Transtheoretical Model for Predicting Smoking Relapse among Malaysian Adults

Smoking cessation is a complex process, often involving a number of unsuccessful attempts prior to achievement of long-term abstinence. Approximately 7580% of smokers who attempt to quit relapse within the first six months (USDHHS, 1990). Initiating and maintaining abstinence could be considered two separate components of the quitting process (McEwen et al., 2001; Hyland et al., 2006). Various physiological, biological and cognitive factors determine whether a smoker is able to maintain abstinence (Piasecki, 2006). The Transtheoretical Model (TTM) is a behavioural change process that has been validated and popularised by Prochaska and colleagues (Prochaska and DiClemente, 1983; Fava et al., 1995; Norman et al., 1998; Velicer et al., 1999). Although it has existed over 20 years ago, it is still famously applied in many smoking cessation behavioural research (Paiva et al., 2012; Campbell et al., 2013; Huang et al., 2013). This model includes five stages of change through which a smoker progresses during the quitting process: pre-contemplation, contemplation, preparation, action and maintenance. Ten processes of change take place during progression across the stages. These 10 processes are further divided into two categories: experiential (dramatic relief, consciousness raising, social liberation, environmental re-evaluation and self re-evaluation) and behavioural