title: Understanding treatment-seeking smokers' motivation to change: content analysis of the decisional balance worksheet.
abstract: The Decisional Balance Worksheet (DBW), an open-ended measure of motivation to change, may be used to record the pros and cons of smoking versus abstinence among treatment-seeking smokers. Recent findings indicated that the open-ended DBW could be quantified to validly reflect people's level of motivation to stop smoking (Collins, Eck, Torchalla, Schröter, & Batra, 2010). The goal of the current study was to enhance our understanding of these participants' motivation to change by examining the qualitative content of their decisional balance. Participants were treatment-seeking smokers (N=268) who had participated in a larger randomized controlled trial of tailored smoking cessation interventions (Batra et al., 2010). Using the DBW, participants recorded their pros and cons of smoking versus abstinence, and content analysis methods were used to extract common themes. Findings indicated that the physical and psychological effects/functions of smoking and abstinence were most commonly mentioned as both pros and cons. Although the decisional balance categories were substantively similar over time, their relative frequency shifted from pre- to posttreatment. For the sample as a whole, the number of pros of smoking generally decreased, whereas the pros of abstinence increased from pre- to posttreatment. Findings suggest that clinicians can expect certain perceived pros and cons to characterize their clients' decision-making process about smoking and abstinence. At the same time, the use of the decisional balance allows for assessment of individuals' unique motivational set.
authors.affiliation: Department of Psychiatry and Psychotherapy, Section of Addiction Research and Addiction Medicine, University Hospital Tübingen, Calwer Str. 24, D-72076 Tübingen, Germany. collinss@uw.edu
authors.forename: Susan E
authors.initials: SE
authors.lastname: Collins
authors.forename: Sandra
authors.initials: S
authors.lastname: Eck
authors.forename: Iris
authors.initials: I
authors.lastname: Torchalla
authors.forename: Martina
authors.initials: M
authors.lastname: Schröter
authors.forename: Anil
authors.initials: A
authors.lastname: Batra
mesh_terms: D000328:Adult; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires