Subtypes of precontemplating smokers defined by different long-term plans to change their smoking behavior

Abstract

Many smokers are not motivated to quit smoking. In the Stages of Change model these smokers are called precontemplators. When developing interventions designed to motivate these smokers to quit, it is of importance to know whether this group is homogeneous or not. In the present study, different groups of precontemplators were distinguished according to their long-term quitting smoking plan: 861 precontemplators were asked to indicate the one plan that best fitted their own plans with regard to their smoking behavior: (1) planning to never quit and not planning to cut down (n = 194), (2) planning to never quit but planning to cut down (n = 186), (3) planning to quit somewhere in the future but not within the next 5 years (n = 290), (4) planning to quit within the next 5 years (n = 136) and (5) planning to quit within the next year but not within the next 6 months (n = 54). These groups of smokers were compared on several variables cross-sectionally and longitudinally. The results indicate that the psychological factors that will have to be targeted in smoking cessation interventions in efforts to motivate smokers to quit could be assessed reliably in precontemplators. Furthermore, precontemplators with different quitting plans differed on several cognitive variables and the quitting plans at pre-test were predictive of quitting activity after 7 months. Precontemplators who received self-help smoking cessation materials made forward changes in quitting plans and these changes seemed to follow a certain order. Forward changes in plans were differentially related to positive outcome expectations, to self-efficacy expectations depending on the quitting plan and not to changes in negative outcomes. The present study is one step in mapping the psychology of low motivation to change behavior.