Elsevier

Addictive Behaviors

Volume 23, Issue 3, May–June 1998, Pages 303-324
Addictive Behaviors

Stages of acquisition and cessation for adolescent smoking: an empirical integration

https://doi.org/10.1016/S0306-4603(97)00074-9Get rights and content

Abstract

Adolescent cigarette smoking acquisition and cessation were integrated into a single nine-stages-of-change continuum using the transtheoretical model of change framework. Findings in a high school student sample (n > 700) showed that a few of the never smokers were planning to try smoking, and half of the current smokers were contemplating quitting. More than half of former smokers were long-term quitters. The high pros of smoking scores assessing coping benefits of cigarettes were related to smoking acquisition and the high con (disadvantages) scores to long-term abstinence. Never smokers were most tempted to try smoking when they anticipated that smoking would help reduce negative and increase positive mood. Current and former smokers were tempted due to peer cigarette offers and negative mood. These temptations were significantly reduced among ex-smokers.

Section snippets

Participants and their recruitment

During the 1992–1993 school year, all 10th and 11th graders who attended vocational-technical training in four high schools in Rhode Island were recruited for a computer-delivered smoking intervention study. Once the schedule of baseline classroom surveys was agreed upon with directors of the schools, parents or guardians were asked to provide passive consent for their child’s participation in the project. Three percent (26 of 971) of the parents or guardians refused their child’s

Current smoking status

Participants were asked to self-define their current smoking status by a single four-response category question. A response alternative “I have never smoked cigarettes” referred to never smokers; “I have tried smoking a few times” referred to experimental smokers; “I used to smoke regularly but I quit” referred to former smokers; and “I am a smoker” referred to current smokers. Responses were cross-validated using standard questions measuring lifetime and current smoking.

A recently emerging

Smoking prevalence

Table 2 presents four different tobacco smoking prevalence indicators in our sample of 10th and 11th graders, in a large statewide high school survey of the same-age students in Rhode Island in 1990–1993 (Hessler, Cavallo, & Buechner 1994) and in a representative national sample of 10th and 12th graders in 1992 (Johnston, O’Malley, & Bachman 1993).

Excluding the ever smoked category, the frequency of cigarette smoking in the last 30 days, in the last 24 hours, and heavy smoking (>1/2 a pack a

Discussion

Our TMC-based and empirically tested nine-stage adolescent smoking acquisition and cessation continuum represents a refinement and extension of previous models that have employed the stage-phase concept to explain adolescent smoking. These models have also defined the stages both by behavior intention and/or overt behavior. The stages have served as a temporal organizational structure in explaining the onset of adolescent tobacco use (Leventhal & Cleary 1980). Progression of smoking acquisition

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