Peer Reviewed: Efficacy of an Emergency Department-based Motivational Teenage Smoking Intervention

West Virginia University, Department of Community Medicine, Prevention Research Center, Office of Drug Abuse Intervention Studies, P.O. Box 9190, Morgantown, WV 26506, USA.
Preventing chronic disease (Impact Factor: 2.12). 02/2007; 4(1):A08. DOI: 10.1111/j.1553-2712.2005.tb00871
Source: PubMed


Motivational interviewing techniques have been minimally researched as a function of a teenage smoking intervention. The present study examined the efficacy of a theory-based motivational tobacco intervention (MTI).
A randomized two-group design was used to compare 6-month post-baseline quit and reduction rates among teenagers who received the MTI with those who received brief advice or care as usual. Participants were smokers aged 14 to 19 years (N = 75) who presented for treatment in a university-affiliated hospital emergency department (ED). Motivational interviewing techniques were used by trained providers to facilitate individual change; stage-based take-home materials also were provided.
Similar to past clinic-based studies of motivational interviewing with teenage smokers, our study found negative results in terms of intervention efficacy for cessation. Six-month follow-up cessation rates were nonsignificant--two teenagers quit smoking. Among teenagers who were available at follow-up, a medium effect size (Cohen's h = .38) was found for reduction and a large effect size (Cohen's h = .69) was found for percentage reduction, although these results also were not statistically significant.
Although the major findings of this study were not significant, the reductions in tobacco use suggest that motivational interviewing may be a clinically relevant counseling model for use in teenage smoking interventions. However, many questions remain, and the current literature lacks studies on trials with significant outcomes using motivational interviewing in smoking cessation. Additionally, more research is needed to examine the suitability of the ED for MTI-type interventions.

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Available from: Candice W Hamilton, Apr 10, 2015
    • "Dentro de la población de adolescentes la EM ha acumulado limitada pero prometedora evidencia (Brown et al., 2003, 2009; Colby et al., 1998, 2005; Horn et al., 2007). Brown et al. (2003) y Colby et al. (1998) han encontrado efectos pequeños, pero no diferencias estadísticamente significativas entre la EM y el consejo breve en conseguir dejar de fumar. "
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    ABSTRACT: Motivational Interviewing (MI) has proved to be effective with a wide range of addictive behaviors. However, in the case of tobacco smoking it is more difficult to demonstrate its effectiveness. MI provides specific motivational strategies for each stage of change. The aim of this paper is to review studies investigating the use of MI in the treatment of smoking in order to provide an update on its effectiveness. To this end, we reviewed the most important research published internationally and in Spain. A review of 33 selected studies leads us to conclude that it is very difficult to assess and compare the results of the studies in view of their variability and heterogeneity. Hence, it is in this area that we see the most contradictory results on its effectiveness. We therefore need more research in order to determine its reliability and possible explanations for the discrepant findings observed in studies of smoking cessation. Finally, we strongly suggest the need to know which treatment location is best, how MI functions in treatment programs and which conditions may affect its effectiveness.
    No preview · Article · Jan 2010 · Adicciones
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    • "In one study, teens who had been arrested or required to appear in court for a variety of offenses were given the option to participate in a diversionary program (Helstrom & Hutchison 2007). The other study recruited participants for treatment who presented for care for any reason in an emergency room in a suburban, university-affiliated hospital (Horn et al. 2007). Neither study reported significant treatment effects. "
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    ABSTRACT: Cigarette smoking is the leading cause of premature morbidity and mortality in the United States. The majority of children smoke their first cigarette in early adolescence, and many older teens have well-established dependence on nicotine. Efforts to promote and support smoking cessation among these youth smokers are critical. The available experimental studies of youth cessation interventions find that behavioral interventions increase the chances of youth smokers achieving successful cessation. Currently there is insufficient evidence for the effectiveness of pharmacological treatments with youth smokers. Many innovative studies have been compromised by challenges in recruiting sufficient numbers of youth, obtaining approval for waivers of parental consent, and high attrition in longitudinal studies. Key areas for future work include bridging the fields of adolescent development and treatment design, matching treatments to developmental trajectories of smoking behavior, better understanding treatment processes and treatment moderators, and building demand for evidence-based cessation treatments.
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    ABSTRACT: Worldwide, between 80,000 and 100,000 young people start smoking every day and up to one in four UK and American teenagers smoke. Many adolescent tobacco programmes focus on preventing teenagers from starting to smoke, but some programmes have been aimed at helping those teenagers already smoking to quit. We identified 24 good quality studies (>5000 participants) that researched ways of helping teenagers to quit. Programmes that combine a variety of approaches, including taking into account the young person's preparation for quitting, support behavioural change and enhance motivation show promise. The number of trials and participants are beginning to be adequate to provide evidence to judge effectiveness. Medications such as nicotine replacement and bupropion have not yet been shown to be successful with adolescents. Trials so far have had different definitions of quitting and many smaller trials did not have enough participants for us to be confident about wider application of the results. Some approaches may be worthy of consideration but there is still a need to provide better evidence before the likely success and costs of large scale service programmes can be estimated accurately.
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