Factors Affecting Stages of Change in Smoking Cessation and Intention to Quit among Asian Students in Korea based on the Transtheoretical Model

The Transtheoretical Model (TTM) has been shown to be a powerful basis for describing and explaining behavior change and designing effective interventions. Previous research has documented its usefulness in the context of smoking cessation as well as other areas but predominantly in US samples. The goal of this study was to provide further data on the applicability of the TTM and the relationship of some of its core constructs (stage of change, self-efficacy, decisional balance) in a German sample of smokers and ex-smokers. Participants (N = 401) were ever-smokers (age M = 47 years, range 35-65, 62% male) who participated in a health check-up for cardiovascular risk factors at their general practitioner's office. For current smokers, significant differences in the number of quit attempts across the stages of change supported the criterion validity of the staging algorithm; differences in number of cigarettes per day were non-significant. Self-efficacy for non-smoking behavior showed an almost linear increase across the stages of change, with significant differences between pre-action and action stages. The pros for smoking cessation also increased significantly across the stages, mainly due to a significantly lower perception of pros by participants in the Precontemplation stage. As expected, the cons for smoking cessation decreased significantly, being lower in Action and Maintenance than in earlier stages. Although the generalizability of the results for the stage distribution is limited by the selectivity of the sample, the results underline the applicability and replicability of these TTM core constructs for smoking cessation with newly developed instruments in a German sample.

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Predictive Value of the Transtheoretical Model to Smoking Cessation in Hospitalized Patients with Cardiovascular Disease

Clinical & Investigative Medicine ◽

10.25011/cim.v30i3.1734 ◽

2007 ◽

Vol 30 (3) ◽

pp. 35

Author(s):

Maud-Christine Chouinard ◽

Sylvie Robichaud-Ekstrand

Keyword(s):

Cardiovascular Disease ◽

Smoking Cessation ◽

Stages Of Change ◽

Transtheoretical Model ◽

Predictive Value ◽

Self Efficacy ◽

Hospitalized Patients ◽

Processes Of Change ◽

Smoking Abstinence ◽

Pros And Cons

Background: Several authors have questioned the Transtheoretical Model (TTM). Determining the predictive value of each cognitive-behavioural element within this model could explain the successes reported in smoking cessation programs. The purpose of this study was to predict point-prevalent smoking abstinence and progression through stages of change at 2 and 6 months, using the constructs of the TTM, when applied to a pooled sample of individuals who were hospitalized for a cardiovascular event. Methods: In a predictive correlation design, recently hospitalized patients (N = 168) with cardiovascular disease (CVD) were pooled from a randomized controlled trial. Independent variables of the predictive TTM comprise stages and processes of change, pros and cons to quit smoking (decisional balance), self-efficacy, and social support. These were evaluated at baseline, 2 and 6 months. Results: Compared with smokers, individuals who abstained from smoking at 2 and 6 months were more confident at baseline to remain non-smokers, perceived less pros and cons to continue smoking, utilized less consciousness raising and self-reevaluation experiential processes of change, and received more positive reinforcement from their social network with regard to their smoke-free behaviour. Self-efficacy at baseline was the only element which predicted that patients would progress through the stages of change between hospital discharge and 6 months. Conclusions: Self-efficacy was the only element which predicted smoking abstinence and progression through stages of change. Observations about the other elements are congruent with the TTM. This study provides important information regarding the application of the TTM to smoking cessation in CVD patients.

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Influence of Processes of Change on Stages of Change for Smoking Cessation

Journal of Applied Social Science ◽

10.1177/19367244211036994 ◽

2021 ◽

pp. 193672442110369

Author(s):

Asrar Ahmad ◽

Jagwinder Singh

Keyword(s):

Smoking Cessation ◽

Behavior Change ◽

Stages Of Change ◽

Significant Influence ◽

Transtheoretical Model ◽

Processes Of Change ◽

Relative Importance ◽

Change Models ◽

The World ◽

The Relationship

Tobacco smoking is the leading cause of death in the world, accounting for more than eight million casualties. To reduce the prevalence of smoking, government and nongovernment players use interventions to reduce smoking and/or incite smoking cessation. These interventions are based on behavior change models. Foremost among those models is the Transtheoretical Model of Behavior Change developed by Dr Prochaska. The transtheoretical model theorizes that smoking cessation is a stage-wise change. This change is enabled by a set of processes of change. The current study identifies the relationship between two basic constructs of the model: processes of change and stages of change. The study also identifies the relative importance of different processes of change in different stages of change. Data analysis from this study shows that different processes of change have a differing influence on various stages of change. Experiential processes have a significant influence on the precessation stages and lack significant influence on the postcessation stages. On the contrary, behavioral processes have a significant influence on the postcessation stages and lack significant influence on the precessation stages.

