Do processes of change predict smoking stage movements? A prospective analysis of the transtheoretical model

Thaddeus A. Herzog, David Brian Abrams, Karen M. Emmons, Laura A. Linnan, William G. Shadel

Research output: Contribution to journalArticle


The transtheoretical model (TTM) posits that processes of change and the pros and cons of smoking predict progressive movement through the stages of change. This study provides both a cross-sectional replication and a prospective test of this hypothesis. As part of a larger study of worksite cancer prevention (the Working Well Trial), employees of 26 manufacturing worksites completed a baseline and 2 annual follow-up surveys. Of the 63% of employees completing baseline surveys, 27.7% were smokers (N = 1,535), and a cohort of these smokers completed the 2-year follow-up. Cross-sectional results replicated previous studies with virtually all the processes of change and the cons of smoking increasing in linear fashion from precontemplation to preparation (all ps <.00001), and the pros of smoking decreasing (p <.01). However, contrary to the hypothesis, the baseline processes of change and the pros and cons of smoking failed to predict progressive stage movements at either the 1- or the 2-year follow-ups. Possible explanations for these findings and concerns about the conceptual internal consistency of the TTM are discussed.

Original languageEnglish (US)
Pages (from-to)369-375
Number of pages7
JournalHealth Psychology
Issue number4
Publication statusPublished - Jul 1999
Externally publishedYes


  • Cancer prevention
  • Health promotion
  • Smoking
  • Social cognitive theory
  • Stages of change
  • Worksites

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Psychology(all)

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