Abstract

The stages of change construct refers to the different psychological states people move through when they change their behaviour. However, the prediction that people in different stages of change need different sorts of interventions to stimulate the change process has scarcely been tested prospectively. An indirect test of this hypothesis would need to assess whether there are stage-specific psychological determinants of forward stage transition. Smoking and quitting history, demographics, three potential psychological determinants of stage transition and stage of change were assessed in over 700 smokers and ex-smokers (T1). After eight months (T2), stage of change was reassessed. The cross-sectional relationships between two of the three psychological measures and stage of change were largely non-linear. In the main prospective analyses on forward stage transition, stage-specific determinants were identified for three of the four possible forward stage transitions. Furthermore, for three of the four possible backward stage transitions, stage-specific determinants of backward stage transition approached significance. For the contemplation stage, none of the determinants under investigation were found to be related to either forward or backward stage transition. The present data indirectly support the notion that stage-specific interventions should target stage-specific determinants of stage transition in smoking behaviour. However, with regard to smokers in the contemplation stage-who comprise a large proportion of smokers in Western countries-no conclusions can be drawn.

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