Analysis of Cigarette Smoker Using Trans-Theoretical Model

This report presents a critical analysis of an interview with a cigarette smoker, applying the Trans-Theoretical Model (TTM) of behavior change. The assignment outlines the TTM's stages: pre-contemplation, contemplation, preparation, action, maintenance, and termination. The smoker, a 55-year-old man with multiple comorbidities, is identified in the contemplation stage. The report details the techniques used during the interview, including establishing trust and highlighting the benefits of quitting. The analysis explores how these techniques facilitated the smoker's consideration of behavior change and the potential for reducing smoking habits. The report reflects on the interview experience, emphasizing the process-oriented nature of behavior change, and suggests further interventions such as nicotine replacement therapy. The conclusion reinforces the smoker's position within the TTM and the importance of motivational techniques in initiating action towards smoking cessation.

Running head: THE TRANS-THEORETICAL MODEL 1
The Trans-Theoretical Model in the Context of a Cigarette Smoker
Your Name
College of Nursing
Capstone Course
Term and Year

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Introduction
The Trans theoretical model (TTM) of behavior change applies in so many areas of life
and specifically in the healthcare context. Different people have different health behaviors that
subsequently affect their health and general wellbeing. The negative effects of these behaviors
leads them to a realization of a need to change and hence the application of the Trans theoretical
model (Charkazi et al., 2017).
In this assignment, a critical analysis of an interview with a person with a negative health
behavior is presented. In this case, he was a cigarette smoker. A description of the Trans
theoretical model of behavior change is also included together with its application on the journey
to independence of this interviewed person. His health challenge is also outlined. It also entails a
description of the techniques used in the interview in order to help the person and a general
overview of the outcome.
The Trans-theoretical Model of Behavior Change
This model of health behavior change was put into context in 1970 (Charkazi et al.,
2017). It was realized after a careful assessment of smokers who desired to quit this habit on
their own. The main intention was to identify why some people quit smoking on their own. It
was discovered that a person quit this habit of cigarette smoking only if he or she is ready (Erol
Balcı & Sisman, 2018). This entirely depends on decision making and an intention to change.
The analyses of this information lead to the realization of six steps of behavior change. These
stages are relatable to anyone with an intrinsic desire to change a health related habit like
cigarette smoking (Charkazi et al., 2017).

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The first stage of the model is the pre-contemplation stage where the person has no
intention to change his or her behavior. This is because the behavior is not perceived to be
problematic to them and they underestimate the advantages of changing the behavior, putting
more emphasis on the disadvantages of changing their behavior. The next stage is the
contemplation stage where they start intending to change the behavior (Charkazi et al., 2017).
This is because the behavior is perceived as being problematic. There is practical consideration
of the benefits, with equal emphasis on both the benefits and the disadvantages (Segall, 2017).
The third stage is the preparation stage. Here, the person is ready to take actions towards
behavior change. Small steps are taken and it is believed that the change will lead to a healthier
life (Charkazi et al., 2017). The fourth stage is action. Here, the person is said to have changed
their behavior over the last 6 month s and intends to keep moving towards a healthier life.
Maintenance is the next stage where the action is sustained and the person intends to continue
with this modified or new behavior. Termination is the last stage. Most people do not reach this
stage and remain in the maintenance stage (Charkazi et al., 2017).
The Person’s Health Challenge in the Context of TTM
The identified health challenge of the interviewed person was cigarette smoking. He said
that this was a habit he started 25 years ago. He is a 55 years old man who has several
comorbidities. He agreed to the fact he had spent a lot of money on his medical bills due to his
many chronic illnesses. These include hypertension, diabetes mellitus type two, chronic
obstructive pulmonary disease, heart disease and asthma.
His health challenge was cigarette smoking. At the time of the interview, he openly stated
to me how this habit had brought so many complications to him. It came to my realization that he

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had started noticing the damage cigarette smoking caused to him and his family. He stated how
his wife and three children complained each and every day of his behavior. He had noticed that it
was bringing him more harm than good. This facilitated our interaction as it helped create a good
rapport between the two of us after he noticed that I had a good intention of help g him cha get
his health behavior.
The person was in the contemplation stage of the Trans-theoretical model of behavior
change. He had appreciated the fact that smoking was just a major deterrent to most of his
desires.in the environmental reevaluation, he noted that his unhealthy behavior affected not only
himself, but also his wife and three children. He had already made up his mind through a self-
evaluation process and decided that he wanted to quit smoking (Nuechterlein, Domino &
Zubieta, 2016). I asked to find out more on what he had really done towards the realization of his
target. All he had to say was that he had planned on quitting. He noted feeling embarrassed of his
behavior, though the addiction was too much for him to stop abruptly. He informed me that he
had continued smoking three packets of cigarette a day. Therefore, he best fits in the
contemplation stage of the Trans theoretical model of behavior change (Erol Balcı & Sisman,
2018).
The Techniques used to address the Health Concern
The first technique that was used in helping the person address his health behavior of
cigarette smoking was ensuring that there was trust between the two of us. Most often, behaviors
such as this one are considered to be bad behaviors. Therefore, the approach in this case
shouldn’t have been the one that condemns the person (Erol Balcı & Sisman, 2018). I had to
make sure that he understood my way of thinking, which was so positive of him. I wanted to help