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Characteristics in Stages of Change and Decisional Balance among Smokers: The Burden of Obstructive Lung Diseases (BOLD)-Australia Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183372 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3372

Author(s):

Marsha A. Ivey ◽

Graeme P. Maguire ◽

Brett G. Toelle ◽

Guy B. Marks ◽

Michael J. Abramson ◽

...

Keyword(s):

Smoking Cessation ◽

Stages Of Change ◽

Transtheoretical Model ◽

Lung Diseases ◽

Decisional Balance ◽

Smoking History ◽

Health Providers ◽

Negative Consequences ◽

Obstructive Lung Diseases ◽

Readiness To Quit

Smoking cessation remains a health promotion target. Applying the Transtheoretical Model to Australian Burden of Obstructive Lung Diseases (BOLD) data, we examined differences in stages of change (SoC) and readiness to quit decisional behaviours. Factors were identified likely to influence readiness of smokers, ≥40 years old, to quit. Analysis was restricted to current smokers classified to one of three stages: pre-contemplation (PC), contemplation (C) or preparation (P) to quit. Their ability to balance positive and negative consequences was measured using decisional balance. Among 314 smokers, 43.0% females and 60.8% overweight/obese, the distribution of SoC was: 38.1% PC, 38.3% C and 23.5% P. Overweight/obesity was associated with readiness to quit in stages C and P and there were more negative than positive attitudes towards smoking in those stages. Males were significantly heavier smokers in PC and C stages. Females used smoking cessation medication more frequently in PC stage, were more embarrassed about smoking and had greater negative reinforcements from smoking. Age started smoking and factors related to smoking history were associated with readiness to quit and increased the odds of being in stage C or P. An overweight/obese smoker was likely to be contemplating or preparing to quit. In these stages, smokers have more negative attitudes toward smoking. Starting smoking later, taking advice on cessation from health providers and using quit medications indicate increased readiness to quit. Evaluating these factors in smokers and developing cessation gain-framed messages may prove useful to healthcare providers.

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Exploring consumer boycott intelligence towards Israel-related companies in Malaysia

Journal of Islamic Marketing ◽

10.1108/jima-06-2017-0070 ◽

2019 ◽

Vol 10 (1) ◽

pp. 208-226 ◽

Cited By ~ 2

Author(s):

Hanizah Hamzah ◽

Hasrina Mustafa

Keyword(s):

Stages Of Change ◽

Transtheoretical Model ◽

Online Survey ◽

Theory Of Planned Behaviour ◽

Stage Of Change ◽

Kuala Lumpur ◽

Socially Responsible ◽

Content Type ◽

Factors Affecting ◽

Intention To Participate

Purpose Drawing on the transtheoretical model (TTM) into the theory of planned behaviour (TPB) framework, this study aims to understand the factors affecting the intention of Malaysian consumers to boycott products and services from companies perceived to be supporting or funding Israel and identify specific TPB variables that are important at each stage of change. Design/methodology/approach Data collected were based on an online survey among 177 respondents working in Malaysian conglomerates based in Kuala Lumpur. Findings The results show moderate intention to participate in the boycott among the respondents with attitude towards boycott, subjective norm and perceived behavioural control of boycott have significant relationship with intention to participate in the boycott towards Israel. The study also found significant linear increases of TPB constructs across the stages of change, which indicated significant influence of all TPB constructs at each stage of change. Originality/value Consumer boycott is not unheard of in Malaysia, but empirical research in the area is still lacking. As markets expand, the consumers also evolve to become more knowledgeable and ethical in their consumption, sometimes choosing to boycott to coerce the companies or brands to be environmentally, ethically and socially responsible. Findings from this study are expected to benefit NGOs or associations that intend to develop more effective campaigns to encourage consumers to use boycott to drive social or ethical causes.

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Perceptions About Mindfulness and Text Messaging for Smoking Cessation in Vietnam: Results From a Qualitative Study

JMIR mhealth and uhealth ◽

10.2196/17337 ◽

2020 ◽

Vol 8 (6) ◽

pp. e17337

Author(s):

Vuong Van Do ◽

Claire Adams Spears ◽

Hoang Van Minh ◽

Jidong Huang ◽

Pamela Buffington Redmon ◽

...

