Transition of Abstinence and Relapse in Smokers Enrolled in a Randomized Trial

• Activity Number: 253
• Type: Contributed
• Date/Time: Monday, July 30, 2012 : 2:00 PM to 3:50 PM
• Sponsor: Biometrics Section
• Author(s): Hung-Wen Yeh*+ and Edward F. Ellerbeck and Jonathan D. Mahnken
• Companies: Kansas University Medical Center and University of Kansas Medical Center and University of Kansas Medical Center
• Keywords: Markov-chain ; transition model ; non-ignorable missing ; EM algorithm ; smoking cessation ; relapse

Abstract

We apply a first-order Markov chain model to analyze the transition of smoking status measured every 6 months in a 2-year randomized smoking cessation trial (three groups of PM, MDM, and HDM), and to identify what factors are associated with the transition from smoking to abstinent and from abstinent to smoking. Missing values due to non-response are assumed non-ignorable and handled by the selection modeling approach. Results suggest that smokers receiving high-intensity disease management (HDM), of male gender, lower daily cigarette consumption, higher motivation and confidence to quit, and having serious attempts to quit were more likely to become abstinent (OR = 1.48, 1.66, 1.03, 1.15, 1.09 and 1.34, respectively) in the next 6 months. Among those who were abstinent, lower income and stronger nicotine dependence (OR = 1.72 for = vs. > 40K and OR = 1.75 for first cigarette = vs. > 5 min) were more likely to have relapse in the next 6 months.