Stages Of Change Research Articles

LIFESTYLE PHYSICAL ACTIVITY IN OLDER WOMEN: ASSOCIATIONS OF CHANGE, SELF-EFFICACY, AND WELL-BEING

Reduction of cardiovascular disease risk in undeserved populations, such as older women, is a top priority of the U.S. Our innovative trial tested a new approach to PA promotion for older women—motivational interviewing (MI), shifting the paradigm from structured exercise to self-selected activities. We present data comparing stage of change (SOC), self-efficacy for exercise (SEE), and well-being: 8 dimensions (physical, social, role limitations, emotional, general mental health, vitality, health perceptions and pain) and associations with physical activity outcomes in the Lifestyle Physical Activity for Women (LPAW) clinical trial. Methods: 106 women, > 60 years old, who did not engage in regular PA, and were not frail, participated in a clinical trial of a tailored MI intervention to increase PA. We report baseline, 3 and 6 month repeated measures and PA associations with SOC, SEE, and well-being (SF36). Results: Of 106 women, 36% were Black and 63% White, with a mean age of 69. Significant improvement in SOC in both arms noted but the proportion in action/maintenance was significantly higher in the PA arm at 3 mos (78% vs. 55%, P=0.045) and 6 mos (79% vs. 50%, P= 0.019). A decrease in SEE for control (p=.001), but not for PA arm (p=.45); at 6 months, The PA arm had greater SEE compared to control. There were significant arm difference for physical component scores of SF36 (p=.02), but not for mental scores. Associations with PA will be tabulated. Conclusions: Preliminary results support the PA intervention, more data to be presented.

The transtheoretical model (TTM) to gain insight into young women's long-term physical activity after bariatric surgery: a qualitative study.

Over the long term, people who have undergone bariatric surgery (BS) remain overly sedentary with inadequate physical activity (PA). The purpose of this study was to apply the transtheoretical model (TTM) to (1) explore in-depth how PA is experienced years after BS and (2) identify the barriers to and facilitators of PA involved at each stage of change (SOC). Seventeen women with a mean age of 32.5 ± 3.3 years and a percentage of total weight loss of 29.6 ± 12.4 were interviewed at a mean of 9.4 ± 3.6 years after BS. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. The distribution of barriers to and facilitators of PA differed with the SOC. In progressing from the precontemplation and contemplation stages to the preparation stage, the women experienced changes in their decisional balance, supported by processes of self-reevaluation and environmental reevaluation. In shifting from preparation to the action and maintenance stages, they experienced intrinsic motivation and self-liberation processes. The relapse stage was associated with a decrease in self-efficacy to cope with life constraints. This study presents an in-depth theory-based exploration of the dynamics of long-term engagement in PA after BS in young women, with clinical implications for providing them with better guidance toward a more physically active lifestyle.

Caregiver-Initiated Mentoring: Developing a Working Model to Mitigate Social Isolation

Contemporary society is characterized by social isolation, polarization, and increased mobility. For many families, naturally-occurring support systems are changing and possibly fading. When parents face child-rearing without adequate support networks, they experience high parenting stress, diminished health, and greater risk of maltreating their children. Children in socially-isolated families are prone to a range of social, emotional, and academic difficulties. Formal mentoring programs can help by connecting children with supportive nonparental adults, but the demand for mentoring outpaces program capacity, and formal mentoring programs are seldom designed to partner with parents. Additional, resourceful approaches are needed. In this study, we explored the potential for developing an approach that fosters parents’ capacity to be gatekeepers to their children’s adult support networks. We used a daylong collaborative workshop to partner with six parents from a low-income housing service and five youth-serving professionals from the community. Participants generated potential strategies by which parents can cultivate informal mentoring relationships and identified specific ideas for helping parents (a) see the value of actively seeking informal mentors, (b) recognize and manage potential risks, and (c) identify and make requests of potential informal mentors. Findings from our workshop were used to develop a Caregiver-Initiated Mentoring approach that could be utilized by clinical social workers and other helping professionals. The approach integrates our findings with empirical research from youth mentoring and conceptual underpinnings from parent help-seeking models, the Transtheoretical Model of Change, and Motivational Interviewing.

UK Postal Delivery Workers' Occupational Sun Safety: Using Behavior Change Theories to Identify Intervention Pathways.

Postal delivery workers have substantial sun exposure. In the United Kingdom (UK) a high proportion of workers possesses a sun sensitive skin type. This population is at elevated risk for skin cancer, yet uptake of sun safety practices is low. Studies are needed to identify the underlying factors that contribute to the uptake of occupational sun safety practices that may be targeted during behavior change interventions. This study integrated the Theory of Planned Behavior (TPB) and the Transtheoretical Model’s stages of change (SoC) as guiding frameworks to identify underlying beliefs that influence UK postal delivery workers’ uptake of occupational sun safety practices. Thirty-four workers participated in semi-structured interviews that used the SoC to establish current receptiveness to and adoption of two sun safety practices (using sunscreen of at least sun protection factor (SPF) 30 on exposed skin and wearing a wide-brimmed hat when working outdoors in the summer). Beliefs underlying current practices were elicited in accordance with the TPB and stratified by the SoC. For sunscreen use and wearing a wide-brimmed hat, 64% and 3% of participants were in the action or maintenance SoC, respectively. Behavioral and control beliefs differed by SoC, with those in the earlier stages more likely than those in the latter stages to report negative attitudes to, and difficulty enacting, sun safety practices. Normative beliefs concerning the views of colleagues and employers towards sunscreen were relatively consistent across the SoC. This study highlights the need for tailored and targeted behavior change interventions. The SoC-stratified accounts of the influence of TPB components on behavior provide a basis for bespoke interventions that reflect inter-individual and inter-practice differences in their working mechanisms.

Engaging Youth (Adolescents and Young Adults) to Change Frequent Marijuana Use: Motivational Enhancement Therapy (MET) in Primary Care

PurposeTo characterize information elicited from adolescent/young adults with frequent cannabis use in Motivational Enhancement Therapy (MET), and determine whether differences exist across stages of change (SOC) for reducing use. Design and methodsPrimary care patients 15–24 years old using cannabis ≥3 times/week enrolled in a pilot randomized intervention trial. All youth were offered two 1-hour MET sessions. Content analysis was used to code and categorize main reasons for use, alternative behaviors, goals, values, pros and cons of change, and compared results between youth in Pre-Contemplation vs. Contemplation SOC. ResultsFifty-six youth completed MET session 1, 46 completed session 2. Most reported their main reason for use was related to emotional coping, negative feelings were a top-3 trigger, and distraction was an alternative way to meet their needs. Youth most frequently described progress in education or career/job as 1-year goals. More than half identified family as a very important value. They most frequently reported pros of using less related to achieving goals, self-improving, and saving money, and a con related to stress/coping. Compared to youth in Pre-Contemplation SOC, those in Contemplation were more likely to identify relationships as both a pro and con of using less cannabis. ConclusionsMET can reveal developmentally appropriate goals, healthy values, and ambivalence about cannabis use that can be used to facilitate movement along the stages of behavior change toward reduction/cessation. Practice implicationsBrief motivational therapy can be used in primary care to gather information important in helping youth to reduce cannabis use.

Mécanismes d’action du groupe d’entraide des Alcooliques Anonymes

ObjectivesAlcoholics anonymous is a widespread mutual help group, which has helped many alcoholics to stay abstinent, but remains controversial due to the spiritual nature of its program. However, it is unlikely that the success of alcoholics anonymous in helping people with alcohol-related disorder remain sober is due solely to spiritual principles. Hence, the aim of the current study was to show that alcoholics anonymous mutual help groups activate mechanisms of action similar to those in cognitive-behavioral therapy and motivational interviewing. Materials and methodsFirst, parallels were established between the transtheoretical model of change and the program of alcoholics anonymous to illustrate the mechanisms by which this mutual help group potentiates cognitive and behavioral changes in people with alcohol-related disorder. Then a questionnaire was used to investigate cognitive and behavioral mechanisms as well as social changes and modifications to depressive and anxious symptoms, in a sample of sober members of alcoholics anonymous. ResultsResults show a notable improvement in the participants’ anxious and depressive symptomatology. In addition, positive changes to the management of negative affect and the management of personal relations were found. The self-efficacy score in this population was higher than that reported in previous studies, which suggests that members of alcoholics anonymous develop high self-efficacy, which can partly be explained by the cognitive, behavioral and social changes generated by the alcoholics’ anonymous program. Changes in the composition of the social environment were observed and showed an increase in the number of close friends as well as an increase in the number of abstinent people in the social circle of the participants in this sample. ConclusionsThis study shows that cognitive, behavioral and social factors contribute to the success of alcoholics anonymous in helping people with alcohol-related disorder stay sober. Hence, alcoholics anonymous mutual help groups can constitute a helpful addition to the maintenance of abstinence in individuals with alcohol-related disorder, during but especially, after professional treatment is completed.

The inclusive family support model: Facilitating openness for post‐adoptive families

AbstractOpen adoptions have increased over the past few decades, and although guidance for considering and creating open adoption agreements exist, one area of needed post‐adoption support is helping adoptive birth/first families navigate open‐adoption relationships after finalization. Adoption agencies have a responsibility to assist adoptive parents, who may have fears and concerns about openness, see the potential benefits rather than only the challenges. This article describes a practice model designed by one agency to help families navigate post‐adoption openness. The Inclusive Family Support model is conceptualized through the theoretical perspectives of family systems theory, ambiguous loss and disenfranchised grief, and the transtheoretical model of change. We highlight the major dimensions of the model, how it will be implemented and evaluated at one agency, and discuss implications for practice and policy.

What motivates people with substance use disorders to pursue treatment? A patient-centered approach to understanding patient experiences and patient-provider interactions

ABSTRACTObjectives: To identify and define potential positive and negative factors in patient experiences and patient-provider interactions that are associated with the pursuit and maintenance of treatment by those suffering from substance use disorders (SUD).Methods: Two focus groups with patients in treatment for SUD were performed. The focus groups focused on questions aimed at mapping factors associated with initiating and maintaining treatment along the transtheoretical model of change. Four in-depth interviews with healthcare providers involved in the treatment of patients with SUD were also conducted to understand providers’ perspective on similar factors.Results: Fourteen patients were included in the focus groups. Patients identified their life prior to treatment as chaotic and further identified internal and external factors that influenced seeking treatment. The four healthcare providers identified primarily social issues such as lack of housing as an external barrier. Both patients and providers cited the importance of a trusting and empathetic relationship between the patient and providers, as well as the patient’s willingness to change as primary motivating factors for the initiation and maintenance of treatment.Conclusions: From a patient and provider perspective, facilitators and barriers for initiating and maintaining may vary by person and are multifactorial.

A Tailored Behavioral Intervention to Promote Adherence to the DASH Diet.

Objectives: In this study, we evaluated the effects of a Transtheoretical model (TTM)-based tailored behavioral intervention (TBI), a non-tailored intervention (NTI) or usual care (UC) on: (1) the Dietary Approaches to Stop Hypertension (DASH) dietary pattern in 533 individuals with uncontrolled hypertension; and (2) the change from baseline to 6 months in proportion of participants in action or maintenance stages of change (SOC). Methods: This was a randomized clinical trial. Diet was evaluated using the validated Harvard DASH score calculated from Willett Food Frequency Questionnaires (range 8-40). The randomized groups were compared using the Wilcoxon rank-sum test, with adjustment for clustering by physician and baseline DASH scores. Results: At 6 months, compared to UC, TBI had a 1.28 point increase in DASH score (p ≤ .01) while NTI was not significant. At 6-month follow-up, TBI was more effective in advancing dietary SOC when compared to UC (56% vs 43%, p < .01) and NTI was not effective (46% vs 43%, p = .64). Conclusions: A phone-delivered tailored TTM-based intervention achieved greater improvement in DASH score and dietary SOC, suggesting that TTM-based tailored interventions can increase patients' dietary adherence.

Rationale and design of a study to test the effectiveness of a combined community health worker and text messaging-based intervention for smoking cessation in India (Project MUKTI).

Nearly 275 million individuals in India consume tobacco every day, with more than 1 million dying annually as a result. Few people in India have access to smoking cessation services, an essential component of combating tobacco use globally. We hypothesize that a strategy of systematic community health worker (CHW) based counseling that covers eligible people who smoke in a geographical area, combined with text messaging support, will result in improved quit rates. The study is a cluster randomized controlled trial that will be conducted at 2 sites in India. Sixteen clusters will be randomized into either an intervention or control arm. A total of 560 smokers between the age of 18 and 70 will be recruited from their home through CHWs. Smokers at all stages of change will be offered the intervention, which is based on the transtheoretical model of change. Pre-contemplative participants will be offered health education and motivational interviewing through CHWs. They will also be offered a low frequency form of text messaging, focused on health education and the benefits of quitting. Participants who are actively contemplating quitting smoking will be offered a more intensive intervention, with more frequent visits by CHWs and more intensive text messaging support. Contemplative participants will be encouraged to set a quit date, and all participants will be assessed periodically for stage of change to provide the appropriate intervention. Participants who set a quit date will be encouraged to use NRT to help with quitting. Control group participants are provided with brief smoking cessation advice only, at the start of the trial. The primary outcome will be self-reported abstinence for the past 14 days, biochemically verified by exhaled CO levels (cut-off 10 ppm) assessed at the end of 1 year of the intervention. We will test whether a CHW-based intervention that incorporates motivational interviewing, text messaging and supportive counseling can prove effective in systematically helping smokers quit.

The Enacted Narrative: A Group-Based Trauma Repair Approach for Veterans Who Have a Post-Traumatic Stress Injury

In this 2017 John McKendy Memorial Lecture, Dr. Marvin Westwood discussed two group-based interventions for veterans who have a post-traumatic stress-injury—guided autobiography and therapeutic enactment—as a trans-theoretical model for change. Narrative-based therapeutic enactment has been highly effective for traumatized individuals—both military and civilian. The presentation included video clips illustrating how the approach is applied in work with Canadian veterans who have operational stress injuries.

Attitudes, self-efficacy and intention towards tobacco cessation in Spanish college students

To determine attitudes towards smoking, perception of self-efficacy, and the intention of smoking cessation in college student smokers, and their variation according to the stage of the tobacco cessation process. Cross-sectional study with 255 college students (18-24 years old) smokers of =1 cigarette per week. Instruments used: a personal interview, Fageström test, trans-theoretical change model, scale of Attitudes, self-efficacy and intention to quit smoking in college smokers and CO in exhaled air. Sample with a majority of women (62%), average age 20.3 years, users of 9.2 cigarettes/day for 5.7 years, with mild dependence on nicotine; 69% were in the stages of pre-contemplation and contemplation. Although smoking was considered to be negative for health and the environment for more than 70%, and 96.7% had negative attitudes towards tobacco, only 45.1% were aware of the associated morbidity and mortality. More than 60% considered tobacco to be a social facilitator, thus anxiety (72.6%) and having friends who smoke (69.4%) are factors considered negative for tobacco cessation. Ninety-one percent believed that they would smoke next year, but 86% stated that they would not be a smoker within five years. One hundred percent of the subjects in pre-contemplation considered that they will smoke during the next year as opposed to 83.5% of those in the stage of preparation. College student smokers show positive attitudes, erroneous beliefs and a low perception of self-efficacy about smoking cessation. All students in the pre-contemplation phase do not even consider smoking cessation in the medium and long term.

Improving Stage of Change in an Employee Wellness Program.

Physical activity readiness of front-line employees caring for adults with disabilities (N = 381) improved during a two-phase project based on stages of change (SOC) theory. In Phase 1, we assessed barriers to, and readiness for, participation in an employee wellness program. We collected data from workers using focus groups and a preintervention physical activity readiness survey. Focus groups (N = 14) identified barriers, including lack of communication about the employee wellness program. With respect to their SOC (N = 82), 7% were in precontemplation, 16% in contemplation, 52% preparation, 5% in action, and 20% in maintenance SOC. In Phase 2, we aimed to improve readiness for participation in the program. We used SOC-based employee Facebook group messages, a health education fair, and measurement through a postintervention physical activity readiness survey. The mean number of "views" in which the workers saw the 16 theory-based messages was 12.2 (range = 0-27). Fourteen adults and 17 children attended the fair. Postintervention survey results (N = 125) indicated physical activity readiness improvement with 1% in precontemplation, 21% in contemplation, 33% in preparation, 33% in action, and 12% in maintenance SOC.

Application of nursing intervention based on transtheoretical model and stages of change in breastfeeding for primiparas

