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Health Education Research Advance Access originally published online on June 8, 2006
Health Education Research 2006 21(3):305-314; doi:10.1093/her/cyl033
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© The Author 2006. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Smoking and the Ø pattern; predictors of transitions through the stages of change

EF Hoving1,2,*, AN Mudde2,3 and H de Vries1,2

1 Department of Health Promotion and Health Education, University of Maastricht, PO Box 616, 6200 MD, Maastricht, The Netherlands
2 Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
3 School of Psychology, Open University of The Netherlands, PO Box 2960, 6401 DL, Heerlen, The Netherlands

*Correspondence to: E. F. Hoving. E-mail: c.hoving{at}gvo.unimaas.nl

Pre-contemplators, contemplators and preparers have previously been described by distinct scores on pros, social influence and self-efficacy, the Ø pattern. The objective of this study was to replicate this pattern in a sample of adult smokers (n = 554), to longitudinally observe stage sequence and identify predictors for forward and backward stage transition. Three hypotheses were formulated: (i) forward transition from pre-contemplation will be predicted by a higher perception of pros concerning smoking cessation, (ii) backward transition from contemplation will be predicted by a lower perception of pros of quitting smoking and (iii) forward transition from preparation will be predicted by a higher self-efficacy perception concerning smoking cessation. The Ø pattern was replicated successfully. Smokers appeared to be more likely to transition to an adjacent stage than to skip a stage in the sequence. For prediction of stage transition, separate analyses were conducted for pre-contemplators, contemplators and preparers. Respondents transitioning forward were compared with respondents remaining in the same stage or transitioning backward and vice versa. Hypothesis (i) and (iii) were confirmed. Additionally, self-efficacy predicted forward transition from pre-contemplation. Implications towards improving interventions and research concerning stage transition are discussed.


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E. S. Smit, C. Hoving, and H. de Vries
Does a typical contemplator exist? Three clusters of smokers in contemplation
Health Educ. Res., October 21, 2009; (2009) cyp059v1.
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