Theoretical applications of smoking cessation interventions to individuals with medical conditions: womenʹs initiative for nonsmoking (WINS)—Part III

This paper reviews the Theory of Self-Efficacy, Transtheoretical Model of Readiness for Change, and Theory of Addictions to provide a basis for smoking cessation, and explores how these theories have been used to guide clinical research and clinical interventions. Selected randomized controlled trials of the past ten years are reviewed for demonstrated efficacy, integration of theory into the design of the interventions, and how theories guide analysis. Results show that surprisingly little effort has been put forth to examine and develop these theories within the context of clinical interventions, despite the claims of importance. For example, the relationship between stages of readiness of change and smoking cessation outcome has not been examined. Despite the complexity of smoking behaviors (quitting, relapsing, maintaining, occasional smoking and so on), the concept of self-efficacy was mostly measured on single occasions over the course of most studies reviewed; multiple measurements of concepts were not utilized in the randomized controlled trials. Taking into account the gaps between theory and application, theory driven nursing strategies are offered.