Objective To explore the effect of nursing intervention based on the transtheoretical model and stages of change on breastfeeding knowledge, self-efficacy, and duration of breastfeeding in newly born pregnant women, aimed to provide reference for breastfeeding behavior health education model for pregnant women. Methods The 130 primiparas who came to the hospital graded a class- three of Shanxi Province for perinatal examination were selected as the research subjects from May to June in 2017, they were divided into test group and control group by random digits table method. In the control group, the normal breastfeeding health guidance was carried out in the three stages of prenatal, hospitalized and after discharge. The test group divided the primipara from the beginning of pregnancy to 6th months postpartum period into 5 stages according to transtheoretical model and stages of change. The new strategy of breastfeeding should be formulated and implemented according to different stages and behavior changing processes. Results The total score of breastfeeding knowledge of primipara were (8.76±1.14), (8.92±1.21), (9.90±1.27), (9.94±1.29) points in control group before intervention, the 3rd day, the 42nd day and the 6th month after delivery, and they were (9.11±1.42), (12.02±1.64), (13.04±1.67), (15.00±1.83) points respectively in test group, the differences were statistically significant(Ftime= 51.823, Fgroup=10.406, Finteractive=56.641, all P < 0.05). The total scores of breastfeeding self-efficacy of primipara were (84.62±1.14), (88.96±1.41), (86.65±1.47), (84.31±1.57) points respectively in control group before intervention, the 3rd day, the 42nd day and the 6th month after delivery, while in test group they were (84.98±1.20), (104.02±1.42), (111.00±1.45), (120.04±1.40) points, the differences were statistically significan (Ftime=12.592, Fgroup=229.674, Finteractive=79.955, all P<0.05). The pure breastfeeding rates of primipara were 60.0% (33/55), 41.8% (23/55), 21.8% (12/55) in control group on the 3rd day, the 42nd day and the 6th month after delivery, they were 84.7% (50/59), 76.3% (45/59), 49.2% (29/59) in the test group. The differences was statistically significant (χ2=8.804, 14.038, 9.235, all P <0.01). Conclusion Breastfeeding intervention based on the theory of behavioral staged transition can help primipara to improve breastfeeding knowledge and self-efficacy, and improve breastfeeding status. Key words: Breast-feeding; Transtheoretical model and stages of change; Nursing care; Intervene

Electric vehicle rental and electric vehicle adoption

This case study describes the project Elbilslandet (The Electric Vehicle Country) in Gotland, Sweden, where the island Gotland is made “ready for electric vehicles” by providing a network of charging infrastructure and electric vehicle rental during several summer seasons. The influence of the electric vehicle (EV) rental scheme on the process towards electric vehicle adoption is investigated using the Protection Motivation Theory (PMT) and the Transtheoretical Model of Change (TTM). Moreover, the travel patterns of electric rental cars are compared with those of conventional rental cars. The main results of this study are the following: Firstly, people renting an EV are on average closer to electric vehicle adoption than people renting a conventional vehicle. Secondly, people who rent an EV are at the time of rental associated with more positive attitudes towards EVs, have more knowledge about EVs and would feel more secure driving an EV. Thirdly, EV-rental does not seem to have a large additional effect on the stage-of-change towards EV-adoption of the participants. Lastly, the driving patterns of EVs do not seem to indicate serious limitations regarding driving distance, parking time and the destinations that have been visited, as compared to the driving patterns of conventional rental cars.

Using the transtheoretical model's stages of change to predict medication adherence in patients with type 2 diabetes mellitus in a primary health care setting.

Qatar is currently experiencing a worrying increase in the prevalence of diabetes mellitus (DM). One of the most common reasons for uncontrolled DM is non-adherence to medications. The socio-behavioral intervention has proven effective in some chronic illnesses. To assess the stages of change (SOC) and medication adherence scores of type 2 diabetes mellitus (T2DM) patients visiting primary healthcare institutions in Qatar, and to evaluate the cause and effect relationship between SOC and adherence to antidiabetic medications. The 8-item Morisky Medication Adherence Scale (MMAS-8) was used to assess medication adherence, and a 2-item SOC questionnaire was utilized to classify the SOC. The analysis to determine if the SOC could predict medication adherence while controlling for demographic characteristics, total number of prescribed medications and disease duration was done using hierarchical multiple regression. The final analysis included 387 patients. In relation to medication adherence, majority of the patients were in the maintenance stage (76.7%), followed by the preparation stage (14.7%), the action stage (3.9%), the contemplation stage (3.4%) and the precontemplation stage (1.3%). Most of the patients were in high adherence towards antidiabetic medications (50.3%) followed by low level (26.4%) and medium level (23.3%). SOC was significant and positively predicted medication adherence, which accounted for around 58 to 60% (p < 0.001) while controlling for covariates. SOC was significant and positively predicted medication adherence. The study recommends that the SOC questionnaire could potentially be used to identify patients at risk for low adherence.

