1. Prochaska & DiClemente Revisited A narrative analysis of peoples lived experience of smoking to ascertain their place on the cycle of change. Angela Spalding MSc BSc(Hons) RMHN

2. . Prochaska & DiClemente Stages of Change Model Angela Spalding March 20152

3. Prochaska & DiClemente (1981) Stages of Change Model Prochaska & DiClemente Stages of Change Model Angela Spalding March 20153

4. Stage one Pre-contemplation “Not Ready for change” Prochaska & DiClemente Stages of Change Model Angela Spalding March 20154

5. Stage one: Pre-contemplation “Smoking helps me to deal with the stress and the boredom. I couldn’t work so smoking helped me fill in time.” Prochaska & DiClemente Stages of Change Model Angela Spalding March 20155

6. Stage one: Pre-contemplation “Smoking is one of my few pleasures and it is part of who I am.” Prochaska & DiClemente Stages of Change Model Angela Spalding March 20156

7. Stage one: Pre-contemplation “Smoking is a social thing most of my friends smoke. I like hanging out with them.” Prochaska & DiClemente Stages of Change Model Angela Spalding March 20157

8. Stage two Contemplation “Getting ready” Looking at their personal cost / benefit analysis (not ours) Prochaska & DiClemente Stages of Change Model Angela Spalding March 20158

9. Stage two: Contemplation “Every time I get a cold it goes to my chest and I get sick. I know smoking isn’t helping. Lots of people don’t smoke now so I think it will be easier this time.” Prochaska & DiClemente Stages of Change Model Angela Spalding March 20159

10. Stage two: Contemplation “It took me 14 years to have the courage to have another go. The second time round was worse for me because this time I knew it was going to be unpleasant and a big personal challenge… the first time you don’t know what to expect. The withdrawal symptoms were awful. I had to go to bed for two days. I didn’t want to socialise. Day three and four were hideous. I felt like my head wasn’t attached to my body…..” Prochaska & DiClemente Stages of Change Model Angela Spalding March 201510

11. Stage three Preparation The number one concern for many people is if they try will they fail? Prochaska & DiClemente Stages of Change Model Angela Spalding March 201511

12. Stage three: Preparation “LT and I quit about the same time. Me first, then LT. We kept asking each other, “have you had a cigarette yet?” And our answers would be No!.. We would shake each other’s hands to congratulate each other. This time I am ready.” Prochaska & DiClemente Stages of Change Model Angela Spalding March 201512

13. Stage four Action “initiating change” Prochaska & DiClemente Stages of Change Model Angela Spalding March 201513

14. Stage four: Action “I find counting days helpful. I have a calendar and at the end of each day I get a big black marker pen and cross off another day.. It gives me a real sense of achievement and makes it kinda fun! Other people encourage me and say ‘what day is it now Tanya?’ I’ve got up to day eighty two.” Prochaska & DiClemente Stages of Change Model Angela Spalding March 201514

15. Stage five Maintenance “Adjusting to change” Prochaska & DiClemente Stages of Change Model Angela Spalding March 201515

16. Stage five: Maintenance “I’ve got money to spend on other things now. Cigarettes used to come first….. even before food.” Prochaska & DiClemente Stages of Change Model Angela Spalding March 201516

17. Stage six Relapse “The journey of change is not neat and linear but an organic spiral” Prochaska & DiClemente Stages of Change Model Angela Spalding March 201517

18. Stage six: Relapse “After a year of not smoking I met a new partner and he smoked… I thought I would just have one to be sociable.” Prochaska & DiClemente Stages of Change Model Angela Spalding March 201518

19. Stage six: Relapse “It wasn’t until I stopped smoking that I realised how much I used smoking as a reward for myself… I started to reward myself with chocolate instead and gained almost 15 kilos… I would rather smoke!” Prochaska & DiClemente Stages of Change Model Angela Spalding March 201519

20. Stage six: Relapse “Over the years, I have made many, many attempts to stop …six, seven eight maybe more … I haven’t really counted. Sometimes my attempts lasted one day, two days sometimes two to three weeks. Today …I haven’t had a cigarettes in four days.” Prochaska & DiClemente Stages of Change Model Angela Spalding March 201520

21. My favourite quote “The philosophy of a smoker is quite different from the philosophy of a non-smoker. So the key thing for me is to learn to think differently. Today I am a non-smoker, and I am taking one day at a time. I am on day thirty one… and I feel good.” Prochaska & DiClemente Stages of Change Model Angela Spalding March 201521

22. …..….. Prochaska & DiClemente Stages of Change Model Angela Spalding March 201522