179737 Transtheoretical Model: An examination of the five stages of change for daily and some day smokers

Tuesday, October 28, 2008

Annette K. McClave, MPH , Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
Shanta R. Dube, PhD, MPH , Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
Ann Malarcher, PhD, MSPH , Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
Martha Engstrom, MS , Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
The Transtheoretical Model, or Stages of Change Model is a well-known model in health psychology applied to smoking cessation. Frequency of smoking may relate to cessation. Some day (SD) smokers make up a substantial portion of the smoking population, however are less likely to quit. We examined how stages of change vary by demographic characteristics among daily and SD current and former smokers. Cross-sectional data from 2003 Tobacco Use Supplement-Current Population Survey (n=190,353) were used to assess Precontemplation, Contemplation, Preparation, Action, and Maintenance among daily smokers (n=59,156) and SD smokers (n=13,021). Weighted percentages were calculated by gender, age, race, education, and residence for stages of change. A multinomial logistic regression was used to model stages of change by smoking groups. Daily and SD Smokers with 16+ years of education were more prevalent in Maintenance than daily and SD smokers with less education (70.1%; 60.8%, respectively). Women were in Maintenance and Contemplation more than men for both smoking groups. When we compared SD smokers to daily smokers, 20.9% versus 29.1% were in Precontemplation, 20.1% versus 14.1% were in Contemplation, 7.1% versus 4.1% were in Preparation, 2.4% versus 2.7% were in Action, and 49.5% versus 50.1% were in Maintenance, respectively. These differences were statistically significant in multinomial logistic regression (p < 0.01). Compared to daily smokers, more SD smokers were preparing to quit but were not actively quitting; whereas, more daily smokers were actively quitting than SD smokers. Cessation programs should incorporate motivational strategies for SD smokers to assist with active cessation.

Learning Objectives:
1.) Identify demographic groups at-risk for smoking cessation by stage of change, and 2.) describe differences in smoking cessation between daily and some day smokers.

Keywords: Health Behavior, Smoking Cessation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Shortly after achieving my Masters in Public Health in Epidemiology from Emory University, I began work for the Office on Smoking and Health at the Centers for Disease Control as an evaluator for state tobacco control programs. My expertise includes over two years of youth and adult state tobacco control program evaluation, as well as research on tobacco-related topics. My previous tobacco-related research includes youth and adult tobacco control program evaluation studies, tobacco survey research, and smoking cessation as it relates to mental health and quality of life. My previous research has been presented in several national conferences, including the 2007 National Conference on Tobacco or Health, the 2006 National Tobacco Control Program Meeting, and the 25th Annual Behavioral Risk Factor Surveillance System (BRFSS) Conference.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.