Views on Public Transport and How Personal Experiences Can Contribute to a More Positive Attitude and Behavioural Change

To reduce car usage, several strategies are needed, one of which focuses on social psychological factors. The aim of this study was to predict and explain bus usage using the theory of planned behaviour and the transtheoretical model of change in a sample of 983 residents. The study also evaluated the effect of providing a group of regular car users (n = 34) with a free travel pass, to be used on busses and trains in the region. A regression analysis showed that the theory of planned behaviour (TPB) explained 26% of the variance in intention to use the bus, increasing to 59% when past behaviour was added. The use of the free travel pass resulted in a more positive attitude towards bus usage, with a large number having either changed or having started to change their behaviour. When the same people were contacted three months later, 50% still used public transport. The conclusion is that negative attitudes and travel habits can be altered by experience. Although, a reduction of car use can only be achieved if several measures are implemented that make car driving less attractive and sustainable modes of transport more attractive.

Predictors of Unhealthy Alcohol Consumption Behavior in Canadian Men

Aims Men are more likely to engage in alcohol consumption, which can have long-term consequences. The objective of our study was to sample Canadian men to determine predictors of hazardous alcohol hazardous as well as predictors for change. Methods Canadian men were surveyed investigating demographics, medical comorbidities, health behaviours, and willingness to change. Alcohol consumption was classified based on validated Audit-C scoring (&gt;3 was positive for dependency or abuse). Stages of change were classified based on the transtheoretical model of change (pre-contemplation, contemplation, preparation, action, and maintenance). Multivariate regression was performed to determine demographic factors as predictors for consumption and change. Results After exclusions and sample stratification, 2000 participants were included. Participants were aged 19–94 (median 48, IQR 34–60). Approximately 773 (38.7%) screened positive based on Audit-C scores. On multivariate analysis, minority status, age, work, income, retirement, living situation, geographic location, and level of education were associated with hazardous drinking. Of those engaging in hazardous drinking, the majority were in pre-contemplation or contemplation 488 (63.1%). On multivariate analysis, various demographic factors were associated with the five stages of change. Conclusion Our study illustrates that approximately 40% of men screen positive for unhealthy drinking behaviour and associated demographic risk factors for those at highest risk. The majority are in the earliest stages in transtheoretical model for change (&gt;60%), and there exist only a few associated demographic risk factors. This warrants awareness of this national problem, insight for patient education and targeted interventions to address hazardous behaviour and reduce morbidity and mortality.

PUSAT INFORMASI DAN KONSELING GERAKAN BEBAS NARKOBA REMAJA MUHAMMADIYAH

Drug prevention in adolescent Muhammadiyah can be implemented through a school program. School programs need to work with school counselors to establish a Skills-Based Free Drug Information and Counseling Center. The method used in Information and counseling center is (1) education, (2) training, and (3) forum discussion group. Peer guidance, peer support, and peer counseling centers with counselors on skills-based students. Cognitive, affective, and skill dimension as the main goal of the drug-free movement. Skills developed in students are open-ended questions, listening to reflection exercises, role-playing, motivational interview skills, and model stages of change.

Association between stages of change for smoking cessation and electronic cigarette use among adult smokers: A nationwide cross-sectional study in Korea.

This study aimed to investigate whether smokers who are ready to quit are more likely to use electronic cigarette (e-cigarette) than those who are not. The association between the ever and current use of e-cigarettes with the stages of change (SOC) model was examined, which reflects the readiness to quit smoking. Current smokers were categorized based on the SOC (precontemplation, contemplation, and preparation). We investigated the associations between quit attempts, intention to quit, and stage of change with e-cigarette use in the general population and different age groups. We used data from the Korea Community Health Survey that was conducted nationwide in 2014, and 45,378 current smokers were included in the study. Adult smokers were more likely to use e-cigarettes simultaneously in the preparation and contemplation stages than in the precontemplation stage (adjusted odds ratio [AOR] of preparation stage: 2.88 and 95% confidence interval [CI]: 2.26–3.66; AOR of contemplation stage: 1.93 and 95% CI: 1.67–2.24). Ever use of e-cigarette was significantly associated with the contemplation stage in smokers younger than 50 years, while current e-cigarette use was greater in the contemplation stage than in the precontemplation stage at all ages. Both ever and current use of e-cigarettes were significantly related with the preparation stage among all age groups except 50–59 years. Because the use of e-cigarette among smokers may continually increase, public health guidance must be provided to different types of dual users. Previous studies on the association between e-cigarette use and the cognitive and behavioral aspects of smokers have conflicting results. This study highlights whether the use of e-cigarettes can be used as an indicator for the readiness to quit smoking. Thus, counselors can encourage smoking cessation and provide tailored interventions.