Mixed feelings: Ambivalence as a predictor of relapse in ex-smokers

Objectives. Ambivalence can be viewed as a normal temporary psychological state in a decision process, for example, on quitting smoking. However, when ambivalence is still present after the decision has been made, it may undermine the motivation to stick to the decision. In smoking cessation, ambivalence can be expected to increase the risk for relapse. Design. In a cohort of 352 ex-smokers, felt ambivalence measured at baseline was used to predict relapse after 1 month. Results. Firstly, felt ambivalence was a predictor of relapse. Secondly, felt ambivalence moderated the strength of the relation between a psychological determinant of behaviour and actual behaviour: anticipated negative self-evaluative emotions only predicted relapse when felt ambivalence was low. Thirdly, the relation of felt ambivalence with relapse was partly mediated by ex-smokers' evaluations of risk situations (situations in which they used to smoke in the past). Conclusion. Ambivalence is related to relapse in different ways and in ex-smokers it may be conceptualized as a non-optimal decision process. Although the role of felt ambivalence needs further study, the data suggest that ambivalence must be taken into account in the practice of relapse prevention. ©2010 The British Psychological Society.