HEALTH PROMOTION Stage of adoption for preventive behaviour against passive smoking among pregnant women and women with young children in Taiwan Chiu-Mieh Huang, Jong-Long Guo, Hsein-Lin Wu and Li-Yin Chien Aims. This study assessed the applicability of the transtheoretical model to prevent exposure to passive smoking among pregnant women and women with young children in Taiwan. We examined whether women in different stages of change had different knowledge, processes of change, decisional balance and self-efficacy. Background. Although previous studies have found a positive association between the presence of children and a mother’s readiness to prevent exposure to passive smoking, a few studies have systematically examined the mothers’ stage of adoption for preventive behaviour against passive smoking. Methods. A cross-sectional survey based on self-reported data was conducted in 2005–2006. A total of 315 women was recruited from perinatal and paediatric clinics at four hospitals. The transtheoretical model measures included knowledge, stages of change, processes of change, decisional balance and self-efficacy towards passive smoking. Results. Of the 315 women in the study, 17Æ1% were at the precontemplation stage, 7Æ9% were at the contemplation/prepa- ration stage and 74Æ9% were at the action/maintenance stage. Women at the action/maintenance stage scored the highest in knowledge, process of change, pros of decisional balance and self-efficacy, followed by the women at the contemplation/ preparation stage and the women at the precontemplation stage. Conclusions. This study supported the applicability of the transtheoretical model theory for adoption of preventive behaviour against passive smoking among pregnant women and women with young children. Relevance to clinical practice. Nurses could educate pregnant women and women with young children to adopt preventive behaviours against passive smoking using stage-matched intervention strategies, targeting the transtheoretical model constructs, to promote behavioural change. Key words: health education, health promotion, nurses, nursing, passive smoking, prevention, Taiwan, transtheoretical model, women’s health Accepted for publication: 7 April 2011 Introduction Passive smoking is a modifiable risk factor for multiple deleterious illnesses and contributes to an excessive number of deaths among non-smokers (Hovell et al. 2000). Decreas- ing exposure to environmental tobacco smoke among non- smokers is one of the leading health indicators listed by the Healthy People 2010 initiative (Maiese 2002). Countermar- keting tobacco strategies have challenged the social accept- ability of smoking as a personal behaviour and emphasised the harmful effects of passive smoking (US Environmental Protection Agency 2002). In Taiwan, 51Æ9% of women and Authors: Chiu-Mieh Huang, PhD, RN, Assistant Professor, Department of Nursing, National Yang-Ming University; Jong- Long Guo, CHES, PhD, Professor, Department of Health Promotion and Health Education, National Taiwan Normal University; Hsein-Lin Wu, MD, Attending Physician, Department of Internal Medicine Cardiopulmonary, Taiwan Adventist Hospital; Li-Yin Chien, ScD, MPH, RN, Professor, Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan Correspondence: Li-Yin Chien, Professor, 155 Section 2, Li-Nong Street, Taipei 11221, Taiwan. Telephone: +886 2 28267142. E-mail: lychien@ym.edu.tw Ó 2011 Blackwell Publishing Ltd, Journal of Clinical Nursing, 20, 3331–3338 3331 doi: 10.1111/j.1365-2702.2011.03803.x