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Coping with the health threat of smoking: An analysis of the precontemplation stage of smoking cessation
Daniels, Jill Walker, Ph.D., University of Maryland Baltimore County, 1998

This study examined two maladaptive ways of coping with the health threat of smoking: threat management, minimizing one's acknowledgment of one's risk of smoking, and cessation hopelessness, adopting an attitude of giving up on the possibility of quitting, and utilized the transtheoretical model of change and protection motivation theory's conceptualization of the process of coping with health threats as it's theoretical and empirical foundation. Precontemplation stage smokers (those not intending to quit in the next six months) drawn from a university and community population completed the study (N = 163). Most participants were female (61%) and Caucasian (71.2%) or African-American (22.7%). Their average age was 36.8 years, mean years of smoking was 19 years and average daily use was 27 cigarettes. Participants completed questionnaires either via mail or in person and were compensated with either course credit or a small cash payment. The measures of threat management and cessation hopelessness, developed for this study, had adequate reliability. Participants were divided into low and high threat management and cessation hopelessness groups using a median split procedure. Multiple analysis of variance and multiple regression analysis were used. Smokers high in threat management had lower experiential process activity, F (5, 154) = 5.19, $p < .001$ and lower cons of smoking, F (1, 160) = 27.59, $p < .001$ than smokers low in threat management. Smokers high in cessation hopelessness did not differ from smokers low in cessation hopelessness on experiential process activity. Smokers high in cessation hopelessness had larger differences between their temptation to smoke and abstinence self-efficacy, F(1, 157 = 17.67), $p < .001.$ Threat management and cessation hopelessness predicted experiential process activity after accounting for the transtheoretical variables of experiential process activity, decisional balance (pros of smoking minus cons of smoking) and temptation minus efficacy, F (2, 153) = 3.13, $p < .05.$ Results suggest that precontemplation stage smokers use maladaptive strategies to cope with their perceived health risk of smoking, and which are related in predicted ways to other variables. Smokers may be helped by intervention efforts that identify and reduce these maladaptive coping strategies in addition to those that encourage adaptive strategies that promote smoking cessation.