Do transtheoretical model measures predict the transition from preparation to action in smoking cessation?

This study tested the predictive value of the Transtheoretical Model (TTM) for the preparation to action stage transition by conducting a detailed examination of changes in TTM components in the days leading up to, and following, a planned quit attempt. Participants were 193 callers to a Quitline telephone service. Only limited support for the TTM was found. Consistent with the TTM, measures of self-efficacy were related to making an attempt and to achieving 7 + days of abstinence. Contrary to the TTM, the behavioral change processes were unrelated to making quit attempts and to short-term abstinence, with the exception of self-liberation, which is conceptually related to self-efficacy. New non-TTM measures assessing commitment to quitting were predictive of outcomes. The results provide strong support for the preparation to action transition being discontinuous, and thus consistent with a stage model. However, they bring into question many of the other postulates of the TTM. Further critical testing and evaluation of the TTM is required.