What kind of smoking identity following quitting would elevate smokers relapse risk?

Background: Research has suggested that smokers who quit smoking and continue to identify themselves as a smoker versus a non-smoker are at greater risk of relapse. This study examines the relationship between post-quit smoker identities and relapse risk of former smokers in Australia and the UK comparing those who still identified as a smoker with firm choice to no longer smoke versus those not expressing a firm choice. Cross-country differences were examined. Methods: Data analysed came from 544 former smokers (quit 1 month or more) who participated in the Australian and UK Waves 9 (2013) and 10 (2014) of the International Tobacco Control (ITC) surveys. Post-quit smoker identities were assessed at baseline and smoking relapse at follow-up. Results: Baseline self-reported smoker identity independently predicted smoking relapse at 12-month follow-up (p <.01). Compared with the subgroup who identified themselves as smokers trying to quit, those who identified themselves as smokers who had chosen to no longer smoke (OR = 0.01, 95% CI = 0.01–0.25, p <.001), ex-smokers (OR = 0.05, CI = 0.01–0.25, p <.001) or non-smokers (OR = 0.07, CI = 0.02–0.37, p <.001) were less likely to relapse at follow-up. No cross-country differences were found. Conclusions: Following quitting, smokers who maintained a smoker identity with a firm choice to no longer smoke or adopted a non-smoker or ex-smoker identity were less likely to relapse than those who failed to do so, suggesting that a clear rule/commitment to not smoke and/or a shift to a non-smoking identity may be protective of relapse.