Stage of Change: Contemplation
This patient is in the Contemplation stage of the Stages of Change Model. They acknowledge smoking is harmful and plan to quit "this year," which indicates thinking about quitting within the next 6 months but without concrete plans for the immediate future (next 30 days) 1.
Understanding the Stages of Change Model
The Transtheoretical Model categorizes smokers into distinct motivational stages 2:
- Precontemplation: No thoughts of quitting 2
- Contemplation: Thinking about quitting within the next 6 months 1
- Preparation: Planning to quit in the next 30 days 1, 2
- Action: Successfully quit for up to 6 months 2
- Maintenance: No smoking for more than 6 months 2
Why This Patient is in Contemplation
The key distinguishing features are:
- Acknowledges health risks: The patient recognizes smoking is harmful, moving them beyond precontemplation 1
- Plans to quit "this year": This timeframe (up to 12 months) places them in contemplation rather than preparation 1
- No immediate action plan: They lack a specific quit date within the next 30 days, which would be required for the preparation stage 1
Clinical Implications for Diabetes Patients
This patient requires specific intervention based on their contemplation stage:
- Provide brief motivational discussion emphasizing the added risks of smoking combined with diabetes, including heightened cardiovascular disease risk, premature death, and accelerated microvascular complications 1
- Offer encouragement to move toward setting a quit date while providing support 1
- Avoid pushing for immediate cessation, as stage-based interventions should match the patient's readiness 2
Common Pitfall to Avoid
Do not misclassify this patient as being in preparation. The preparation stage specifically requires intention to quit within the next 30 days, not just "this year" 1. Research shows that including quit attempts in the preparation stage definition significantly impacts stage distribution, and arbitrary timeframes can lead to misclassification 3.
Answer: B) Contemplation