Transtheoretical model constructs in smokers with and without medical illness: a second look at the medical effect.

The present report describes an investigation of differences in transtheoretical model constructs between 275 smokers with any medical illness, smokers with chronic illness specifically, and smokers who are medically healthy. In contrast to a previous report by Kristeller et al., we did not find higher process scores among medically ill smokers, instead finding more relapses and higher temptation scores among the medically ill smokers. Chronically ill smokers in particular reported high temptation to smoke in negative affect and habit/craving situations. Moreover, greater number of chronic illnesses was associated with increasing temptation and pros of smoking. We conclude that while medical smokers may report more quit attempts, they may have more difficulty staying quit than their healthy counterparts. Helping medically ill smoking patients to cope more effectively with highly tempting situations, to decrease perceived benefits of smoking, and to increase their use of the processes of change may lead to greater cessation success.