International Primary Care Respiratory Group
 

Model of smoking initiation and cessation cycles
Source: Prignot J. A tentative illustration of the smoking initiation and cessation cycles. Tob Control 2000; 9: 113

 Initiation cycle

In an attempt to understand the 'lifecycle' of smoking, a number of models for the initiation phase' or the 'quit' phase have been developed.[44] This rather more complex model aims to describe a smokers career from their first to their final cigarette.[45] Prignaut describes a number of critical points in that career:
  1. Non smoker
  2. Occasional smoker, trying it out. Because of the addictive nature of smoking, only very few will not move beyond this stage.
  3. Regular smoker
  4. Happy smoker. No real worries about smoking. This phase can last for many years and is equivalent to the 'pre-contemplative' stage described in the cycle of change.[44]
  5. Ambivalent smokers. Beginning to weigh up the pros and cons of smoking. Supportive intervention at this 'contemplative' stage can help the smoker prepare to quit and into action phases. Inappropriate intervention can reinforce smoking and delay the move to action.
  6. Preparing to quit
  7. Action: First quit attempt
  8. Some will succeed and become 'happy ex-smokers.....
  9. .... many will relapse and move round the spiral several times ....
  10. .....before finally succeeding in quitting
  11. Some will continue to smoke.
No two smokers will follow exactly the same path, but models such as these may help clinicians understand the point a patient has reached in their smoking career and tailor their approach accordingly.