Cross-sectional studies integrating motivational stages with expectancy value models have suggested that contemplating smokers pcrceive more advantages of quitting and social support than precontemplators. Moreover, smokers preparing to quit were found to differ h m precontemplators and contemplators by having higher selfefficacy expectations.Using the ASE model, the present study confirmed the findings of these cross-sectional studies. The longitudinal design of this study, however, facilitated prediction of transitions that smokers made during a 10-month follow-up. Smokers who progressed from precontemplation perceived more advantages of quitting than those who remained in precontemplation. Smokers regressed from contemplation perceived fewer advantages of quitting than those who did not regress. Finally, smokers who progressed from preparation had higher self-efficacy expectations than those who did not progress.In sum, the present study provided longitudinal support for the #-pattern, which suggests tailoring of health educational messages to subjects in the various stages of change.

Although tailored interventions consisting of only a few pages of information lead to more quitting than no intervention in the short term, the long-term efficacy of a single tailored intervention still has to be proven. In the present study smokers were reactively recruited and randomly allocated to one of four intervention conditions: (1) outcome information, (2) self-efficacy enhancing information, (3) both sorts of information or (4) no information. Smokers in the three experimental groups received computer-generated tailored feedback containing the condition-specific information, by mail. The results from the 14 months follow-up can be summarized as follows. Compared to the no information condition, all three experimental conditions led to significantly more smokers who had engaged in 24-h quit attempts. However, no experimental condition led to more 7-day quitting than the no information condition. With regard to continuous abstinence, the experimental condition offering a combination of outcome information and self-efficacy enhancing information had a significant effect, compared to the no information condition. It is concluded that a minimal six-page tailored intervention can be beneficial in supporting smokers to quit smoking, even after 14 months.

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Pre-contemplators, contemplators and preparers have previously been described by distinct scores on pros, social influence and self-efficacy, the Ø pattern. The objective of this study was to replicate this pattern in a sample of adult smokers (n = 554), to longitudinally observe stage sequence and identify predictors for forward and backward stage transition. Three hypotheses were formulated: (i) forward transition from pre-contemplation will be predicted by a higher perception of pros concerning smoking cessation, (ii) backward transition from contemplation will be predicted by a lower perception of pros of quitting smoking and (iii) forward transition from preparation will be predicted by a higher self-efficacy perception concerning smoking cessation. The Ø pattern was replicated successfully. Smokers appeared to be more likely to transition to an adjacent stage than to skip a stage in the sequence. For prediction of stage transition, separate analyses were conducted for pre-contemplators, contemplators and preparers. Respondents transitioning forward were compared with respondents remaining in the same stage or transitioning backward and vice versa. Hypothesis (i) and (iii) were confirmed. Additionally, self-efficacy predicted forward transition from pre-contemplation. Implications towards improving interventions and research concerning stage transition are discussed.

OBJECTIVES: This study examined the reach, effectiveness, and cost-effectiveness of a mass media-led smoking cessation campaign including television shows, a television clinic, a quit line, local group programs, and a comprehensive publicity campaign. METHODS: A random sample of baseline smokers (n = 1338) was interviewed before and after the campaign and at a 10-month follow-up. A nonpretested control group (n = 508) of baseline smokers was incorporated to control for test effects. RESULTS: Most smokers were aware of the campaign, although active participation rates were low. Dose-response relations between exposure and quitting were found. The follow-up point prevalence abstinence rate attributable to the campaign was estimated to be 4.5% after control for test effects and secular trends. The cost per long-term quitter was about $12. CONCLUSIONS: In spite of a massive rise in tobacco promotion expenditures prior to the campaign and the absence of governmental control over the media, the campaign under study may have increased normal cessation rates substantially.

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Objectives:To provide data on the prevalence of cigarette use by male and female South African students of different ethnic backgrounds in grades 8–10 (ages ⩽ 11 to ⩾ 17 years), their age of initiation of cigarette use, as well as their access to cigarettes through underage sales.Design:A nationally representative survey was conducted using self administered questionnaires translated into seven languages.Setting:School based.Participants:Students in grades 8–10 in all of South Africa’s nine provinces.Outcome measures:The prevalence data for current users of cigarettes (smoked on one or more days in 30 days preceding the survey), and for the age of initiation (first smoking cigarettes before the age of 10) were analysed.Results:Of the 160 selected schools, 123 schools participated in the survey. The completed survey comprised 6045 of 7074 selected students; 23% of the sample reported being current users of cigarettes. Significantly more males (28.8%) than females (17.5%), and significantly more “Coloured” students than “Black/African” students were classified as current smokers. Sex was the strongest contributor to the prediction of current smoking status. On the issue of age of initiation, 18.5% of students reported having first smoked cigarettes before the age of 10 years with more “Black/African” students than “Coloured” having done so.Conclusions:In order to tailor tobacco control programmes to the needs of students, historical “racial”/ethnic and sex differences have to be taken into account. Specific determinant studies are needed to understand these differences and to develop appropriate responses.