Nonprogressing profiles in smoking cessation: what keeps people refractory to self-change?

A 2-year cross-sequential analysis of informal self-change efforts at smoking cessation evaluated the use of coping operations and the mediation of cognitive judgments among four composite profiles. Subjects (N = 544) were grouped by stage of readiness to change (contemplation, action, relapse, and maintenance) and assessed every 6 months on 10 change processes, self-efficacy, and the decisional balance between the "pros" and "cons" of smoking. Two change status profiles, contemplation to maintenance, and relapse to maintenance, were selected as exemplars of optimal linear progress; two others, chronic contemplation and chronic relapse, illustrated nonprogressing patterns in which subjects remained stuck in the same stage for 2 years. Multivariate and univariate ANOVA results indicated that nonprogressing smokers overutilize certain experiential change processes rather than underutilizing behavioral strategies, as was predicted. Implications of these results for specialized self-help interventions are discussed in the context of a comprehensive model of change for the addictive behaviors.