Introduction:
The prevalence of smoking is determined by three major parameters: initiation, cessation, and relapse. Various wider health determinants influence these parameters. Existing literature has mostly focused on investigating determinants of smoking initiation and cessation, whereas studies investigating smoking relapse in-depth are scarce.
Aim
This analysis aims to estimate the prevalence of cigarette smoking relapse and determine its predictors in a representative sample of adult former smokers in the United States.

Methods:
This quantitative research project analysed secondary data retrieved from the Tobacco Use Supplement-Current Population Survey (TUS-CPS) 2010-11 cohort with a total sample size of 3,621 participants. Smoking relapse was defined as picking up smoking in 2011 after reporting smoking abstinence in 2010. The prevalence of relapse over the 12-month follow-up period was estimated in different subgroups. Multivariate logistic regression models were applied to determine associations between smoking relapse and a broad spectrum of sociodemographic and environmental factors.

Results:
A total of 184 former smokers reported smoking relapse by 2011 (weighted prevalence: 6.8%. 95%CI: 5.7%-8.1%). Prevalence and odds of relapse were higher among young people compared to the oldest age group (65-years and above). Former smokers living in smoke-free homes had 60% lower odds of relapse compared with those living in homes that allowed smoking inside (aOR:0.40; 95%CI: 0.25-0.64). Regarding race/ethnicity, only Hispanics had significantly higher odds of relapse compared to whites (non-Hispanics). Odds of relapse were higher among never-married, widowed, divorced and separated couples compared to the married group. Continuous smoking cessation for 6-months or more significantly decreased odds of relapse among the study sample.

Conclusions:
Wider health determinants influenced prevalence of smoking relapse among US adults; individual as well as lifestyle characteristics were associated with relapse, highlighting the need for designing targeted interventions to prevent it.