Enhanced motivational interviewing versus brief advice for adolescent smoking cessation: Results from a randomized clinical trial

BackgroundMotivational interviewing (MI) is widely used for adolescent smoking cessation but empirical support for this approach is mixed.MethodsAdolescent cigarette smokers 14–18 years old (N = 162) were recruited from medical, school, and community settings and randomly assigned to enhanced MI or brief advice (BA) for smoking cessation. MI comprised an in-person individual session, a telephone booster session one week later, and a brief telephone-based parent intervention. BA consisted of standardized brief advice to quit smoking. Assessments occurred at baseline, post-treatment and at 1-, 3-, and 6-month follow ups.ResultsBiochemically-confirmed 7-day point prevalence abstinence rates were low (e.g., 4.5% for MI; 1.4% for BA at 1 month) and did not differ significantly by group at any follow up. Only those in MI reported significant decreases in cigarettes smoked per day (CPD) from baseline to 1 month. At 3 and 6 months, smokers in both groups reported significantly reduced CPD with no differences between groups. MI reduced perceived norms regarding peer and adult smoking rates, while BA had no effect on normative perceptions. No group differences emerged for self-reported motivation or self-efficacy to quit smoking.ConclusionsFindings support the efficacy of MI for addressing normative misperceptions regarding peer and adult smoking and for modestly reducing CPD in the short-term; however, these effects did not translate to greater smoking abstinence. MI may have more promise as a prelude to more intensive smoking intervention with adolescents than as a stand-alone intervention.

► We compared two brief smoking cessation interventions for adolescents.
► Motivational interviewing (MI) reduced smoking more than brief advice (BA).
► MI also reduced perceptions of adolescent and adult smoking norms.
► Rates of smoking cessation were low and did not differ by group.
► We conclude that MI has positive proximal effects but does not lead to cessation.