Pre-contemplation
| Not considering change. Resigned, lack of control over situation. Denial (situation and consequences) | 1884–1914 |
Consolidation of tobacco industry; tobacco control laws repealed; government support during second world war; promotion in Hollywood |
Contemplation
| Weighing benefits and costs of behaviour, proposed change | 1950–1964 |
Increasing concerns in medical literature re correlation between cancer and tobacco |
Preparation
| Experimenting with small changes | 1960–mid 1980s |
Increased literature; initial policy proceedings (Minnesota); tobacco industry on the defensive |
Action
| Taking a definitive action to change | Late 1980s–current |
Voluntary efforts of independent, private institutions; successful legislative efforts; changing social norms; litigation successes |
Maintenance
| Maintaining new behaviour over time | Current |
Social reinforcement; retain political backing; consolidation of successes; implementation and enforcement. |
Relapse
| Experiencing normal part of process of change. Usually feels demoralised | Future |
Potential setbacks; change in political climate; movement fragmentation; change in voluntary movement effort |