chapter. Self-liberation means comm

chapter. Self-liberation means committing to a quit date, in this
case).
The trial outcomes, stage of change and smoking status, were
measured by paper and phone administered questionnaires 12
months from baseline. Smoking status was defined as 24-h point
prevalence abstinence or 6-month sustained abstinence, both selfreport
and confirmed by salivary cotinine less than 15 ng/ml. For
the analysis for change in stage, we calculated the percentage
making positive movements for the control arm and all TTM arms
combined, calculating odds ratios (OR) and 95% confidence intervals
(CI) for the difference without and with adjustment for
potential confounders. These were trial (four-arm versus threearm),
gender, age, ethnic group, educational attainment, social
class, cigarette consumption, Nicotine Dependence (Heatherton,
Kozlowski, Frecker, & Fagerstrom, 1991), and partner smoking
status. We calculated the mean score and difference for change in
stage score. For the analysis on stage matching, we calculated the
percentage quitting and making positive movements in stage,
calculating odds ratios and 95% CIs using logistic regression. The
hypothesis was that the greater relative effect of the TTM-based
interventions would be evident for participants allocated to the
stage-matched TTM arms than to the control arm. This was tested
by a multiplicative interaction term and the c2 test for including
this in these regression equations. Those with missing starting
stage were necessarily excluded from these analyses. For the
analyses, we grouped together all TTM-based intervention arms, as
there was no evidence that the phone or nurse components
affected quit rates. The results were examined only in those followed
up (76.4%) and all those, imputing missing data as smoking
and no change in stage as appropriate. There were no significant
differences in stage of change or smoking-related variables
between those not followed up and those that were. However,
those who were lost to follow up were statistically significantly
more likely to have incomplete data on baseline characteristics,
Table 1
Baseline distribution of stage UK, 1998/9
Control, n (%) TTM, n (%)
Manual Phone Nurse All TTM
combined
Precontemplation 316 (45.8) 303 (44.4) 310 (45.3) 202 (48.9) 815 (45.8)
Contemplation 247 (35.8) 275 (40.3) 248 (36.2) 152 (36.8) 675 (37.9)
Preparation 94 (13.6) 69 (10.1) 86 (12.6) 40 (9.7) 195 (10.9)
Not able to stage 33 (4.5) 36 (5.3) 41 (6.0) 19 (4.5) 96 (5.4)
PC C P A M
------ CR ------
------ DR ------
------ ER ------
SR
SL
------ CM ------
------ HR ------
------ CC ------
------ SC ------
Fig. 1. Processes of change needed to move from each stage.
Table 2
Processes of change and their definitions related to smoking
Process Definition
Consciousness raising (CR) Becoming aware of causes, consequences,
and treatment for smoking cessation
Dramatic relief (DR) Becoming emotionally moved by smoking
or future imagined non-smoking state
Environmental reevaluation (ER) Thinking about how smoking affects others
and the environment
Self-reevaluation (SR) Evaluating self-image
Self-liberation (SL) Committing to action
Social liberation (SoL) Smoke-free alternatives in society
Counter-conditioning (CC) Substituting healthy behaviours for smoking
Stimulus control (SC) Avoiding cues to smoke, adding new cues
to do alternatives
Contingency management (CM) Rewards for controlling smoking urges
Helping relationships (HR) Getting support from others