Is There a Difference Between a Slip and a Relapse?

Debates between ex-smokers about the meanings of 'slip' and 'relapse' are often contentious. Such discussions generally reflect fears that a break in tobacco abstinence makes full relapse inevitable, or that anything short of NOPE (Not One Puff Ever) implies permission to light up at will. Many insist that quit-dates should measure absolute abstinence from tobacco, and that loose quit-smoking definitions threaten quit-smoking peers. Dually-addicted ex-smokers often object that if alcoholics or junkies ingested even a tiny amount of alcohol or heroin, they'd have to start over and change their sobriety date. The common consensus of these debates is that there should be no distinction made between slips and relapses. 

So Is There a Difference Between Slips and Relapses?

In the quit-smoking world, a slip is defined as a simple break in abstinence, while a relapse is considered a return to previous smoking levels and behaviors. Both terms refer to smoking episodes, with the primary difference being the degree, duration or severity of smoking. Seems pretty cut and dry, but the issue gets more complicated when we consider a common psychological phenomenon called the Abstinence Violation Effect (AVE).  If you've ever broken a New Year's Resolution or gone off a diet, you've probably experienced the AVE yourself; it's that little voice that told you, "You messed up, so you might as well give up." Among smokers, the AVE usually manifests as, "Well, you already had a puff and blew your quit, so just go ahead and buy a pack (or a carton)."

Post-slip inventories often uncover thought and behavior patterns that led to the abstinence break, but slips typically appear to be spontaneous, coming 'out of the blue' in moments of anxiety, boredom, or lowered inhibition. The power of the AVE requires an urgent response. Research consistently indicates that if promptly addressed, most slips can be stopped in their tracks before the AVE sets in. Treating a slip as just a temporary bump in the road can more effectively prevent a full relapse than heated arguments about definitions, resetting quit-dates or quit-stats, etc.

[Note: What distinguishes smoking slips from those of other addictions is environment: ex-smokers are more likely to have been breathing the secondhand smoke of others prior to their slip, meaning they were already ingesting their drug of choice before they made a choice to use it. In alcoholic terms, this would be analogous to a sober person drinking a diet Coke into which his peers were methodically dropping small amounts of booze.]

In our opinion, the question isn't really about slips vs relapses, it's about what the ex-smoker's attitude ought to be during the quit, and what their response should beif a slip occurs. The default position during quitting must be N.O.P.E. at all times.Not One Puff Ever. No level of smoking is safe, and any deviation from that position threatens the health of everyone connected to the smoker. But since nicotine is one of the most powerful addictive substances known to humans, and use of it can transcend normal willpower, we must be prepared for a slip and ready to prevent its escalation into full relapse. All other questions about quit-dates, accumulated time, and quit-statistics should be dealt with later on, once the quit is again secure. First Things First.

So What Does All This Mean to Ex-Smokers, and Those Who Support Them?

To the 'slipper': Avoid bad environments whenever possible, until you're strong enough to handle them. Pay more attention to your triggers. Connect with your support network often (and immediately, if you slip), by phone, text, internet, or personal visit, and next time reach out before you take that puff. Examine the thought patterns that seduced you into the lie about 'just one'. Be grateful you dodged the bullet this time; next time you may not be so lucky.

To those who care about the 'slipper': Try to be supportive, and be upset at the addiction, not the addict. Use tough love if you feel the need, but remember that slips and relapses are often part of the process, and can convince apathetic ex-smokers to be more committed to their quits. A good rule of thumb? "Say what you mean, but don't say it mean." Don't pressure the slipper to define quitting your way, or you may make it easier for them to conclude they can't succeed. And remember that tobacco is the toughest addiction of all to beat; if you've been smoke-free yourself since day one, you are blessed -- but not invulnerable.

KTQ, and visit QuitNet if you think you might slip,

Alan P, MTTS