Preventing relapse to cigarette smoking by behavioral skill training.

Two relapse prevention conditions (skill training vs. discussion control) were crossed with two levels of aversive smoking (6 vs. 30 second inhalations). One hundred thirty-five subjects were recruited. One hundred twenty-three subjects completed treatment. Differences in abstinence rates and in number of cigarettes smoked favoring the skill training condition were found at 6 and 52 weeks from study start. Exploratory analyses indicated that at 52 weeks lighter smokers (20 cigarettes per day or fewer at pretreatment) were more likely to be favorably affected by the skill training condition than heavier smokers. Subjects assigned to the skill training condition were more likely to report use of coping skills, but did not differ from the discussion condition in perceived costs and benefits of change or of smoking, or in mood dysphoria or physical complaints. Abstinent subjects reported less mood disturbance than nonabstinent subjects at weeks 3, 6, and 26, and fewer physical complaints at week 52. The relation of these findings to a model of maintenance of therapeutic change is discussed.