Smoking cessation: the state of the science. The utility of the Transtheoretical Model in guiding interventions in smoking cessation.

Smoking remains the most significant modifiable risk factor for the leading causes of death in the United States. The most frequently used theoretical model used to guide interventions directed toward smoking cessation has been the Transtheoretical Model (TTM) (Prochaska and DiClemente, 1983), although the effectiveness and efficacy of the model's use in guiding smoking cessation interventions has not been fully evaluated. A non-statistical meta-analytic approach was used to examine reports of the use of the TTM in smoking cessation interventions. Three elements were considered for inclusion in this integrated review: the clear specification of the use of a theoretical framework, a specified intervention directed towards changing smoking behavior, and a specified outcome of smoking behavior change. From 1,500 research articles, 16 reports fit these criteria. The assessment of the research reviewed indicates that the TTM has not been fully tested in smoking cessation interventions, nor have process mediators been used to determine the mechanism of smoking behavior change.