Keyword(s):

Smoking Cessation ◽

Focus Groups ◽

Transtheoretical Model ◽

Text Messaging ◽

Developed Countries ◽

Text Messages ◽

Smoking Cessation Program ◽

Intention To Quit ◽

Message Content ◽

Middle Income

Background With 15.6 million smokers, Vietnam is one of the top 10 largest cigarette-consuming countries in the world. Unfortunately, smoking cessation programs are still scarce in Vietnam. Mindfulness-based and text messaging–based interventions have been increasingly used in smoking cessation studies in developed countries, with promising results. Given the exponential growth of mobile phone usage in Vietnam in recent years, mobile health interventions could be a potential strategy to increase smoking cessation in Vietnam. However, substantial cultural adaptations are needed to optimize the effectiveness of these interventions among Vietnamese smokers. Objective This study aims to involve qualitative research to inform the development of a mindfulness-based text messaging smoking cessation intervention for Vietnamese smokers. Methods A total of 10 focus groups were conducted with 71 Vietnamese male smokers aged between 18 and 65 years (5-9 participants per focus group). Overall, 5 focus groups were conducted with smokers who had the intention to quit (ie, preparation stage of change in the transtheoretical model), and 5 focus groups were conducted with smokers who did not have the intention to quit (contemplation or precontemplation stage). The focus groups were audio recorded, transcribed verbatim, and analyzed using NVivo 12 software (QSR International). Results The major themes included smoking triggers, barriers and facilitators for quitting, the perceptions of text messaging and mindfulness approaches for smoking cessation, and suggestions for the development of a text messaging–based smoking cessation program. Common smoking triggers included stress, difficulties concentrating, and fatigue. Frequently encountering other people who were smoking was a common barrier to quitting. However, participants indicated that concerns about the harmful effects of smoking on themselves and their wives and children, and encouragement from family members could motivate them to quit. The participants preferred diverse message content, including information about the consequences of smoking, encouragement to quit, and tips to cope with cravings. They suggested that text messages be clear and concise and use familiar language. Most smokers perceived that mindfulness training could be useful for smoking cessation. However, some suggested that videos or in-person training may also be needed to supplement teaching mindfulness through text messages. Conclusions This study provides important insights to inform the development of a text messaging–based smoking cessation program that incorporates mindfulness for Vietnamese male smokers. The results could also be useful for informing similar programs in other low- and middle-income countries.

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Seven in every ten khat chewers in Gondar City had an intention to stop khat chewing: cross-sectional study using Transtheoretical Model

BMC Psychiatry ◽

10.1186/s12888-020-02984-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Asmamaw Adugna ◽

Telake Azale ◽

Simegnew Handebo

Keyword(s):

Stages Of Change ◽

Transtheoretical Model ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Intention To Quit ◽

Sectional Study ◽

Cross Sectional ◽

Logistic Regression Models ◽

Khat Chewing ◽

Study Participants

Abstract Background Khat chewing practice is rapidly expanding worldwide and currently, an estimated over 10 million people chew khat daily. The transtheoretical model explains how behavior change occurs across the stages of change. So, this study aimed at assessing the intention to stop khat chewing and associated factors among khat chewers in Gondar City, northwest Ethiopia. Methods Community-based cross-sectional study was conducted from March to April 2019 in Gondar City, northwest Ethiopia. Six hundred five khat chewers participated in the study from six randomly selected kebeles. The data were collected using structured and interviewer-administered questionnaire. Bivariate and multiple logistic regression models were fitted. Adjusted Odds ratio (AOR) with 95% confidence interval (CI) and p-values less than 0.05 were used to declare a significant association. Results Of the study participants, 69.3% (95% CI: 65.8–72.9) had the intention to stop khat chewing within 6 months or before. The majority of the participants (55.4%) were at the contemplation stage. Higher self-reevaluation [AOR = 2.8, (95%CI: 1.6–5.0)], environmental reevaluation [AOR = 1.9, (95%CI: 1.1–3.3)] and social liberation [AOR = 1.8, (95% CI: 1.0–3.1)] were associated with intention to quit khat chewing. In addition, using additional substances daily, khat dependency, and early age initiation of khat chewing were associated with lower intention to quit khat chewing. Conclusion The majority of the khat chewers had the intention to quit khat chewing. Increased self-reevaluation, environmental reevaluation, and social liberation process of changes were associated with enhanced intention of quitting khat chewing. Thus, stage-based interventions should be done to inspire khat chewers to realize their motivation of stopping khat chewing.

