Table 1. Application of Maibach and Cotton's strategies for movement from one stage to another, based on social cognitive theory, to adolescent smoking cessation context.

Stage-based Content Development Strategy for Stomp Out Smokes (S.O.S.)
Precontemplation. The adolescent does not intend to quit smoking in the foreseeable future. Strategies to move to contemplation stage are:

• Enhance the adolescent's knowledge of, and outcome expectancies about smoking.
• Personalize the adolescent's risk of smoking.
• Emphasize the benefits of quitting smoking.
• Encourage the adolescent to reevaluate his/her outcome expectancies including information about the benefits of quitting smoking.
  

Contemplation. The adolescent begins to consider quitting smoking sometime in the next six months. Strategies to move to the preparation stage are:

• Encourage adolescent to specifically consider changing something about him/herself.
• Encourage the adolescent to try not smoking on a specific occasion or try cutting down his/her cigarette consumption.
• Promote and reinforce positive outcome expectations.
• Identify and dispute commonly held misconceptions about negative consequences.
• Suggest ways to minimize legitimate drawbacks.
• Enhance self-efficacy by identifying how to effectively overcome perceived barriers to quitting.

Preparation. The adolescent plans to quit in the next 30 days. Strategies to move to the action stage are:

• Teach and encourage the adolescent to restructure his/her environment so important cues to quit smoking are obvious and socially supported.
• Encourage adolescent to identify and plan ways to overcome barriers to quitting that he/she is most likely to face.
• Encourage the adolescent to set specific quitting goals, and teach him/her how to set incremental goals.
• Promote enhanced self-efficacy to cope with situations the adolescent anticipates may be problematic as well as other obstacles that may arise when he/she is trying to quit.
• Provide social reinforcement of behaviors that contribute to the goal of quitting smoking.

Action. The adolescent quits and is able to stay quit for a while. Strategies to move to the maintenance stage are:

• Encourage refinement of skills and strategies to avoid relapse, and to cope productively with setbacks that threaten full relapse.
• Bolster self-efficacy for dealing with new barriers to staying quit and with setbacks ("slips") that threaten relapse.
• Encourage the adolescent to feel good about him/herself as he/she progresses toward the goal of complete and sustained smoking cessation, especially in the face of temptation.
• Reiterate and reinforce the concrete benefits of quitting as well as the adolescent's self-evaluative benefits of quitting.

Maintenance. The adolescent consolidates the non-smoking behaviors and incorporates them into his/her daily routine. At this point the teen is considered to have successfully quit.

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