Redefining smoking relapse as recovered social identity – secondary qualitative analysis of relapse narratives

ABSTRACT

Although many people in the general population manage to quit smoking, relapse is common. Theory underpinning the determinants of smoking relapse is underdeveloped. This article aims to specify theoretical insight into the process of relapse to smoking, to underpin effective intervention development. Secondary qualitative analysis of extended narratives of smoking relapse (n = 23) were inductively coded within our conceptual framework of a socially situated narrative theoretical approach to identity. Smoking relapse is conceptualized as a situated rational response to a “disruption” in individual narrative identity formation, and an attempt to recover a lost social identity. Emotional reactions to relapse, such as not only pleasure, but also guilt and shame, support this assertion by demonstrating the ambivalence of re-engaging in a behavior that is situated and rational in terms of individual identity formation, yet ostracized and stigmatized by wider culture.

KEYWORDS:

• Tobacco smoking relapse
• social identity
• secondary qualitative analysis

Acknowledgements

We thank service user representatives for their invaluable feedback in developing analysis, and study participants involved in the qualitative data collection. We acknowledge the support of the NIHR, through the Primary Care Research Network. Smokefree Norfolk assisted with identifying and recruiting participants to the process evaluation study and we are grateful for their support.

Disclosure of potential conflicts of interest

Visit the HTA programme website for more details www.hta.ac.uk/link to project page. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Department of Health (Project 09/91/36).

No conflicts of interest. We attest that we have herein disclosed any and all financial or other relationships that could be construed as a conflict of interest.

Clinical trial registration

In this paper, we utilize secondary qualitative analysis of process evaluation data collected in the UK as part of an NIHR HTA funded randomized controlled trial of a self-help smoking relapse prevention intervention (ISRCTN 36980856).

Additional information

Funding

This work was supported by fellowship funding from the Society for the Study of Addiction. The SHARPISH trial was funded by the NIHR Health Technology Assessment programme (Project 09/91/36).