Alcohol: Stages of Change (Short Form)

Alcohol Stage Item for non-dependent drinkers

Males (females use 4 or more in a row)

In the last month have you had 5 or more drinks in a row?

1.	Yes, and I do not intend to stop drinking 5 or more drinks in a row.	☐
2.	Yes, but I intend to stop drinking 5 or more drinks in a row during the next 6 months.	☐
3.	Yes, but I intend to stop drinking 5 or more drinks in a row during in the next 30 days.	☐
4.	No, but I have had 5 or more drinks in a row in the past 6 months.	☐
5.	No, and I have not had 5 or more drinks in a row in the past 6 months.	☐
6.	No, I have never had 5 or more drinks in a row.	☐

Scoring

1 = Precontemplation
2 = Contemplation
3 = Preparation
4 = Action
5 = Maintenance
6 = Non bingers

Note: Contact Dr. Laforge for more information on validity and reliability of this instrument.

References

Laforge, R. G., Maddock, J. E., & Rossi, J. S. (1998). Comparison of five stage methods for alcohol abuse among college students. Annals of Behavioral Medicine, 20, 170 (Abstract).