Subtypes within the precontemplation stage of adolescent smoking acquisition

The present study examined the existence of three possible subtypes within the precontemplation stage of smoking acquisition: committers, immotives, and progressives. The sample of the study included young people from six European countries (mean age = 13 years) who had never smoked regularly (n = 21 535). A cross-sectional design was used to assess cognitive determinants of smoking behavior: attitudes towards smoking, perceived social influences, and self-efficacy to remain a nonsmoker. Adolescents within the various stages of smoking acquisition were compared with regard to standardized T scores on these risk factors. The results showed that adolescents in the three subgroups of precontemplation differed from each other on every cognitive determinant tested, revealing a higher risk to start smoking among progressives than among immotives. Immotives revealed a higher risk to start smoking than committers. It is concluded that the use of subtypes within acquisition precontemplation in research on adolescent smoking may be a promising tool for investigating the initiation continuum and for improving the quality of both the implementation and evaluation of prevention programs.