Stages of change analysis of smokers attending clinics for the medically underserved

To determine whether smokers at clinics providing care for the medically underserved can be characterized according to the transtheoretical stages of change model. Prospective, descriptive study. Smokers in the waiting rooms of clinics providing care for the medically underserved. Standardized questionnaires that assessed stages of change, processes of change, decisional balance, and self-efficacy and temptation. The smoking rate of subjects interviewed at 4 clinics was 44%. Two hundred current smokers completed the questionnaires. Smokers claiming that they planned to quit within 6 months scored higher on experiential process statements that are consistent with quitting smoking than did smokers who claimed they were not planning to quit within 6 months. They also scored higher on behavioral statements related to quitting. Concerns about the negative aspects of smoking were more important to smokers planning to quit than to smokers not planning to quit, whereas the statements assessing positive aspects of smoking were rated the same. Fifty-five percent of the smokers were smoking a pack or more each day and reported smoking more during negative situations and from habit than did smokers who smoked less than a pack a day. Smokers planning to quit who still smoke at least a pack a day may benefit from counseling to decrease smoking for specific reasons or from pharmacologic aids. Smokers at the clinics who planned to quit smoking reported experiences and behaviors that were consistent with their stated desire to quit and should be counseled in the same fashion as smokers from more traditional practices.