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The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Thursday, July 13, 2006 - 12:00 PM

The Transtheoretical Model of Behaviour Change applied to Adolescent Smoking: A Systematic Review

Andy Graham, MSc, Smoke Free North East, Civic Centre, Newcastle Road, Chester le Street, England

Objective: The success of adult cessation services in the UK based on the stages of change or Transtheoretical Model (TTM) has led researchers to question whether this approach can be applied to adolescents. This paper documents the results of a qualitative systematic review of studies based on stage of change/TTM, addressing smoking cessation and adolescents. The objective is to provide professionals seeking to develop interventions for adolescent smokers, with a source of evidence of effectiveness of this approach.

Methods: Systematic review has long been established as a way of synthesizing best evidence on a subject. This paper reports the stages involved in systematic review: question formulation, searching the literature, screening, examination, quality assessment and data extraction, and how these were applied to adolescent smoking cessation studies using the TTM/stages of change model. Studies of varying design and methodological quality were located and were summarised in tabular form.

Results: The review located 12 studies falling into two groups: those seeking to validate the constructs of the TTM, and those reporting the results of interventions based on the TTM/stages of change. A synthesis of emergent issues concluded that while the validation studies broadly supported the constructs of the TTM, intervention studies provided inconclusive results or failed to support the TTM over other conditions. Study quality varied widely. Sample size was often small, highlighting difficulties with recruitment, problems were apparent with the measurement of stage of change, and theoretical fidelity across the studies was not consistent.