M5 Trans-Theoretical and Precaution Adoption

The International Classification of Diseases regards smoking addiction as a disease. This highlights the need for regular treatment of the disease due to the occurrences of relapse. As such, the psychological aspect of the disease requires treatment. The transtheoretical model (TTM) is considered as a comprehensive and integrative behavioral change model for smoking cessation (Koyun & Eroglu, 2014). When TTM model is used in helping smokers quit smoking, it allows the application of suitable interventions for specific change stages where the individual is involved thereby increasing the success rate (Astroth et al, 2002).

The change phases present the opportunity for making the decisions of a suitable treatment plan for the smoker. Studies indicate that only 7.9% of smokers are capable of quitting without help. On the other hand, the use of medication, behavioral support, and nicotine replacement increase the quit rate to over 35 percent (Karatay et al, 2010). TTM comprises of four constructs. The Stage of Change (SOC) stipulates the individual’s behaviors and thoughts about changing the behavior. The Process of Change (POC) explicates the methods the individual is using while changing the behaviors. Self-Efficacy (SE) elucidates the confidence of the individual regarding how long he will tolerate the craving for smoking. The Decisional Balance (DB) explains the benefits and costs of shifting to the target behavior. Explaining these constructs to individual smokers prepares them psychologically in the quitting process (Siero et al, 2004).

Non-adherence to health behaviors in pursuit of treatment and disease management is common among people attempting to quit smoking. Individual’s failure to adhere to instructions despite knowing the consequences of resistance to change health behaviors. Motivational Interviewing (MI) seeks to help such individuals decide to engage actively in positive health behaviors so that the disease outcomes are affected positively (Kavookjian, n.d.). Non-adherence to smoking cessation stems from some form of ambivalence or resistance.

MI tactics are designed to investigate and resolve the ambivalence that hinders decision making for acts that benefit health. Considering that it is patient-centered, it gauges the readiness of the person to take action on the target behavior, applies specific strategies and skills that value the person’s autonomy, and facilitates decision-making and confidence. The use of MI in smoking cessation stimulates behavior change by inspiring the person’s internal motivation to change while addressing resistance to change (Kavookjian, n.d.).

Concepts that attempt to explicate health behavior by concentrating on convictions about costs and benefits of specific actions are pertinent only to individuals who have been sufficiently engaged by the health risk to have developed such beliefs (Weinstein et al, n.d.). The Precaution Adoption Process Model (PAPM) seeks to establish the stages entailed when individuals start health-protective behaviors and thereby determines the dynamics that lead people to progress from one phase to the next.

The PAPM theory stresses the existence of qualitative disparities among individuals and query whether alterations in health behaviors can be explained by a distinct prediction equation. Considering that quitting smoking is a process, PAPM suggests the development of a series of illustrative equations for every transition stage. The approach presents the likelihood of greater precision, increased intervention effectiveness, and higher intervention efficiency. By presenting the stages that individuals seeking to quit smoking undergo, the model allows the tailoring of interventions based on the stage devoid of the need to scrutinize an array of possible tailoring variables.

The PAPM concept is important for smoking cessation as it allows the facilitator to understand the different stages the individual is dealing with when attempting to quit. For example, a person who quits smoking must contend with acute withdrawal experiences during the early stages. However, the person must contend with the diverse challenges inherent in the maintenance stage. Therefore, the model helps in tailoring appropriate interventions for every stage of smoking cessation.


Astroth, D. et al. (2002). Theories and applications in theory at a glance: A guide for health promotion practice. Journal of Dental Hygiene, 76(4), 286-295.

Kavookjian, J. (n.d.). Motivational interviewing. Science and Practice of Pharmacotherapy, 1-18.

Koyun, A., & Eroglu, K. (2014). The transtheoretical model is use for smoking cessation. European Journal of Research on Education, 130-134.

Siero, F. W. et al. (2004). Periconceptional smoking: An explanatory study of determinants of change in smoking behavior among women in the fertile age range. Health Education Research, 19(4), 418-429.

Weinstein, N. et al. (2008). The precaution adoption process model. Health Behavior and Health Education, 123-147.

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