Characteristics of patients with COPD in three motivational stages related to smoking cessation

Sander R Hilberink, Johanna E Jacobs, Maryanne Schlösser, Richard P T M Grol, Hein de Vries
Patient Education and Counseling 2006, 61 (3): 449-57

OBJECTIVE: To characterize patients with chronic obstructive pulmonary disease (COPD) in different motivational stages related to smoking cessation.

METHODS: 633 smoking COPD patients from 67 general practices participated in a cross-sectional study. The patients were compared with respect to health indicators, demographics, self-efficacy, nicotine dependence, attitudes, and action plans.

RESULTS: In line with previous Dutch results, smokers in precontemplation associated significantly fewer advantages with smoking cessation than smokers contemplating quitting and preparing to quit. Preparers had significantly higher self-efficacy expectations about quitting than the other smokers. Patients preparing to quit suffered from more COPD complaints than precontemplators. Smokers contemplating quitting and preparing to quit developed more plans to turn intentions to quit into action.

CONCLUSION: More than 50% of the smokers with COPD are amenable to smoking cessation support. Preparers and contemplators did not differ as much as previous studies found. It would be advantageous to tailor COPD counseling to two distinct groups (unmotivated smokers and smokers motivated to quit), to discuss the advantages of quitting with unmotivated smokers, and to increase self-efficacy, and action planning for smokers motivated to quit.

PRACTICE IMPLICATIONS: COPD patients are amenable to counseling to quit smoking. Addressing COPD complaints may contribute to greater motivation.

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