Research on smoking cessation, combined with clinical observations of a wide variety of patients, suggests that people relapse many times before then going on to ultimate success in making change. Smokers have been found to make three to four action attempts before they become maintainers117. The aim during the relapse stage is, first, to help people evaluate what went wrong, and to see if they can move back through precontemplation to contemplation again, having learnt new lessons about themselves and the changes they were considering. Aspects to consider in this process include reviewing negative emotions that might again distort thinking. Open-ended questions addressing these feelings are a useful way to help people 'express'

their feelings. Second, a systematic approach to identifying what went wrong is required. Relapse can then be normalized, and not viewed to be predictive of future failure. Indeed, it can be argued that when people learn from these experiences they are more likely to be successful when they progress around the cycle the next time.

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