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Maryland Tobacco Control Resource Center (TCRC)
Programs (General)Maryland Tobacco Control Resource Center (TCRC)Health Behavior Models and Measures

Health Behavior Models and Measures

Behavior Change Models:

There are a number of theoretical models in the literature that address effective ways to change health behaviors. The pages below outline basic theories, their major constructs, and the recommended strategies to help clients reduce tobacco use.

Measures:

Stages of Change & Readiness  

The Stages of Change Algorithm can be used in research to determine an individual’s current stage of change for quitting tobacco.

Processes of Change for Quitting Smoking

The Processes of Change Questionnaire is a self-report measure that assesses an individual’s use of experiential and behavioral processes of change to quit smoking. Used in both practice and research.

Temptation to Smoke 

The Temptation to Smoke Scale is a self-report measure that assesses how tempted an individual is to smoke in a variety of situations. Used in both practice and research.

Confidence to Abstain (Self-Efficacy)

The Smoking Self-efficacy Scale is a self-report measure that assesses an individual's confidence to abstain from smoking in a variety of situations. Used in both practice and research.

Decisional Balance (Pros & Cons of Smoking)

The Decisional Balance Scale is a self-report measure of the pros and cons a person perceives in terms of smoking. Used in both practice and research.

Screening for Tobacco Use

The first question should be asked of ALL patients, and can be helpful in identifying “former smokers” that may otherwise be mistaken as “never-smokers.” The Tobacco Screening Measure was developed by Maryland M.D.s Making a Difference (MD3), and can also be found on their Pocket Guide for Tobacco, Alcohol, and Drug Screening, Brief Intervention, Referral, and Treatment.  Used primarily in practice.

Nicotine Dependence

The Fagerström Test for Nicotine Dependence (FTND) consists of six multiple-choice questions meant to assess how strongly “addicted” an individual is to nicotine. Used in both practice and research.

* Permission to use this scale for purposes other than research should be obtained from K. L. Fagerström.

Smoking History

A Smoking History Questionnaire is meant to provide a more detailed picture of both current and past tobacco use. Questions may vary depending upon the purpose or goals of this measure’s use. Traditionally has been used in research, but also has clinical applicability.  

** Please follow the links above for more information about the models and measures, or visit the HABITS Lab website.

References

  1. https://www.lung.org/getmedia/a12811b6-bed5-4649-8735-036255630231/Stages-of-Change_Quick-Reference-Guide
  2. Pribadi ET, Devy SR. Application of the Health Belief Model on the intention to stop smoking behavior among young adult women. J Public Health Res. 2020 Jul 2;9(2):1817. doi: 10.4081/jphr.2020.1817. PMID: 32728563; PMCID: PMC7376467.
  3. Elshatarat RA, Yacoub MI, Khraim FM, Saleh ZT, Afaneh TR. Self-efficacy in treating tobacco use: A review article. Proceedings of Singapore Healthcare. 2016 Dec; 25(4): 243-248. https://doi.org/10.1177/2010105816667137
  4. Topa G, Moriano JA. Theory of planned behavior and smoking: meta-analysis and SEM model. Subst Abuse Rehabil. 2010 Dec 6;1:23-33. doi: 10.2147/SAR.S15168. PMID: 24474850; PMCID: PMC3819188.