Smoking Cessation Cycle

Smoking Cessation Cycle as referenced by Prochaska et al. 1992, 1993; Prochaska and DiClemente 1982

Contented User: A stage of pre-contemplation. No intention of taking action within the next 6 months. May be uninformed or underinformed of health consequences or may have attempted change many times and lost confidence that quitting is possible. Appears unmotivated or resistant to change.

Thinking About Quitting: A stage of contemplation. Intends to change in the next 6 months. Aware of pros and cons of changes. Profound ambivalence or behavioral procrastination can develop as the person balances the pros and cons.

Deciding to Quit: A stage of preparation. Intends to take action soon, usually within 30 days. May have a plan, such as buying a book, joining a class, or talking to a counselor. Very interested in changing and has already decided to do so. Setting a quit date or signing up for a smoking cessation class are 2 types of preparation. Taking Zyban® and setting a quit date is another example.

Quitting: A stage of action. A person has made behavior modifications within the last 6 months. With smoking, this step is equated with total abstinence.

Trying to Stay Quit: A stage of maintenance. Working to prevent relapse, although fewer urges than someone in the action stage. Maintenance may last from 6 months to 5 years; however, some smokers remain in maintenance permanently.

Relapsing: A stage of relapse. The moment a patient first returns to smoking. He or she returns to one of the other stages of the Transtheoretical Model. As a clinician, you can help motivate the patient to progress closer to the action stage.

Staying Quit: A stage of termination. No urge to do the behavior that is being avoided (e.g., no temptation to smoke) and 100% self-efficacy in managing it. Will never return to the old habit regardless of the situation. Former smokers are not likely to reach the termination stage. About 20% of ex-smokers reach termination.


Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: applications to addictive behaviors. American Psychologist. 1992; 47: 1102-1114.

Prochaska JO, DiClemente CC, Velicer WF, Rossi JS. Standardized, individualized, interactive, and personalized self-help programs for smoking cessation. Health Psychology. 1993; 12: 399-405.

Prochaska JO, DiClemente CC. Transtheoretical therapy: toward a more integrative model of change. Psychotherapy: Theory, Research and Practice. 1982; 19: 276-288.

Resource Type: