Addiction versus stages of change models in predicting smoking cessation

Abstract

Prospective data from the California Tobacco Surveys (n = 2066) were used to perform a critical test of the Prochaska et al. (1991) stages of change model. When the stages of change model was used as a stand alone predictor, smokers in preparation at baseline were more likely to be in cessation at follow-up than smokers in pre-contemplation at baseline (ORadj = 1.9). When stage membership was combined with baseline measures of addiction including smoking behaviors and quitting history, it was not a significant predictor of future cessation. A prediction equation that combined daily vs. occasional smoking, cigarettes per day smoked, life-time quits of at least a year, and quits of more than 5 days in the previous year discriminated smokers in cessation at follow-up of 1 to 2 years better than did the stages of change model. The area under the ROC curve for the equation based on addiction measures was 69.3% vs. 55.1% for the stages of change. Cessation rates ranged from 7.7% to 35.7% for the four-category addiction equation compared with 15.1% to 24.9% for stages of change model.

Smoking Restrictions Among Households of Childhood and Young Adult Cancer Survivors: Implications for Tobacco Control Efforts

“…22 In this study, we did not observe an association between household smoking restrictions and motivation to quit (i.e., interest in quitting, quit attempts). These findings are in contrast to previous studies that document a significant relationship between home smoking restrictions and previous quit attempts, 16,17,19 as well as interest in quitting. 19 However, it was encouraging to note that more than 60% of participants, regardless of home smoking restrictions, were interested in quitting in the next 30 days (i.e., preparation stage).…”

“…12 Home smoking restrictions (defined as ''limiting or banning cigarette smoking in the home'') 10 have been shown to reduce exposure of nonsmokers and children to secondhand smoke 13 and its associated adverse health effects. [13][14][15] Restricting smoking in the home has also been associated with a number of smoking-related outcomes among adult smokers, including decreased daily cigarette consumption, 10,16 greater interest in quitting and increased quit attempts, [16][17][18][19][20] successful cessation, [18][19][20] and relapse prevention. 10 Additionally, home bans are associated with less smoking uptake among children of smokers.…”

Tobacco Cessation Behaviors Among Older Homeless Adults: Results From the HOPE HOME Study

“…35,36 Time to first cigarette after waking, a nicotine dependence measure predictive of smoking cessation, 37 was not associated with making a quit attempt in adjusted analysis. Concurrent use of other tobacco products, which is common among homeless adults, 38 may reduce reliance on cigarettes and may reduce the predictive validity of time to first cigarette after waking as a predictor of cigarette quit attempts.…”

Quitting Without Reporting Having Tried: Findings From a National Survey

“…The study of quit attempts has provided many insights into the process of smoking cessation (Etter, Prokhorov, & Perneger, 2002;Etter & Sutton, 2002;Farkas et al, 1996;Garvey, Bliss, Hitchcock, Heinold, & Rosner, 1992;Gilpin, Pierce, & Farkas, 1997;Hu & Lanese, 1998;Vangeli & West, 2012). A well-established finding is the close relationship between attempting to quit smoking and succeeding (Vangeli, Stapleton, Smit, Borland, & West, 2011).…”

“…A well-established finding is the close relationship between attempting to quit smoking and succeeding (Vangeli, Stapleton, Smit, Borland, & West, 2011). For example, a recent quit attempt is associated with the likelihood of a new attempt (Etter & Sutton, 2002), and having recently managed at least a week of abstinence or having ever managed more than a year are both predictive of later long-term success (Farkas, et al, 1996;Gilpin, et al, 1997). As a result of these relationships, together with the frequency of unsuccessful attempts, it is widely assumed that smokers rarely quit successfully without 'attempting' to do so.…”