first month of a quit attempt, but not abstainers, females had significantly higher adversity scores than males. Cigarette craving, which was independent from depressive affect, increased for low adversity participants, but not those with no adversity nor high adversity. These results demonstrate that sex and relapse status interact to predict adversity and that craving for nicotine may be an important additional mediator of relapse. These results add further support to the previous cross-sectional evidence of an adversity and smoking relationship. Further studies to clarify how adversity complicates smoking cessation and impacts smoking behaviors are warranted.

Original languageEnglish (US)
Pages (from-to)71-77
Number of pages7
JournalAddictive Behaviors
StatePublished - Sep 1 2016

Bibliographical note

Funding Information:
This research was supported in part by National Institute of Health grants R01DA016351 and R01DA027232 . NIH had no role in the study design, collection, analysis or interpretation of the data, writing of the manuscript, nor decisions to submit the paper for publication.

Publisher Copyright:
© 2016 Elsevier Ltd.


  • Adverse childhood events
  • Cessation
  • Depression
  • Relapse
  • Smoking
  • Tobacco


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