Patterns of Change: Dynamic Typology Applied to Smoking Cessation.

Patterns of change occurring in a combined cross-sectional and longitudinal (cross-sequential) analysis of 14 variables were investigated in a two-year study of self-change approaches to smoking cessation. Every six months for five rounds, subjects (N = 544) were assessed on 10 change processes, self-efficacy, temptations to smoke, and their decisions weighing the pros and cons of smoking. Subjects were also assessed on which of the following four stages of change they were in at each round: precontemplation, contemplation, action and maintenance. Dynamic clustering was employed to group subjects on the basis of their patterns of changes in stages over the five rounds. This yielded 14 profile groups (longitudinal typologies) which initially were compared on the 14 variables. Patterns of change on each of the variables became clear when the data were integrated cross-sectionally and longitudinally to form composite developmental profiles. The basic pattern of change processes can best be represented by a mountain metaphor. The change processes followed a general pattern of increasing from precontemplation to contemplation, peaked at a particular stage of change and then declined either to precontemplation levels or to somewhat higher levels if used as relapse prevention strategies. Temptation and the pros of smoking followed a linear pattern of decreasing across the stages, while self-efficacy increased linearly. The patterns of change and the mountain metaphor can be used as an organizing principle for developing models of change. The models can be used to develop therapy programs and self-help programs based on how people change their own problem behavior.