Brief motivational intervention for adolescent smokers in medical settings

Center for Alcohol and Addiction Studies, Box G-BH, Brown University, Providence, Rhode Island 02912, USA.
Addictive Behaviors (Impact Factor: 2.76). 07/2005; 30(5):865-74. DOI: 10.1016/j.addbeh.2004.10.001
Source: PubMed


This study evaluated the efficacy of using a brief motivational intervention to reduce smoking among adolescent patients treated in a hospital outpatient clinic or Emergency Department. Patients aged 14-19 years (N=85) were randomly assigned to receive either one session of motivational interviewing (MI) or standardized brief advice (BA) to quit smoking. The assessment and intervention were conducted in the medical setting proximal to the patient's medical treatment. Patients were proactively screened and recruited, and were not seeking treatment for smoking. Follow-up assessments were conducted at 1, 3, and 6 months post-intervention. Self-report data indicated that 7-day abstinence rates at 6-month follow-up were significantly higher in the MI group than in the BA group, but this difference was not confirmed biochemically. Self-reported smoking rate (average cigarettes per day) was significantly lower at 1, 3, and 6 months follow-up than it was at baseline. Cotinine levels indicated reduced smoking for both groups at 6 months, but not at 1 month. At 3-month follow-up, only those in MI showed cotinine levels that were significantly reduced compared to baseline. Findings offer some support for MI for smoking reduction among non-treatment-seeking adolescents, but overall changes in smoking were small.

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    • "Research has demonstrated strong effects of motivational interviewing (MI) at reducing smoking (Colby et al., 2005; Peterson, Kealy, & Mann, 2009). Effective brief interventions activate client motivation through increasing change talk—client produced discussion on the benefits of change—and thereby increase readiness to change (Apodaca & Longabaugh, 2009). "
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    ABSTRACT: The psychological construct, readiness to change, is established as a central construct within behavioral change theories such as motivational interviewing (MI). Less is known about the interplay of mechanisms for change within adolescent treatment populations. Understanding the timing and interactive influence that adolescents' readiness to stop smoking and peer smoking have on subsequent tobacco use is important to advance intervention research. Toward this end, we used ecological momentary assessment (EMA) data from an automated texting smoking intervention randomized controlled trial to model the interactive effects of readiness to stop smoking and friends smoking on adolescent tobacco use. Two hundred adolescents were randomized into experimental treatment or attention control conditions, provided smart phones, and were followed for 6months. African American youth represented the majority of the sample. We collected monthly EMA data for 6months on friends smoking and readiness to stop smoking as well as survey outcome data. We tested a moderated mediation model using bias corrected bootstrapping to determine if the indirect effect of treatment on cigarettes smoked through readiness to stop smoking was moderated by friends smoking. Findings revealed that readiness to stop smoking mediated the effects of treatment on cigarettes smoked for those adolescents with fewer friends smoking, but not for those with more friends smoking. These results support importance of peer-focused interventions with urban adolescents and provide target mechanisms for future research. Copyright © 2015. Published by Elsevier Inc.
    Journal of substance abuse treatment 07/2015; DOI:10.1016/j.jsat.2015.07.009 · 2.90 Impact Factor
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    • "When applied to smoking, however, results have been mixed. With teenagers, MI for smoking cessation has reduced cotinine levels but not point-prevalence abstinence at outcome (Colby et al., 2005), and, in a separate study, reduced cigarettes per day, but only in the short-term (Colby et al., 2012). In a small study with adult smokers in a general medical setting, there was no effect of MI on smoking rate (Colby et al., 1998). "
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    ABSTRACT: Residential treatment for substance use disorders (SUD) provides opportunity for smoking intervention. A randomized controlled trial compared: (1) motivational interviewing (MI) to brief advice (BA), (2) in one session or with two booster sessions, for 165 alcoholics in SUD treatment. All received nicotine replacement (NRT). MI and BA produced equivalent confirmed abstinence, averaging 10% at 1month, and 2% at 3, 6 and 12months. However, patients with more drug use pretreatment (>22days in 6months) given BA had more abstinence at 12months (7%) than patients in MI or with less drug use (all 0%). Boosters produced 16-31% fewer cigarettes per day after BA than MI. Substance use was unaffected by treatment condition or smoking cessation. Motivation to quit was higher after BA than MI. Thus, BA plus NRT may be a cost-effective way to reduce smoking for alcoholics with comorbid substance use who are not seeking smoking cessation.
    Journal of substance abuse treatment 10/2013; 46(3). DOI:10.1016/j.jsat.2013.10.002 · 2.90 Impact Factor
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    • "To alleviate the impact on health behavior, counseling and brief interventions have been developed and have demonstrated evidence of efficacy in reducing alcohol use [8,9], including among young individuals [10,11]. For smoking, brief counseling interventions among young individuals and adolescents are promising (especially with the increasing use of electronic media tools), but evidence is very limited [12-15]. "
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    ABSTRACT: Visual analog scales (VAS) are sometimes used to assess change constructs that are often considered critical for change. Aims of Study: 1.) To determine the association of readiness to change, importance of changing and confidence in ability to change alcohol and tobacco use at baseline with the risk for drinking (more than 21 drinks per week/6 drinks or more on a single occasion more than once per month) and smoking (one or more cigarettes per day) six months later. 2.) To determine the association of readiness, importance and confidence with alcohol (number of drinks/week, number of binge drinking episodes/month) and tobacco (number of cigarettes/day) use at six months. This is a secondary analysis of data from a multi-substance brief intervention randomized trial. A sample of 461 Swiss young men was analyzed as a prospective cohort. Participants were assessed at baseline and six months later on alcohol and tobacco use, and at baseline on readiness to change, importance of changing and confidence in ability to change constructs, using visual analog scales ranging from 1–10 for drinking and smoking behaviors. Regression models controlling for receipt of brief intervention were employed for each change construct. The lowest level (1–4) of each scale was the reference group that was compared to the medium (5–7) and high (8–10) levels. Among the 377 subjects reporting unhealthy alcohol use at baseline, mean (SD) readiness, importance and confidence to change drinking scores were 3.9 (3.0), 2.7 (2.2) and 7.2 (3.0), respectively. At follow-up, 108 (29%) reported no unhealthy alcohol use. Readiness was not associated with being risk-free at follow-up, but high importance (OR 2.94; 1.15, 7.50) and high confidence (OR 2.88; 1.46, 5.68) were. Among the 255 smokers at baseline, mean readiness, importance and confidence to change smoking scores were 4.6 (2.6), 5.3 (2.6) and 5.9 (2.7), respectively. At follow-up, 13% (33) reported no longer smoking. Neither readiness nor importance was associated with being a non-smoker, whereas high confidence (OR 3.29; 1.12, 9.62) was. High confidence in ability to change was associated with favorable outcomes for both drinking and smoking, whereas high importance was associated only with a favorable drinking outcome. This study points to the value of confidence as an important predictor of successful change for both drinking and smoking, and shows the value of importance in predicting successful changes in alcohol use. Trial registration number
    BMC Public Health 08/2012; 12(1):708. DOI:10.1186/1471-2458-12-708 · 2.26 Impact Factor
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