title: The efficacy of motivational interviewing versus brief advice for adolescent smoking behavior change.
abstract: OBJECTIVE
  In this study we sought to evaluate the efficacy of motivational interviewing (MI) compared with structured brief advice (SBA) for adolescent smoking behavior change.
  
  
  METHODS
  Participants (N=355) were randomly assigned to 5 sessions of either MI or SBA. The primary outcomes were attempts to reduce and to quit smoking, smoking reduction, and cotinine-validated 7-day point-prevalence smoking abstinence at the end of treatment (week 12) and the 24-week follow-up.
  
  
  RESULTS
  White adolescents were ∼80% less likely to attempt to cut back (odds ratio [OR]: 0.21; confidence interval [CI]: 0.08-0.53) and >80% less likely to attempt to quit smoking compared with black adolescents (OR: 0.17 [CI: 0.06-0.46]). Adolescents who were at least planning to cut back or quit smoking at baseline were almost 3 times more likely to attempt to cut back (OR: 2.87 [CI: 1.26-6.52]) and to attempt to quit smoking (OR: 3.13 [CI: 1.19-8.26]). Adolescents who received MI were ∼60% less likely than adolescents who received SBA to try to quit smoking (OR: 0.41 [CI: 0.17-0.97]). However, adolescents who received MI showed a greater reduction in cigarettes smoked per day than adolescents who received SBA (5.3 vs 3.3 fewer cigarettes per day). There were no statistically significant differences between MI and SBA in smoking abstinence (5.7% vs 5.6%, respectively).
  
  
  CONCLUSIONS
  The effects of MI on adolescent smoking behavior change are modest, and MI may best fit within a multicomponent smoking cessation treatment approach in which behavior change skills can support and promote smoking behavior change decisions.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, 3535 Market St, Suite 4100, Philadelphia, PA 19104, USA. audrain@mail.med.upenn.edu
authors.forename: Janet
authors.initials: J
authors.lastname: Audrain-McGovern
authors.forename: Sarah
authors.initials: S
authors.lastname: Stevens
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Murray
authors.forename: Sara
authors.initials: S
authors.lastname: Kinsman
authors.forename: Allan
authors.initials: A
authors.lastname: Zuckoff
authors.forename: Jon
authors.initials: J
authors.lastname: Pletcher
authors.forename: Deborah
authors.initials: D
authors.lastname: Moss
authors.forename: Agnieshka
authors.initials: A
authors.lastname: Baumritter
authors.forename: Susan
authors.initials: S
authors.lastname: Kalkhuis-Beam
authors.forename: Elyse
authors.initials: E
authors.lastname: Carlson
authors.forename: Daniel
authors.initials: D
authors.lastname: Rodriguez
authors.forename: E Paul
authors.initials: EP
authors.lastname: Wileyto
mesh_terms: D000293:Adolescent; D037001:Directive Counseling; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D015999:Multivariate Analysis; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology*