Huh? The shape of the what??
The shape of the "relapse curve" my friends. That's medical-speak for "when do people cave?"
I don't know about you, but that question was hugely important to me in the first few weeks after quitting. Particularly in the first two weeks, when I was obsessively looking for any scrap of information that would explain things to me, I wanted desperately to know where I stood. I still think it's a reasonable thing to want to know. Here is the information that is easy to find: 95% of people who try to quit smoking on their own are unsuccessful. Ouch. But that raises a pretty basic question in a quitter's mind: When does that happen? Do 50% of people give in on day 1? Do 75% of people make it for a month before they can't take it anymore? If I make it through day 3 (when the nicotine is actually gone from my bloodstream) am I well on my way? What are my odds of success right now?
Please read those questions again. They make sense, right? They are not the musings of some mad genius, nor are they the product of deeply held ignorance? They mark me as neither an idiot savant nor an idiot proper? I'll assume your silence means that you agree. They seem to me painfully obvious questions.
Apparently though, no one has actually asked them in any systematic way. Yes, you read that right. No one. Trust me, I have the advanced research skills that come with graduate degrees. I also have access to the second largest research library in Canada, a library that serves both a medical school and a university hospital. The dearth of information is downright shocking. (Note to medical researchers everywhere: there's a big comprehensive, well funded study here just waiting to happen).
Here is what I did manage to find. One article: "Shape of the relapse curve and long-term abstinence among untreated smokers." I won't quote at length from the article, but I'll share the two most important results: "There is a paucity of studies reporting relapse curves of self-quitters" and "Cessation studies should report relapse curves."
It's actually an interesting read for the information it does manage to collect, as well as for the gaping holes it identifies in smoking cessation research. The authors did what is called a meta-study -- that is, they took a bunch of data from other large-scale studies, mashed it together, and asked a new question of it. The article largely focuses on what they were unable to find.
For one, not a single one of the studies they identified actually started with a group of smokers who intended to quit, and then followed them through the process. Each study relied on a retrospective report from its subjects. More alarmingly though, there was no standard definition among the studies of what constituted a "relapse." Some defined it as any nicotine use, even if that meant one drag, once, in the course of an entire year. Others defined it as a relapse to "regular" smoking. (I have since learned that there is an entire ideological firestorm surrounding what might constitute success, or a relapse. Stay tuned for my take on that whole load of baggage.)
Rumour has it that smoking related illness costs billions of dollars a year in health care costs alone. I can't quote you figures, but it's common knowledge that huge amounts of money are spent studying smoking cessation. How is it even conceivable that this fundamental question has not been asked: when do the odds tip in my favour? This is such a colossal oversight that it tempts me to conspiracy theories. What is it that the NRT industry doesn't want me to know?
What they don't want you to know is that the relapse curve is more like a relapse cliff. According to this study, approximately 90% of smokers who relapse do so within the first 8 days. 8 days! The remaining 10% of relapsers adopt a leisurely pace and spread themselves fairly evenly from day 8 to day 180.
Now, if there was a true and deeply felt desire to actually help people quit smoking (on the part of anyone -- government, non-profits, big pharma, whatever), would you not lead with that?
If you can make it through 8 lousy days, your chance of success is 90%.
8 days.
90%
Ninety freakin' percent!!!
Now why do you suppose the statistic we're bombarded with most often is that 95% of people who try to quit on their own will not succeed?
You can have your 95%. I'm very satisfied with my 90 thank you very much.
