Associations between the transtheoretical processes of change, nicotine dependence and adolescent smokers' transition through the stages of change

Aims: To examine the significance of the transtheoretical processes of change in predicting transition through the stages of change in adolescent smokers, as well as the relative role of nicotine dependence in predicting stage transitions. Design: In grades 9 and 10, adolescents' stage of change, the use of processes of change and nicotine dependence were assessed (T1). Stage transitions were assessed 1 year later (T2). Response rate was 73.2%. Setting: Twenty-five secondary schools throughout the Netherlands participated in the present study. Participants: Respondents were 721 adolescents who were classified as smokers at T1 and consequently completed the paper-and-pencil questionnaire at T2. Measurements: Stages of change and processes of change were assessed according to the original transtheoretical measures. Nicotine dependence was measured using a newly developed multi-dimensional scale consisting of 11 items. Findings: Few associations were found between the processes of change and stage transitions. Nicotine dependence contributed significantly to the explanation of adolescents' transition from preparation to action, after adjustment for processes of change. No evidence for a moderating effect of nicotine dependence in the relation between the processes of change and stage transitions was found. Conclusions: Processes of change do not seem significant in explaining adolescents' stage transitions. As an alternative for promoting the use of the processes of change for intervention purposes in adolescents, it might be more useful to focus on treating nicotine dependence.

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