Predictive value of aspects of the Transtheoretical Model on smoking cessation in a community-based, large-group cognitive behavioral program.
OBJECTIVE
To evaluate the predictive value of aspects of the Transtheoretical Model (TTM) of behavior change as applied to smoking cessation in a large-group, community-based cognitive-behavioral intervention.


METHODS
Cognitive-behavioral intervention followed by 3-month assessment of smoking status.


METHODS
Regional Outpatient Cancer Centre.


METHODS
A total of 2069 participants in smoking cessation clinics held between 1992 and 1999.


METHODS
Eight 90-min sessions over 4 months utilizing education, self-monitoring, a group quit date, and behaviour modification techniques.


METHODS
Cessation rates at 3 months postquit date. Differences between successful and unsuccessful participants on the baseline TTM variables of: stages of change, processes of change, decisional balance and situational temptations, as well as of precessation demographic, smoking history, and smoking behavior variables.


RESULTS
Nonsmokers at 3 months endorsed using more of only one of the processes of change (Reinforcement Management) more than smokers prior to starting the program. They also endorsed more Cons of Smoking and had a more negative Decisional Balance score. When the variables of tobacco tolerance on the Fagerstrom Test for Nicotine Dependence (FTND), marital status, association with the Cancer Centre, and amount of vigorous exercise were first entered in a logistic regression model, Reinforcement Management and Cons of Smoking continued to be predictive of smoking cessation success, but again none of the other TTM variables added explanatory power.


CONCLUSIONS
TTM variables measured prior to program attendance added little predictive value for cessation outcome beyond that explained by demographic and smoking history variables. Future studies may benefit from reassessing the TTM variables at the quit date and the 3-month assessment of smoking status to evaluate how the program impacted these variables.
Department of Psychosocial Resources, Tom Baker Cancer Centre, 1331 29 Street Northwest, Calgary, Alberta, Canada T2N 4N2. lindacar@cancerboard.ab.ca
Linda E
LE
Carlson
Paul
P
Taenzer
Jan
J
Koopmans
Ann
A
Casebeer
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000592:standards*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D012680:Sensitivity and Specificity; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome