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）：吸烟仍然是美国最重要的可预防死亡原因之一。尽管大多数吸烟者有兴趣戒烟，但只有五分之一的人准备随时尝试戒烟。不幸的是，很少有旨在增强尚未准备好戒烟的吸烟者的动机或准备的干预措施。一种专注于增强行为改变动机和承诺的干预方法是动机访谈（MI）。 MI 已被证明可以有效解决各种成瘾和健康行为，但戒烟的结果绝大多数都是负面的，并且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，它们并不是旨在直接测试 MI 是否对尚未准备好戒烟的吸烟者更有效，特别是 MI 是否在激励戒烟尝试方面更有效。此外，几乎所有的戒烟都集中在特殊人群，如公共住房居民、青少年和精神疾病患者，其中许多人在戒烟方面面临着巨大的环境和生理障碍。因此，本研究的主要目的是在一般成年吸烟者样本中测试 MI 对激励尚未准备戒烟的吸烟者尝试戒烟的有效性。我们将随机分配符合条件的吸烟者进行动机访谈 (MI)、基于 PHS 指南的咨询控制 (GBC) 或简短建议 (BA)。主要结局是随机分组和 6 个月随访之间是否发生（或不发生）任何自我报告的戒烟尝试持续至少 24 小时。第二个目标是检查各组之间 6 个月的随访戒烟率，以提供效应大小估计，该估计可用于设计以戒烟为主要结果的大规模研究。 BA 参与者将在 7 周内接受 1 次会议，MI 和 GBC 参与者将接受 5 次单独会议（2 次面对面会议，3 次电话会议）。所有决定戒烟的参与者都将获得伐尼克兰（Chantix）。我们预计需要招募 255 名尚未准备好戒烟的吸烟者来检测建议的治疗效果。公共卫生相关性：吸烟仍然是美国最重要的可预防死亡原因之一，尽管大多数吸烟者有兴趣戒烟，但五分之四的人尚未准备好在任何特定时间点尝试戒烟。该项目通过测试一种称为动机访谈的新颖咨询方法来解决缺乏旨在提高戒烟准备度的方法的问题。潜在的公共卫生影响是巨大的，因为它可以将有效戒烟干预措施的范围扩大到大多数无动力的吸烟者，并缩短开始吸烟和戒烟之间长达数十年的滞后期。