Prevalences of Stages of Change for Smoking Cessation in Adolescents and Associated Factors: Systematic Review and Meta-Analysis

J Adolesc Health. 2019 Feb;64(2):149-157. doi: 10.1016/j.jadohealth.2018.09.005. Epub 2018 Nov 14.

Abstract

Purpose: To synthesize evidence on the prevalences of stages of change (Transtheoretical Model) for smoking cessation in adolescents and associated factors.

Methods: A systematic search of Web of Science (Thomson Reuters), SCOPUS (Elsevier), MEDLINE/PubMed, CINAHL (EBSCO) and PsycINFO (APA) was conducted to identify eligible studies. Two calibrated reviewers selected studies independently, extracted data, and appraised studies. A qualitative synthesis of the findings and meta-analysis of the prevalences of the stages of change for smoking cessation were carried out. A quality effects model was used to estimate the pooled prevalences.

Results: Eleven studies (N = 6469 adolescents) from five middle- to high-income countries were included in the review. Precontemplators accounted for 41% of smokers in earlier stages of change (95%CI: 34%-49%). In such a group, a lowered decisional balance, the lowest self-efficacy, and highest nicotine dependence were found (p < .05).

Conclusions: A higher overall prevalence of adolescents in precontemplation stage for smoking cessation was observed. Such group displayed more unfavorable smoking-related behaviors and characteristics than adolescents in other stages. The evidence is limited due to the lack of studies in adolescents living in low-income countries.

Keywords: Adolescent; Behavior change; Cigarette smoking; Smoking cessation; Stages of change; Transtheoretical Model.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Cigarette Smoking / epidemiology
  • Cigarette Smoking / psychology*
  • Decision Making
  • Female
  • Humans
  • Male
  • Prevalence
  • Self Efficacy
  • Smoking Cessation / methods
  • Smoking Cessation / psychology*
  • Tobacco Use Disorder / classification