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

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.