Residual attraction to smoking and smoker identity following smoking cessation.

INTRODUCTION: Anecdotal reports suggest that some long-term ex-smokers retain a residual attraction to smoking and a "smoker identity," although little systematic data on this exist. These are important because they may increase the likelihood of relapse. This study aimed to quantify the extent of these characteristics in relation to length of abstinence. METHODS: A postal questionnaire on residual attraction to smoking, smoker identity, and vulnerability to relapse was sent to 1,390 adults known to have been abstinent for 4 weeks after treatment support with a large stop smoking service in England. Time since the end of treatment varied between 6 weeks and 3 years. Three hundred and fifty-seven ex-smokers responded and were included in the analysis. RESULTS: The proportion of ex-smokers reporting a residual attraction to smoking, a smoker identity, and a vulnerability to relapse declined with duration of abstinence (all p < .001), although even among those having 2 years or more of abstinence, 37.4% (95% CI = 27.9%-47.7%) reported some residual attraction and 16.3% (95% CI = 9.6%-25.2%) retained a smoker identity. By contrast, after 2 or more years of abstinence, only 7% thought they would ever return to smoking (95% CI = 2.9%-14.2%). DISCUSSION: The findings suggest that residual attraction to cigarettes is common among long-term ex-smokers, and a significant minority retain a smoker identity. Further studies are needed to determine how far these characteristics are associated with late relapse.