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BMC Public Health. 2012; 12: 708.
Published online Aug 29, 2012. doi:  10.1186/1471-2458-12-708
PMCID: PMC3490974
Predictive value of readiness, importance, and confidence in ability to change drinking and smoking
Nicolas Bertholet,corresponding author1 Jacques Gaume,1,2 Mohamed Faouzi,1 Gerhard Gmel,1 and Jean-Bernard Daeppen1
1Department of Community Medicine and Health, Alcohol treatment center, Lausanne University Hospital, Beaumont 21b, P2, 02, Lausanne, 1011, Switzerland
2Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
corresponding authorCorresponding author.
Nicolas Bertholet: Nicolas.Bertholet/at/chuv.ch; Jacques Gaume: jacques_gaume/at/brown.edu; Mohamed Faouzi: Mohamed.Faouzi/at/chuv.ch; Gerhard Gmel: Gerhard.Gmel/at/chuv.ch; Jean-Bernard Daeppen: Jean-Bernard.Daeppen/at/chuv.ch
Received February 21, 2012; Accepted August 20, 2012.
Abstract
Background
Visual analog scales (VAS) are sometimes used to assess change constructs that are often considered critical for change. Aims of Study: 1.) To determine the association of readiness to change, importance of changing and confidence in ability to change alcohol and tobacco use at baseline with the risk for drinking (more than 21 drinks per week/6 drinks or more on a single occasion more than once per month) and smoking (one or more cigarettes per day) six months later. 2.) To determine the association of readiness, importance and confidence with alcohol (number of drinks/week, number of binge drinking episodes/month) and tobacco (number of cigarettes/day) use at six months.
Methods
This is a secondary analysis of data from a multi-substance brief intervention randomized trial. A sample of 461 Swiss young men was analyzed as a prospective cohort. Participants were assessed at baseline and six months later on alcohol and tobacco use, and at baseline on readiness to change, importance of changing and confidence in ability to change constructs, using visual analog scales ranging from 1–10 for drinking and smoking behaviors. Regression models controlling for receipt of brief intervention were employed for each change construct. The lowest level (1–4) of each scale was the reference group that was compared to the medium (5–7) and high (8–10) levels.
Results
Among the 377 subjects reporting unhealthy alcohol use at baseline, mean (SD) readiness, importance and confidence to change drinking scores were 3.9 (3.0), 2.7 (2.2) and 7.2 (3.0), respectively. At follow-up, 108 (29%) reported no unhealthy alcohol use. Readiness was not associated with being risk-free at follow-up, but high importance (OR 2.94; 1.15, 7.50) and high confidence (OR 2.88; 1.46, 5.68) were. Among the 255 smokers at baseline, mean readiness, importance and confidence to change smoking scores were 4.6 (2.6), 5.3 (2.6) and 5.9 (2.7), respectively. At follow-up, 13% (33) reported no longer smoking. Neither readiness nor importance was associated with being a non-smoker, whereas high confidence (OR 3.29; 1.12, 9.62) was.
Conclusions
High confidence in ability to change was associated with favorable outcomes for both drinking and smoking, whereas high importance was associated only with a favorable drinking outcome. This study points to the value of confidence as an important predictor of successful change for both drinking and smoking, and shows the value of importance in predicting successful changes in alcohol use.
Trial registration number
ISRCTN78822107
Keywords: Readiness to change, Importance of changing, Confidence in ability to change, Unhealthy alcohol use, Smoking
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