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Stress Alleviation and Reward Enhancement: Two Promising Targets for Relapse Prevention

  • Jed E. Rose
    Correspondence
    Address correspondence to Jed E. Rose, Ph.D., Duke University Medical Center, Center for Nicotine and Smoking Cessation Research, Department of Psychiatry and Behavioral Sciences, 2424 Erwin Road, Suite 201, Durham, NC 27705
    Affiliations
    Center for Nicotine and Smoking Cessation Research, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
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      It is well known that relapse following cessation of cigarette smoking or other addictive behaviors is a critical barrier to long-term success. The relapse process relentlessly erodes the proportion of patients remaining abstinent, even after patients have received intensive state-of-the-art behavioral and pharmacological treatment. At 1 year after initial treatment, only about 25% of smokers remain abstinent—a 75% relapse rate (
      • Gonzales D.
      • Rennard S.I.
      • Nides M.
      • Oncken C.
      • Azoulay S.
      • Billing C.B.
      • et al.
      Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs. sustained-release bupropion and placebo for smoking cessation: A randomized controlled trial.
      ). After 10 years, rates of relapse are still higher, with less than 10% of smokers remaining abstinent (
      • Richmond R.L.
      • Kehoe L.
      Ten-year survival outcome of the nicotine transdermal patch with cognitive behavioural therapy.
      ).
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