After using one or more of the assessment tools, the professional working with you will have sufficient information to know what you need to quit using nicotine. However, that the professional will not yet know if you are ready to make a serious attempt to quit.
Merely asking "Do you currently smoke?" or "Do you currently chew tobacco?" gathers information about your behavior but not about the thinking behind the behavior. Knowing your thoughts and motivations are crucial to success in quitting smoking or chewing, because advice and treatment must match your stage to be successful.
People who resume smoking or chewing six weeks or more after quitting did not do so because of withdrawal symptoms. Rather, it is generally understood that emotional reasons motivate their relapse.
The "Transtheoretical Model of Change" is based on discrete stages along the continuum of change in many different types of behavior, including all forms of nicotine dependence. These stages are termed precontemplation, contemplation, preparation, action, maintenance and relapse.
Several instruments have been designed to measure your readiness to change. The best known is the University of Rhode Island Change Assessment (URICA). A version of it is available below.
In looking at the chart below, you will note that the behavior named is "smoking." If you are addicted to another tobacco product, or are hooked on nicotine replacement medication, please just substitute yoru product and behavior for the "smoking' words below.
| Summary of Questions To Ask Yourself Based on the Stages of Change | |||
|---|---|---|---|
| Stage of Readiness | Patient response to: "What are your thoughts and feelings about quitting smoking?" | Goal of Intervention | Typical Physician Intervention |
| Precontemplation | "I like to smoke." | Introduce ambivalence | "Your emphysema will improve after you've quit smoking." |
| Contemplation | "I like to smoke, but I know I need to quit." | Resolve ambivalence | "How will your life be better after you've quit smoking?" |
| Preparation | "I'm ready to quit." | Identify successful strategies | "Choose a 'quit day' and let's make plans for it." |
| Action | "I'm not smoking, but I still think about smoking from time to time." | Provide solutions to specific relapse triggers | "How can you deal with your desire to smoke in those situations?" |
| Maintenance | "I used to smoke." | Solidify patient's commitment to a smoke-free life | "This would be a good time to share your experience with other people." |
Precontemplation
People in the precontemplation stage respond with a nonambiguous answer, indicating that they have no intention of changing. Some actual responses by smokers in this stage have been the following:
Anger: "Just get off my back, all right?"
Entitlement: "Who do you think you are to tell me what to do?"
Ignorance: "I already smoke a low-tar cigarette, so there's no need to quit."
Denial: "Some people get lung cancer from smoking, but it won't happen to me."
Defiance: "I'll smoke if I want to."
The goal in the precontemplation stage is to get you to realize your mixed feelings, so you will begin to seriously consider quitting.
Contemplation
People in the contemplation stage usually respond with two answers, one about wanting to quit and the other about wanting to continue smoking. Some actual responses by smokers in this stage have been:
"I want to quit smoking, but I don't think I can."
"I like smoking, but I'm concerned about this cough."
The goal of counseling in the contemplation stage is to explore both sides of your mixed feelings (with the emphasis on how your life will improve after quitting), which helps you move forward with "quitting."
Preparation
People in the preparation stage respond with a nonambiguous answer, indicating that they have reached a resolution. Even though they are still smoking, they have made the decision to quit. They typically respond with statements like these:
"You finally convinced me to quit smoking, Doc."
"I heard there's new medication out to help me quit without the agony I experienced last time."
The goal of counseling in this stage is to assess your previous attempts to quit and identify what worked before (to build on prior successes) and identify the barriers to success that stopped you in the past.
People in the precontemplation stage and patients in the contemplation stage have not yet decided to quit smoking; only people in the preparation stage have reached that point.
Action
The professional's responsibility is to guide you one stage at a time toward the point where you actually stop smoking--which is the action stage. Although this transition takes some people many years, others move from contemplation through preparation and into action within a single clinical encounter.
Where do you want to be in a 2 months? A year? How will you answer these questions so as to make it possible for your treating professional to work with you?
Suggestion: be an adult and be honest. Keep your adolescent self out of it, and tell the truth, the whole truth, and nothing but the truth.