What question did this study set out to answer?

The study aims to assess baseline characteristics of adolescent smokers and evaluate smoking behavior changes over time using the Transtheoretical Model.

April 25, 2026Open Access

The transtheoretical model and smoking cessation: findings from a youth-friendly clinic

Key Points

The study aims to assess baseline characteristics of adolescent smokers and evaluate smoking behavior changes over time using the Transtheoretical Model.
Conducted a retrospective observational study at a specialized smoking cessation clinic.
Included 159 adolescent participants, tracking their progression through the TTM stages over 12 months.
Monitored smoking cessation rates, with a particular focus on behavioral therapy interventions.
60% attrition by 12 months with 64 participants remaining; maintenance stage increased from 15.3% to 17.1%.
Smoking reduction rates were 47.6% at 3 months, 48.5% at 6 months, and 53.1% at 12 months.
No statistical difference in nicotine replacement therapy effectiveness across follow-up periods.

Abstract

Starting to smoke at a younger age leads to more smoking-related health problems. There is still a lack of literature on ‘adolescent smoking cessation’ treatment approaches. This study aimed to describe baseline information on adolescent smokers at the time of initial visit, and to evaluate changes in smoking behaviour and stage progression within a youth-friendly clinical setting informed by the Transtheoretical Model (TTM). Retrospective observational study of adolescents attending a specialized smoking cessation clinic. A total of 159 participants were included, 35.2% of whom were female. The most common TTM stage was ‘preparation’ (47.8%). Completing the 3- and 6-month stages was considered a significant change compared to the initial visit. Participant numbers decreased to 64 at 12 months, corresponding to ~ 60% attrition. In the retained group, the percentage of participants in stage 5 (maintenance) increased from 15.3% at 6 months to 17.1% at 1 year. The smoking reduction was 47.6% for patients followed up for 3 months, 48.5% for those followed up for 6 months, and 53.1% for those followed up for 12 months. According to the Nicotine Replacement Therapy (NRT) and modified Fagerström Tolerance Questionnaire (mFTQ) scores, there was no statistical difference in responses to smoking cessation at 3, 6, and 12 months. The Parents Together group had a higher response rate at the three-month assessment. Baseline data showed that those who were tattooed, regularly drank alcohol, and had a forensic history smoked more cigarettes. Participants who smoked less at baseline showed a significantly positive response at follow-up. Behavioural therapy was effective for smoking cessation/reduction and the TTM stages in the retained group. At the smoking cessation clinic, risky behaviours require closer monitoring and proper referral. While our study emphasises the importance of a youth-friendly clinical environment, the effectiveness of TTM remains uncertain and should be evaluated alongside data from similar clinics.

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