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<p>Tobacco consumption remains the single greatest preventable cause of death globally, claiming over eight million lives annually. Although global smoking prevalence has declined, relapse among ex-smokers persists, particularly during large societal disruptions such as pandemics, armed conflicts, and economic crises. This integrative review synthesizes empirical evidence and theoretical frameworks on the behavioural dynamics of smoking relapse during such disruptions. WHO technical guidance and MPOWER documentation were used for policy synthesis. Literature was retrieved from PubMed, Scopus, EMBASE, JSTOR, Google Scholar, Researchgate, and grey sources (2005–2025), focusing on relapse, initiation, cessation attempts, and service access under disruptive conditions. Drawing on Marlatt and Gordon’s Relapse Prevention Model, the Transactional Model of Stress and Coping, Socio-ecological Model, and the Resource and Opportunity Cost Model, the study identifies multifactorial relapse drivers across individual, interpersonal, community, and structural levels. Evidence indicates heterogeneous outcomes: during COVID-19, anxiety triggered relapse for some, while health concerns motivated cessation in others. In conflicts, trauma, displacement, and weakened healthcare increased relapse, whereas economic crises produced stress-induced relapse. Factors associated with smoking relapse included psychological distress, unemployment, disrupted social networks, and tobacco industry opportunism. The resilience and support systems were integrated mental health and cessation services, community support, accessible pharmacotherapies, economic safety nets, and public health communication. Relapse during societal disruptions is shaped by intersecting psychological, social, and structural pressures, underscoring the need for multi-level interventions. Strengthening cessation infrastructure, embedding stress and trauma supports, and safeguarding equity in tobacco control policies are essential to mitigate relapse risk during future societal disruptions.</p>

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Behavioural dynamics of smoking relapse during large societal disruptions integrative review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月14日

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  • Barnabas Ogheneruru Okposio,
  • Ogbonna Ogbonna Bassey,
  • Ejiroghene Andrew Akpevba,
  • Zino Akpofure,
  • Elizabeth Adedoyin Ayodele

摘要

Tobacco consumption remains the single greatest preventable cause of death globally, claiming over eight million lives annually. Although global smoking prevalence has declined, relapse among ex-smokers persists, particularly during large societal disruptions such as pandemics, armed conflicts, and economic crises. This integrative review synthesizes empirical evidence and theoretical frameworks on the behavioural dynamics of smoking relapse during such disruptions. WHO technical guidance and MPOWER documentation were used for policy synthesis. Literature was retrieved from PubMed, Scopus, EMBASE, JSTOR, Google Scholar, Researchgate, and grey sources (2005–2025), focusing on relapse, initiation, cessation attempts, and service access under disruptive conditions. Drawing on Marlatt and Gordon’s Relapse Prevention Model, the Transactional Model of Stress and Coping, Socio-ecological Model, and the Resource and Opportunity Cost Model, the study identifies multifactorial relapse drivers across individual, interpersonal, community, and structural levels. Evidence indicates heterogeneous outcomes: during COVID-19, anxiety triggered relapse for some, while health concerns motivated cessation in others. In conflicts, trauma, displacement, and weakened healthcare increased relapse, whereas economic crises produced stress-induced relapse. Factors associated with smoking relapse included psychological distress, unemployment, disrupted social networks, and tobacco industry opportunism. The resilience and support systems were integrated mental health and cessation services, community support, accessible pharmacotherapies, economic safety nets, and public health communication. Relapse during societal disruptions is shaped by intersecting psychological, social, and structural pressures, underscoring the need for multi-level interventions. Strengthening cessation infrastructure, embedding stress and trauma supports, and safeguarding equity in tobacco control policies are essential to mitigate relapse risk during future societal disruptions.