Thaddeus A. Herzog

According to the transtheoretical model (J. O. Prochaska & C. C. DiClemente, 1983), current smokers can be usefully divided into three distinct stages. Questionnaire items needed for staging smokers contain questions about intentions to quit within fixed time frames (30 days and 6 months) and require "Yes" or "No" responses. However, some smokers might not think of quitting in terms of fixed time frames. If this were the case, these smokers would select "Yes" or "No" arbitrarily and be assigned to stages on the basis of arbitrary responses. This research employed a sample of high school smokers (n = 775) to address this issue by expanding the available responses to the stages of change (SOC) questionnaire items. In addition to "Yes" and "No," smokers were given the option of "Don't know/Undecided." When responding to the 30-day and 6-month questions, 33.1% and 35.8% of smokers, respectively, chose "Don't know/ Undecided." These results suggest that the SOC questionnaire items do not capture qualitative distinctions among adolescent smokers.

To assess the validity of the stages of change (SOC) algorithm for current smokers. This study was a mail-based, cross-sectional survey study of 242 adult smokers. The main outcome measures were the SOC algorithm and a variety of alternative questionnaire items measuring motivation to quit smoking. The results revealed that the SOC algorithm systematically underestimated motivation to quit smoking relative to a variety of other measures. Further, the stages of change do not appear to be qualitatively distinct categories. More than half the precontemplators were contemplating cessation, and many precontemplators intended to quit. Most contemplators were not merely contemplating cessation but rather were trying to quit currently. In summary, there is a divergence between the concepts underlying the SOC - precontemplation, contemplation, and preparation - and the operational definitions of these concepts.

Data from the Working Well trial (n = 2379) were used to test the capacity of 19 variables to predict smoking cessation at 1- and 2-year follow-ups. Among the core constructs of transtheoretical model (TTM), stage of change was the best predictor. The processes of change and the pros and cons of smoking were relatively ineffective predictors. Among other variables, self-efficacy, cigarettes per day, duration of longest quit attempt during the previous year, and the contemplation ladder were the most effective stand-alone predictors. A composite of cigarettes per day and quit duration was particularly effective for predicting cessation. Consistent with Farkas et al. (Farkas AJ, Pierce JP, Zhu SH, Rosbrook B, Gilpin EA, Berry C, Kaplan RM, Addiction 91:1271–1280, 1996), multivariate analyses including the composite variable (cigarettes per day and quit duration) and the stages of change revealed the composite variable to be the better predictor of cessation.

The theory of "alcohol myopia" (C. M. Steele & R. A. Josephs, 1990) suggests that an intoxicated person is disproportionately influenced by immediate, superficial aspects of experience and that effortful, controlled cognitive processing is impaired. The present research examined the effects of alcohol intoxication on social inferences, which refer to perceived reasons, causes, and explanations of events. When asked to focus on the dispositions of others, intoxicated participants tended to exaggerate the extent to which dispositions were influencing behaviors. When asked to focus on the situational conditions in which a behavior took place, intoxicated participants tended to exaggerate the importance of situational influences. The results are consistent with both recent models of social inference and the theory of alcohol myopia.

Smoking-related cues tend to produce urges and cardiac responses in smokers. This reactivity has been assumed to reflect prior classical conditioning. However, little direct evidence exists supporting the notion that environmental cues can be classically conditioned to cigarette smoking. In this study, 8 smokers received 22 daily trials during which 2 cue complexes (comprising visual, olfactory, and auditory stimuli) were paired with smoking (CS+ trials) and not smoking (CS- trials). Reactivity to the environmental cues, as measured by self-report of urge and pulse rate, increased across CS+ trials, diverging from responses in the CS- trials. Reactivity was stronger among light smokers and those who verbalized awareness of smoking contingencies. Findings indicate that environmental cues can be classically conditioned to smoking.