Prepared by Amelia Lee
Before initiating any smoking cessation intervention, it is essential to assess an individual’s readiness to change. The Transtheoretical Model (TTM), also known as the Stages of Change Model, offers a valuable framework for understanding where a person is in their behavior change journey. This model outlines five core stages:
- Precontemplation: The individual does not yet see smoking as a problem and has no immediate intention to quit.
- Contemplation: The person is aware of the risks of smoking but remains ambivalent about change.
- Preparation: The individual intends to take action soon and may begin small steps, such as cutting down.
- Action: Active efforts are made to quit and change behavior.
- Maintenance: Focus shifts to sustaining abstinence and preventing relapse.
Tailoring support according to the stage of change is essential for effective intervention. For those in precontemplation, the goal is to raise awareness and spark curiosity about change—without confrontation. In the contemplation stage, exploring the pros and cons of smoking helps resolve ambivalence. Preparation involves developing a clear action plan, setting quit dates, and identifying support systems. During the action stage, providing encouragement, strategies for coping with cravings, and reinforcement is key. In maintenance, it is important to focus on building long-term resilience and preventing relapse.
Alongside this model, the Spirit of Motivational Interviewing (MI) provides the guiding mindset that shapes practitioner–patient interactions. The spirit of MI rests on four pillars:
- Partnership: Working collaboratively, not authoritatively.
- Acceptance: Honoring the patient’s autonomy and individuality.
- Compassion: Prioritizing the patient’s welfare and showing genuine care.
- Evocation: Drawing out the patient’s own motivations and values.
This person-centered approach helps create a safe, empathetic, and respectful environment where patients feel empowered to share openly. When healthcare professionals embody this spirit, it enhances trust, reduces resistance, and supports lasting behavior change. By combining the TTM framework with the core principles of MI, practitioners can deliver tailored, compassionate, and effective support that meets individuals where they are in their journey toward smoking cessation.