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him. However, I had to gather more information from him through an interrogative process.
Listening was an important part of this. This ensured that rapport was created between us. I had
to first of all create an enabling environment where he was free to air out all his concerns. This
enabled me to know his way of thinking and where to effectively start from.
The second technique used to help him quit cigarette smoking was informing him the
benefits of quitting. At the same time, we discussed about the disadvantages of smoking
cigarettes. The most important thing I got to here was that he had spent a lot of money on his
medical expenditure. That formed my basis of this technique. I informed him of how cigarette
smoking is a risk factor for the development of so many diseases (Owusu, Quinn, Wang,
Aibangbee & Mamudu, 2017). This is indeed the leading cause of preventable diseases in the
world. We had to agree that smoking had led to his chronic obstructive pulmonary disease and
the exacerbation of his asthma. He also had other conditions such as heart disease and
hypertension. We agreed that quitting cigarette smoking would help reduce these disease
conditions including diminished health, of which he was a victim.
Outcome of the Interview
. Along the interview, he admitted that he had a bad health behavior. I realized that he was
ready to start taking action. He even wanted to abruptly quit smoking but I advised him against
doing the same. After asking for the alternative solutions, I told him that he could try reducing
the number of cigarettes per day. He was so much convinced this would work for him, especially
after I informed him that in one year of quitting, the risk for heart attacks drops sharply (Xiao,
2019). More so, the risk for cancer development drops by nearly half within 5 years (Charkazi et
al., 2017). He said that he would discuss the strategy with his wife so that she could help him.

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This is because his wife had always wanted him to quit smoking. I suggested to him that his wife
would him by making sure that the number of cigarettes he smoked per day was reducing
gradually and keeping the records for him.
Analysis of the Techniques
The techniques used were appropriate for this specific person. They enabled me to touch
on almost every specific aspect of cigarette smoking. We were able to find a solution to his
problem and he even committed to doing his best. He got a chance to know the specific benefits
he could get after quitting cigarette smoking. However, this could have been more meaningful to
him if more there was more time to enable follow up of this specific patient, in order to
determine his progress.
My reflection of this experience is that I got to understand that behavior change is a
process just as stipulated by the trans-theoretical theory. I got to understand how the patient was
struggling with the journey to quitting cigarette smoking. He was a bit fare of as he had already
appreciated the fact that smoking was causing more harm than good to him and was in stage two,
contemplation, of the Trans theoretical model of health behavior change. The alternatives that
could be used to help him would be the use of medications like the nicotine patch and lozenges
(Onor et al., 2017).
Conclusion
In conclusion, the patient interviewed was a chronic cigarette smoker who was in stage
two of the Trans theoretical model of behavior change. He was interviewed with the involvement
of motivational talks. This helped him make a firm decision that he would make a step and take

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action in order to stop this behavior. The techniques used included creating trust between the two
of us and mentioning the pros and cons of cigarette smoking.
References
Charkazi, A., Seyyedghasemi, N., Sharifirad, G., Shahnazi, H., Mirkarimi, K., Mansourian, M.,
& Ekrami, Z. (2017). Understanding the behaviour of cigarette smoking among Iranian
smokers: Application of trans-theoretical model. Jordan Medical Journal, 51(2), 57-67.
Erol, S., Balcı, A. S., & Sisman, F. N. (2018). Effect of transtheoretical model based smoking
cessation program on high school students. Journal of Nutrition and Health Sciences, 5,
301.
Nuechterlein, E. B., Ni, L., Domino, E. F., & Zubieta, J. K. (2016). Nicotine-specific and non-
specific effects of cigarette smoking on endogenous opioid mechanisms. Progress in
Neuro-Psychopharmacology and Biological Psychiatry, 69, 69-77.
Onor, I. O., Stirling, D. L., Williams, S. R., Bediako, D., Borghol, A., Harris, M. B., ... &
Sarpong, D. F. (2017). Clinical effects of cigarette smoking: epidemiologic impact and
review of pharmacotherapy options. International journal of environmental research and
public health, 14(10), 1147.
Owusu, D., Quinn, M., Wang, K. S., Aibangbee, J., & Mamudu, H. M. (2017). Intentions to quit
tobacco smoking in 14 low-and middle-income countries based on the transtheoretical
model. Drug and alcohol dependence, 178, 425-429.
Segall, P. J. (2017). Readiness for Positive Change: A Conceptual Framework Integrating
Positive Psychology and the Transtheoretical Model of Behavior Change.

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Xiao, J. J. (2019). Developing Action-Taking Programs in Sustainable Consumption Education:
Applying the Transtheoretical Model of Behavior Change (TTM). Available at SSRN
3335887.