title: Naturalistic changes in the readiness to quit tobacco smoking in a German general population sample.
abstract: BACKGROUND
  This study examines naturalistic changes, i.e., changes that occur without formal interventions, in the motivational readiness to quit tobacco smoking. The transtheoretical model (TTM) with the proposed five stages of change (precontemplation, contemplation, preparation, action, maintenance) is used as the theoretical framework.
  
  
  METHODS
  Data were collected as part of a representative general population study in Germany. A total of 786 individuals was assessed two times, 6 months apart, with respect to stage of change. Latent Transition Analysis (LTA) was employed as a special statistical method to analyze stage movements over time.
  
  
  RESULTS
  The best-fitting model to describe naturalistic stage movements included both forward and backward movements. A high proportion of the sample was in the precontemplation stage across both measurement occasions. There were high rates of stage regressions over the 6-month period.
  
  
  CONCLUSIONS
  In a German representative population of smokers, smoking behavior change toward abstinence does not occur naturally in a substantial amount over the 6-month period without intervention. Differing findings in studies for populations in the United States could be due to methodological differences or differences in tobacco-control conditions.
authors.affiliation: Ernst-Moritz-Arndt-University Greifswald, Institute of Epidemiology and Social Medicine, Germany. schumann@mail.uni-greifswald.de
authors.forename: Anja
authors.initials: A
authors.lastname: Schumann
authors.forename: Christian
authors.initials: C
authors.lastname: Meyer
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Rumpf
authors.forename: Ulfert
authors.initials: U
authors.lastname: Hapke
authors.forename: Ulrich
authors.initials: U
authors.lastname: John
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003710:Demography; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009042:Motivation; D040242:Risk Reduction Behavior; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D014026:Nicotiana