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Health Education Research Advance Access originally published online on December 20, 2006
Health Education Research 2008 23(1):1-9; doi:10.1093/her/cyl157
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© The Author 2006. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

The challenge of embracing a smoke-free lifestyle: a neglected area in smoking cessation programs

C. J. Segan1,3,*, R. Borland1, A. Hannan2 and S. Stillman2

1 Cancer Control Research Institute
2 The Victorian Smoking and Health Program (Quit Victoria), The Cancer Council Victoria, 1 Rathdowne St, Carlton, Victoria 3053, Australia
3 Program Evaluation Unit, School of Population Health, University of Melbourne, Parkville, Victoria 3010, Australia

* Correspondence to: C. J. Segan. E-mail: csegan{at}unimelb.edu.au

Relapse prevention theory and practice has focussed on teaching coping skills to deal with withdrawal and temptations to relapse with the result that treatments appear to be effective in reducing relapse over the short term, but not over the longer term. Once cravings subside ex-smokers face a further task of adjusting to a smoke-free lifestyle that involves learning to think and act like a non-smoker. To highlight this task, we operationalized a new conceptual framework that describes three tasks of quitting (the 3Ts): (i) making a quit attempt; (ii) learning to effectively deal with cravings and withdrawal; and (iii) adapting to a smoke-free lifestyle. This was introduced to the Quitline service in Victoria, Australia, in preparation for a randomized controlled trial aimed at testing whether a program of four to six extra callbacks could help ex-smokers with the third task and as a result reduce rates of relapse compared with Quitline's standard callback program. This paper describes the conceptual framework (focussing on the third task) and initial reactions to it from both Quitline advisors and callers. The conceptual framework is now integrated in the service and appears to have changed the way Quitline operates and the apparent expectations of its clients.

Received on April 6, 2006; accepted on October 5, 2006


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