Tobacco Dependence, Tobacco Recovery and the Stages of Change

Researchers DiClemente and Prochaska introduced a five-stage model of change to help us understand addictions and motivation to change. This model is based on observations of how people changed behaviors such as smoking or problem drinking. What is most interesting, to me, about this model, is that the goal for each stage is NOT to quit smoking, but instead, the goal is broken down into smaller, manageable chunks – the goal is to move to the next stage. Seems more do-able to me! The stages are:

• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance
• Relapse

When applied to tobacco dependence and tobacco recovery, The Tobacco Dependence Program developed these Stages of Change statements listed below. I encourage you to place a check mark next to the statement which best describes you and your thoughts and feelings.

• I currently smoke or use tobacco and am certain I do not want to quit. (Pre-contemplation)
• I am willing to think about quitting, but am not sure I am ready to quit now.(Contemplation)
• I am interested in quitting smoking or tobacco use in the next six months, and I would be interested in any assistance I could get.(Preparation)
• I have recently stopped smoking or using tobacco and need to work at not slipping back to using.(Action)
• I have not smoked or used tobacco products for over six months. (Maintenance)
• I have recently begun smoking or using tobacco products after a period of abstinence. (Relapse)

Pre-Contemplation

While we are in the Pre-Contemplation stage, we are not yet willing to change. There is no ambivalence and we have positive associations with smoking. We may deny the problem or rationalize the negative consequences. Our goal is to move from Pre-Contemplation to Contemplation as we explore personal advantages of being tobacco free and think about smoking and the possibility of becoming tobacco-free. We consider what motivates us to stop, what we enjoy most and least about smoking and what might cause us to consider quitting.

Contemplation

During the Contemplation stage, we are thinking about making changes. We experience an internal conflict as we have a desire to stop and fears about stopping all at the same time. We are ambivalent. Our goal is to move from Contemplation to Preparation as we consider why we smoke, personal benefits of stopping, previous attempts, what concerns us most about smoking, what concerns us most about stopping, and gather information about recovery.

Preparation

During the Preparation stage, we are smoking and have decided to stop soon. We are ready and wanting to be tobacco-free, will accept help, may have a quit date, have a quit plan, can envision ourselves as tobacco-free. At the same time, we fear failure. (I quit before and relapsed – what will be different this time??) Our goal is to move from Preparation to Action as we explore what we learned from previous attempts, who might help or hurt our recovery plans, decide quit date information, and explore which situations pose recovery risks. We prepare to live without tobacco and see it as a challenge because for us, everything is associated with tobacco.

Action

During the Action stage, we stopped smoking and all tobacco use. We are committed to recovery, made lifestyle changes, have less urgent and less frequent withdrawal symptoms, and are working through short-term discomfort in order to achieve long-term benefits. We are getting used to being tobacco-free, developing coping strategies, have a relapse prevention plan in place as we continue to deal with any remaining depression, anxiety, withdrawal and frustration. Our goal is to move from Action to Maintenance as we identify what is helping our recovery, what are our next steps, who can support our recovery efforts, what relapse prevention skills work best, and what situations might make it difficult to stay stopped. Our task is to stay stopped, navigate life without tobacco and deal with the fact that we feel that all of our energies are directed at not smoking.

Maintenance

During the Maintenance stage, our recovery is stable and we now identify ourselves as non-smokers. We may occasionally want to smoke. We may find that we now offer information to others or perhaps help others or work with others who want to become tobacco-free. We are aware of relapse triggers and have planned responses for those triggers. We know our high-risk situations and face them armed with an array of recovery tools. Our goal is to become more comfortable in our role as a non-smoker as we explore the changes we have successfully made to stabilize our recovery, note differences in our behaviors and attitude, continue to monitor high-risk situations, and become aware of other issues which may surface. We have broken free from tobacco, know that using other forms of tobacco are unsafe for us, and have taken and continue to take steps to maintain our recovery.

Relapse

Relapse is a part of the stages of change for most of us who become tobacco-free. Relapse is a return to behaviors (smoking) or a return to thoughts about the addiction. Relapse is identified by smoking or other tobacco use after a period of abstinence. But relapse occurs in thought as well – loss of interest in, commitment to or motivation for recovery. We return to old behaviors (with or without tobacco use) and disengage from recovery. Our goal is to contain the relapse, return to recovery and to make the relapse therapeutic – that is – learn from the experience. As we do so, we look at what we learned, what strategies were helpful, shore up our support system, take steps today to get on track and stay on track. Two very important questions are:

• (When we make any decisions) Will this decision help my recovery or hurt my recovery?
• What would I do if I wanted to relapse?

Answers to these questions provide very practical, useful information. Because relapse can occur during any stage, it simply indicates that more work needs to be done at this stage. We must remember that recovery is PROCESS not an EVENT.

I hope that this information on Stages of Change will provide helpful and useful information for you and that it will help you on your journey to becoming and remaining tobacco-free. Until next time, this is Cory the Counselor from the Chicago area signing off for now….and reminding you to stick to it, please don’t give up – you can do it!

« Previous Next »

Back To Profile | Back To Article List