The Effects of Transtheoretical Model-Based Interventions on Smoking Cessation in Taiwan: A Longitudinal Study

Guo, Su-Er

Purpose: The adverse effects of cigarette smoking have caused a noticeable increase in smoking-related diseases and death globally. The purpose of this study is to assist smokers in smoking cessation with interventions based on the Transtheoretical Model (TTM) and to evaluate the effects of TTM-based interventions on knowledge about the hazardous effects of smoking, attitude toward smoking, and movement through stages of change.

Methods:

In this quasi-experimental longitudinal study, a structured questionnaire was administered pre-intervention (pretest, Time 1), post-intervention (3 months, Time2), and at follow-up (6 months, Time 3). Participants aged 18 years and older were recruited in a regional hospital in Taiwan and divided into 2 groups (experimental group, n = 100; comparison group, n = 100). The interventions involved 6 counseling sessions in 3 months with the implementation of recommendations from a textbook of smoking cessation therapy edited by the Health Promotion Administration (2013), Taiwan. The intervention effect was assessed using the generalized estimating equation (GEE) model with robust standard error and exchangeable working correlation matrix for the adjustment of time. The intervention effect was verified when a significant two-way interaction effect(s) (of time by treatment) emerged, which indicates that a difference exists from pretest to posttest between groups. The TTM stage at each time-point between the study groups was compared using Fisher’s exact test.

Results:

The experimental and comparison groups were homogeneous in the basic variables of demographic characteristics, lifestyle, and disease history. The experimental group showed a greater improvement than the comparison group in scores on knowledge of cigarette smoking. The groups significant differed between Time 1 and Time 3 for the stages of precontemplation, contemplation, and action (P < .01).

Conclusion:

A TTM-based smoking cessation intervention significantly increased knowledge of the hazardous effects of smoking and resulted in improvement in stages of change at a 6-month follow-up among smokers.