title: Do processes of change predict smoking stage movements? A prospective analysis of the transtheoretical model.
abstract: The transtheoretical model (TTM) posits that processes of change and the pros and cons of smoking predict progressive movement through the stages of change. This study provides both a cross-sectional replication and a prospective test of this hypothesis. As part of a larger study of worksite cancer prevention (the Working Well Trial), employees of 26 manufacturing worksites completed a baseline and 2 annual follow-up surveys. Of the 63% of employees completing baseline surveys, 27.7% were smokers (N = 1,535), and a cohort of these smokers completed the 2-year follow-up. Cross-sectional results replicated previous studies with virtually all the processes of change and the cons of smoking increasing in linear fashion from precontemplation to preparation (all ps < .00001), and the pros of smoking decreasing (p < .01). However, contrary to the hypothesis, the baseline processes of change and the pros and cons of smoking failed to predict progressive stage movements at either the 1- or the 2-year follow-ups. Possible explanations for these findings and concerns about the conceptual internal consistency of the TTM are discussed.
authors.affiliation: Brown University Center for Behavioral and Preventive Medicine, Brown University School of Medicine, and The Miriam Hospital, Providence, Rhode Island 02906, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Herzog
authors.forename: D B
authors.initials: DB
authors.lastname: Abrams
authors.forename: K M
authors.initials: KM
authors.lastname: Emmons
authors.forename: L A
authors.initials: LA
authors.lastname: Linnan
authors.forename: W G
authors.initials: WG
authors.lastname: Shadel
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009042:Motivation; D011446:Prospective Studies; D016540:Smoking Cessation / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000517:prevention & control* / Q000523:psychology*