title: Processes of change related to smoking behavior among cancer patients.
abstract: OBJECTIVE
  The purpose of this study was to examine the degree to which transtheoretical model processes of change (methods and strategies for cessation) were associated with smoking status and quitting behavior (ie, intentions and attempts to quit) among patients with head and neck or lung cancer. The relationship between medical variables and processes of change was also explored.
  
  
  METHODS
  Twenty-nine smokers and 45 abstainers who were recruited from treatment clinics within a comprehensive cancer center completed a brief survey. Multivariate analysis of variance and Pearson correlation procedures were used to evaluate hypothesized relationships.
  
  
  RESULTS
  As hypothesized, quitters used behavioral processes such as counter-conditioning and reinforcement management significantly more than smokers and used self-reevaluation, an experiential process, significantly less than smokers. Contrary to the hypothesis, however, quit attempts and intentions were associated with both experiential (ie, consciousness raising and self-reevaluation) and behavioral (ie, reinforcement management and self-liberation) processes of change. Use of the processes of change was not influenced by medical variables, including cancer type, illness phase, disease stage, type of current medical treatment, and duration of illness.
  
  
  CONCLUSIONS
  These findings suggest that behavioral counseling to promote smoking cessation for patients with cancer should involve assisting the patient to do the following: develop an awareness of the health risks related to continued smoking; devise and use alternative behaviors; implement the use of reinforcement strategies for cessation successes; and develop a sense of confidence and commitment about quitting as well as healthy lifestyle values. These strategies are discussed within the context of models and guidelines for smoking cessation in clinical practice.
authors.affiliation: Division of Population Science, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schnoll
authors.forename: Michael
authors.initials: M
authors.lastname: Malstrom
authors.forename: Calvin
authors.initials: C
authors.lastname: James
authors.forename: Randi L
authors.initials: RL
authors.lastname: Rothman
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Miller
authors.forename: John A
authors.initials: JA
authors.lastname: Ridge
authors.forename: Benjamin
authors.initials: B
authors.lastname: Movsas
authors.forename: Corey
authors.initials: C
authors.lastname: Langer
authors.forename: Michael
authors.initials: M
authors.lastname: Unger
authors.forename: Melvyn
authors.initials: M
authors.lastname: Goldberg
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D010361:Patients; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology