DISTRIBUTION OF SMOKERS BY STAGE IN 3 REPRESENTATIVE SAMPLES

Objectives. A key variable for the design of individual and public hea lth interventions for smoking cessation is Stage of Change, a variable which employs past behavior and behavioral intention to characterize an individual's readiness to change. Reactively recruited samples dist ort estimates of the stage distribution in the population because such samples attract a disproportionate number of late-stage participants. Three representative samples are described which provide accurate est imates of the stage distribution in the population. These samples are of adequate size to permit within-sample comparisons with respect to s ex, age, Hispanic or non-Hispanic origin, race, and education level. T he implications of using stage distribution as a tool for planning int ervention is discussed. Method. The first sample of 4,144 smokers was from the state of Rhode Island and involved a random-digit-dial survey . The second sample of 9,534 smokers was from the state of California and involved a stratified random-digit-dial survey. The third sample o f 4,785 smokers was from a total of 114 worksites located in four diff erent geographic locations. Results. The stage distributions were appr oximately identical across the three samples, with approximately 40% o f the sample in Precontemplation, 40% in Contemplation, and 20% in Pre paration. The stage distribution was generally stable across age group s with the exception of the 65 years and older group. Education level did affect the stage distribution with the proportion of the sample in Precontemplation decreasing as education level increased. In all thre e samples, minor differences in stage distribution were related to His panic origin and race, but the pattern was not consistent across the s amples. Conclusions. The pattern of stage distribution has important i mplications for the design of interventions. Existing interventions ar e most appropriate for the Preparation stage, but the majority of the three samples were in the first two stages, resulting in a likely mism atch between the smoker and the intervention. The stability of distrib ution across age suggests that interventions that are appropriately ma tched to stage can be applied across all age groups. The differences f ound with respect to education, Hispanic origin, and race can serve as a guide to the tailoring of intervention materials. (C) 1995 Academic Press, Inc.