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Perceptions About Mindfulness and Text Messaging for Smoking Cessation in Vietnam: Results From a Qualitative Study (Preprint)

10.2196/preprints.17337 ◽

2019 ◽

Author(s):

Vuong Van Do ◽

Claire Adams Spears ◽

Hoang Van Minh ◽

Jidong Huang ◽

Pamela Buffington Redmon ◽

...

Keyword(s):

Smoking Cessation ◽

Focus Groups ◽

Transtheoretical Model ◽

Text Messaging ◽

Developed Countries ◽

Text Messages ◽

Smoking Cessation Program ◽

Intention To Quit ◽

Message Content ◽

Middle Income

BACKGROUND With 15.6 million smokers, Vietnam is one of the top 10 largest cigarette-consuming countries in the world. Unfortunately, smoking cessation programs are still scarce in Vietnam. Mindfulness-based and text messaging–based interventions have been increasingly used in smoking cessation studies in developed countries, with promising results. Given the exponential growth of mobile phone usage in Vietnam in recent years, mobile health interventions could be a potential strategy to increase smoking cessation in Vietnam. However, substantial cultural adaptations are needed to optimize the effectiveness of these interventions among Vietnamese smokers. OBJECTIVE This study aims to involve qualitative research to inform the development of a mindfulness-based text messaging smoking cessation intervention for Vietnamese smokers. METHODS A total of 10 focus groups were conducted with 71 Vietnamese male smokers aged between 18 and 65 years (5-9 participants per focus group). Overall, 5 focus groups were conducted with smokers who had the intention to quit (ie, preparation stage of change in the transtheoretical model), and 5 focus groups were conducted with smokers who did not have the intention to quit (contemplation or precontemplation stage). The focus groups were audio recorded, transcribed verbatim, and analyzed using NVivo 12 software (QSR International). RESULTS The major themes included smoking triggers, barriers and facilitators for quitting, the perceptions of text messaging and mindfulness approaches for smoking cessation, and suggestions for the development of a text messaging–based smoking cessation program. Common smoking triggers included stress, difficulties concentrating, and fatigue. Frequently encountering other people who were smoking was a common barrier to quitting. However, participants indicated that concerns about the harmful effects of smoking on themselves and their wives and children, and encouragement from family members could motivate them to quit. The participants preferred diverse message content, including information about the consequences of smoking, encouragement to quit, and tips to cope with cravings. They suggested that text messages be clear and concise and use familiar language. Most smokers perceived that mindfulness training could be useful for smoking cessation. However, some suggested that videos or in-person training may also be needed to supplement teaching mindfulness through text messages. CONCLUSIONS This study provides important insights to inform the development of a text messaging–based smoking cessation program that incorporates mindfulness for Vietnamese male smokers. The results could also be useful for informing similar programs in other low- and middle-income countries.

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Smoking Cessation among Hong Kong Chinese Smokers Attending Hospital as Outpatients: Impact of Doctors' Advice, Successful Quitting and Intention to Quit

Asia Pacific Journal of Public Health ◽

10.1177/101053950401600207 ◽

2004 ◽

Vol 16 (2) ◽

pp. 115-120 ◽

Cited By ~ 8

Author(s):

D.K.H. Yu ◽

K.K. Wu ◽

A.S.M. Abdullah ◽

S.C. Chai ◽

S.B. Chai ◽

...

Keyword(s):

Smoking Cessation ◽

Hong Kong ◽

Public Hospitals ◽

Intention To Quit ◽

Chinese Patients ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Affecting ◽

Quit Smoking ◽

Quitting Smoking

To identify factors affecting current smokers' intention to quit smoking and factors associated with successful quitting among ex-smokers in Hong Kong. A cross-sectional survey of Chinese patients attending medical and surgical Specialist Outpatient Clinics (SOPCs) of public hospitals in Hong Kong, using a structured questionnaire. Results of the 642 respondents, 21% were current smokers, 9% were ex-smokers and 69% were non-smokers. 74% of the smokers reportedly received quitting advice from doctors. Among the current smokers, past quitting attempts, receiving information from sources other than doctors, believing that doctor's advice was useful, believing that all smokers should quit smoking and a positive attitude towards quitting were associated with intention to quit. Among those who had attempted to quit, being older (aged 50 or above), being retired / unemployed and consuming more than 10 cigarettes per day were associated with successful quitting. We found that advice from doctors on quitting smoking did not have any impact on Chinese smokers quitting or future intention to quit and reflect the inadequacy of advice given by Hong Kong doctors. The predictors of intention to quit and successful quitting identified in the study could be used to design future smoking cessation services. Asia Pac J Public Health 2004; 16(2): 115-120.

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