Preoperative Smoking Cessation in Chronic Respiratory Disease: A Community-Based Approach Guided by the Transtheoretical Model

This study critically evaluates the Transtheoretical Model (TTM) of behaviour change and proposes a tailored smoking cessation intervention for adults with chronic respiratory disease, a high-risk group for poor surgical outcomes. Through a narrative review and critical appraisal of TTM, a targeted intervention was developed, integrating behavioural theory and motivational interviewing within community-based healthcare and preoperative care settings. The proposed intervention, delivered through local "support hubs," is stage-specific and designed to enhance readiness for change by combining motivational interviewing, self-efficacy reinforcement, and decisional balance strategies. Theoretical modelling was informed by behavioural literature and case examples such as the Salford Hub, ensuring contextual relevance and feasibility. The intervention is anticipated to improve engagement and quit rates while enhancing accessibility and reducing disparities in care for individuals with conditions such as chronic obstructive pulmonary disease (COPD) and asthma. Although long-term outcomes require further study, existing evidence supports the short-term benefits of such behavioural approaches. Overall, the TTM provides a flexible and personalised framework for smoking cessation that, when combined with motivational interviewing and community-based delivery, may significantly improve outcomes for high-risk surgical patients with chronic respiratory disease. Although long-term outcomes require further study, the proposed framework may improve short-term engagement and quit rates; further implementation research is warranted.