Can Motivational Interviewing be Effective for Smoking Cessation?

动机访谈对戒烟有效吗？

• 批准号: 8136053
• 负责人: DELWYN CATLEY
• 金额: $ 22.66万
• 依托单位: UNIVERSITY OF MISSOURI KANSAS CITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-29 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8136053
• 关键词: Abstinence; Addictive Behavior; Address; Adherence; Adolescent; Adult; Behavior Therapy; Cause of Death; Chantix; Counseling; Effectiveness; Enrollment; Face; Guidelines; Health; Health behavior; Hour; Individual; Intervention; Measures; Mediating; Mental disorders; Methods; Motivation; Outcome; Participant; Patient Self-Report; Persons; Pharmaceutical Preparations; Pharmacotherapy; Physiological; Prevalence; Public Health; Public Housing; Randomized; Readiness; Relative (related person); Research; Sampling; Self Determination; Smoker; Smoking; Telephone; Testing; Theoretical model; Time; Tobacco smoking; Work; base; behavior change; behavioral clinical trial; brief advice; design; follow-up; interest; motivational enhancement therapy; named group; novel; primary outcome; randomized trial; smoking cessation; standard of care; theories; therapy design; treatment as usual; treatment effect; varenicline

DESCRIPTION (provided by applicant): Tobacco smoking remains one of the most significant preventable causes of death in the U.S. Although most smokers are interested in quitting, only one in five are ready to make a quit attempt at any point in time. Unfortunately, few interventions designed to enhance motivation or readiness among smokers who are not ready to quit are available. One intervention method that focuses on enhancing motivation for and commitment to behavior change is Motivational Interviewing (MI). MI has been shown to be effective for addressing a variety of addictive and health behaviors, however findings for smoking cessation have been overwhelmingly negative and all prior studies have significant limitations. One important limitation of prior studies is that they were not designed to directly test whether MI is more effective for smokers who are not ready to quit, and in particular, whether MI was more effective at motivating quit attempts. Moreover, nearly all focused on special populations such as public housing residents, adolescents, and people with mental illness, many of whom face significant environmental and physiological barriers to quitting. Therefore, the primary aim of this study is to test, among a sample of general adult smokers, the effectiveness of MI for motivating quit attempts among smokers not yet ready to quit. We will randomly assign eligible smokers to Motivational Interviewing (MI), a PHS Guidelines-based counseling control (GBC), or brief advice (BA). The primary outcome will be the occurrence (or not) of any self-reported quit attempt lasting at least 24 hours between randomization and 6 month follow-up. The secondary aim will be to examine 6 month follow-up quit rates between the groups in order to provide an effect size estimate that could be used in designing a large scale study with a primary outcome of smoking cessation. Participants in BA will receive 1 session and participants MI and GBC will receive 5 individual sessions (2 in-person, 3 phone) over 7 weeks. All participants who decide to quit will be provided with varenicline (Chantix). We project needing to enroll 255 smokers who are not ready to quit to detect the proposed treatment effect. PUBLIC HEALTH RELEVANCE: Tobacco smoking remains one of the most significant preventable causes of death in the U.S. and although most smokers are interested in quitting, four in five are not ready to make a quit attempt at any given point in time. This project addresses the lack of methods designed to increase readiness to quit by testing a novel counseling method known as Motivational Interviewing. The potential public health impact is large because it could extend the reach of effective cessation interventions to the majority of smokers who are unmotivated and reduce the decades-long lag between smoking initiation and cessation.

描述（由申请人提供）：烟草吸烟仍然是美国最重要的可预防死亡原因之一，尽管大多数吸烟者对退出感兴趣，但只有五分之一的人准备在任何时候戒烟。不幸的是，很少有旨在提高尚未准备好退出的吸烟者动机或准备就绪的干预措施。一种侧重于增强动力和对行为改变承诺的干预方法是动机访谈（MI）。 MI已被证明可有效解决各种成瘾性和健康行为，但是戒烟的发现绝大多数是负面的，所有先前的研究都有很大的局限性。先前研究的一个重要局限性是，它们不是为了直接测试MI是否对尚未准备好戒烟的吸烟者更有效，特别是MI是否更有效地激发了戒烟尝试。此外，几乎所有人都集中在特殊人群上，例如公共住房居民，青少年和患有精神疾病的人，其中许多人面临着重大的环境和生理障碍。因此，这项研究的主要目的是在一般成年吸烟者的样本中测试MI在尚未准备好戒烟的吸烟者中的戒烟尝试的有效性。我们将随机将合格的吸烟者分配给动机访谈（MI），基于PHS指南的咨询控制（GBC）或简短建议（BA）。主要结果将是任何自我报告的戒烟尝试的发生（或不），在随机分组和6个月随访之间持续至少24小时。次要目的是检查两组之间的6个月的随访率，以提供效果大小估计值，该估计值可用于设计大规模研究，并以戒烟为主要的结果。 BA的参与者将获得1次会议，MI和GBC的参与者将在7周内接受5个个人会议（2次面对面，3个电话）。所有决定退出的参与者都将提供Varenicline（Chantix）。我们预计需要招募255名尚未准备好戒烟来检测拟议治疗效果的吸烟者。公共卫生相关性：烟草吸烟仍然是美国最重要的预防死亡原因之一，尽管大多数吸烟者对退出感兴趣，但五分之一的人尚未准备好在任何给定时间点戒烟。该项目解决了缺乏旨在通过测试一种被称为动机访谈的新型咨询方法来增加准备就绪的方法。潜在的公共卫生影响很大，因为它可以将有效的戒烟干预措施扩展到大多数没有动力的吸烟者，并减少吸烟启动和停止之间长达数十年的滞后。