Common method for smoking cessation may not be best option

Trouble quitting? Maybe it's your motivation

Motivational interviewing, a popular counseling technique for many addictive behaviors, might not be the ideal treatment choice for those who smoke cigarettes. A University of Alabama at Birmingham researcher says the reason might be, well — motivation.

smoking_cessation_webIn findings published in the Journal of Consulting and Clinical Psychology, Peter S. Hendricks, Ph.D., says that motivational interviewing produced only modest improvement for people in treatment for smoking-cessation. The results were surprising because the technique has been effective for other addictive substances.

Motivational interviewing was developed as a means to help people change behavior by eliciting their own intrinsic reasons for change instead of persuading them to change. MI uses a non-judgmental, empathic approach to help people overcome their own ambivalence about changing.

"The issue here may be that most smokers are not ambivalent about quitting. In fact, there is good reason to believe that smokers very much want to stop smoking" said Hendricks, an assistant professor of health behavior in the UAB School of Public Health. "For example, the Centers for the Disease Control and Prevention estimates that approximately 70 percent of smokers want to quit. Ninety percent of smokers in Australia, Canada, the United Kingdom and the United States regret that they ever started smoking and would not start smoking again if given a second chance.  Furthermore, 80 percent of those smokers have tried to quit, and at any given time almost half of all smokers are actively trying to stop smoking."

Hendricks and co-author Jennifer Hettema, Ph.D., of the University of Virginia, conducted a meta-analysis of 31 different studies using motivational interviewing for smoking-cessation.  Those 31 trials involved 8,165 subjects. The authors found that motivational interviewing did help, but the effect was small and less than expected when compared to results seen with alcohol and other drugs.

Hendricks' work did show that motivational interviewing may be promising for adolescents and those with medical problems, low tobacco dependence or little motivation to quit. For these reasons, Hendricks says that researchers should continue to explore the efficacy of motivational interviewing for smoking-cessation, paying particular attention to potential moderating factors.

Still, Hendricks concludes, "most smokers may not need an intervention like motivational interviewing to help them stop. What they appear to need is a program designed to help them overcome the dependence on cigarettes."

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