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Open AccessArticle

Characteristics in Stages of Change and Decisional Balance among Smokers: The Burden of Obstructive Lung Diseases (BOLD)-Australia Study

1
School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
2
Department of ParaClinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago
3
Western Health, Footscray 3011, Australia
4
Respiratory and Environmental Epidemiology Group, Woolcock Institute of Medical Research, University of Sydney, Sydney 2037, Australia
5
Sydney Local Health District, Camperdown 2050, Australia
6
South Western Sydney Clinical School, University of New South Wales, Sydney 2052, Australia
7
School of Medicine, University of Tasmania, Hobart 7005, Australia
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(18), 3372; https://doi.org/10.3390/ijerph16183372
Received: 16 July 2019 / Revised: 4 September 2019 / Accepted: 6 September 2019 / Published: 12 September 2019
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Smoking cessation remains a health promotion target. Applying the Transtheoretical Model to Australian Burden of Obstructive Lung Diseases (BOLD) data, we examined differences in stages of change (SoC) and readiness to quit decisional behaviours. Factors were identified likely to influence readiness of smokers, ≥40 years old, to quit. Analysis was restricted to current smokers classified to one of three stages: pre-contemplation (PC), contemplation (C) or preparation (P) to quit. Their ability to balance positive and negative consequences was measured using decisional balance. Among 314 smokers, 43.0% females and 60.8% overweight/obese, the distribution of SoC was: 38.1% PC, 38.3% C and 23.5% P. Overweight/obesity was associated with readiness to quit in stages C and P and there were more negative than positive attitudes towards smoking in those stages. Males were significantly heavier smokers in PC and C stages. Females used smoking cessation medication more frequently in PC stage, were more embarrassed about smoking and had greater negative reinforcements from smoking. Age started smoking and factors related to smoking history were associated with readiness to quit and increased the odds of being in stage C or P. An overweight/obese smoker was likely to be contemplating or preparing to quit. In these stages, smokers have more negative attitudes toward smoking. Starting smoking later, taking advice on cessation from health providers and using quit medications indicate increased readiness to quit. Evaluating these factors in smokers and developing cessation gain-framed messages may prove useful to healthcare providers. View Full-Text
Keywords: stages of change; decisional balance; smoking cessation; gender difference; Burden of Obstructive Lung Disease (BOLD) stages of change; decisional balance; smoking cessation; gender difference; Burden of Obstructive Lung Disease (BOLD)
MDPI and ACS Style

Ivey, M.A.; Maguire, G.P.; Toelle, B.G.; Marks, G.B.; Abramson, M.J.; Wood-Baker, R. Characteristics in Stages of Change and Decisional Balance among Smokers: The Burden of Obstructive Lung Diseases (BOLD)-Australia Study. Int. J. Environ. Res. Public Health 2019, 16, 3372.

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