The relation between processes-of-change and stage-transition in smoking behavior: a two-year longitudinal test of the Transtheoretical Model

Abstract

Aims: To test the theoretical predictions of the Transtheoretical Model regarding process-use and progressive stage-transition in relation to smoking behavior.

Design and setting: Secondary data analyses of a 2-year longitudinal worksite-based smoking-cessation study [Working Well Trial (Abrams, D., Boutwell, W., Grizzle, J., Heimendinger, J., Sorensen, G., & Varnes, J. (1994). Cancer control at the workplace: The Working Well trial. Preventative Medicine, 23, 15-27)].

Findings: The results demonstrated some support for the predictions generated from the Model: those making the transition from the Precontemplation stage to the Contemplation stage showed a heightened use of experiential processes-of-change from the baseline measurement to the 2-year follow-up, while those remaining in the Precontemplation stage reported no differences across time in their ratings of experiential and behavioral processes-of-change. Contrary to Transtheoretical Model's claims, however, smokers moving from the Contemplation stage to the Preparation stage over the 2-year period did not manifest an increasing use of experiential or behavioral processes over time in comparison to their counterparts remaining in the Contemplation stage.

Conclusions: Given the lack of longitudinal relation between process-use and the Contemplation-to-Preparation transition, the findings in this paper undermine the Transtheoretical Model's central tenet that stage-matched processes-of-change serve as the primary mechanisms of stage progression from the Contemplation stage to the Preparation stage.