Final answer:
The statement that indicates the patient is in the preparation stage of smoking cessation is "I am really working hard to stop smoking."
Step-by-step explanation:
The statement that indicates the patient is in the preparation stage of smoking cessation is option c. "I am really working hard to stop smoking."
Referring to the stages of change model, the preparation stage is characterized by the individual actively taking steps and making plans to quit smoking. In this stage, the individual is motivated to quit and may already be engaging in actions such as seeking out resources and support to assist in the quitting process.
In contrast, options a and b show a lack of readiness or ambivalence toward quitting, while option d indicates a person who has already taken action by obtaining nicotine patches and gum.