From appetitive to aversive: Motivational interviewing reverses the modulation of the startle reflex by tobacco cues in smokers not ready to quit

•Viewing tobacco pictures in smokers not ready to quit inhibited the startle reflex, indicative of appetitive activation.•However, after Motivational Interviewing or Prescriptive Advice the same tobacco pictures potentiated the startle reflex.•This effect was stronger in the Motivational Interviewing than in the Prescriptive Advice group.

Motivational Interviewing (MI) is a treatment method that has proven effective for increasing motivation to change and decreasing the consumption of different drugs. However, the results of studies examining the impact of MI on tobacco consumption are contradictory. Moreover, evidence of the effectiveness of MI for modifying well-validated psychophysiological indices of motivational change is still lacking. The aim of the present study was to use the startle probe paradigm and self-report measures of motivational change to assess the effectiveness of MI, compared to Prescriptive Advice (PA) and no treatment, in a sample of 53 smokers (28 male) who were not ready to quit smoking. After the intervention, the MI group reported increased motivation to change compared to both the PA and control groups. MI participants also had a potentiated startle reflex in response to tobacco-related pictures compared to the other two groups. These findings provide evidence that MI reverses the underlying motivational system activated by tobacco related cues.