title: Efficacy of brief motivational interviewing on smoking cessation at tuberculosis clinics in Tshwane, South Africa: a randomized controlled trial.
abstract: OBJECTIVE
  Tuberculosis (TB) patients who smoke risk adverse TB outcomes and other long-term health effects of smoking. This study aimed to determine the efficacy of brief motivational interviewing by lay health-care workers (LHCWs) in assisting TB patients to quit smoking.
  
  
  METHODS
  Multi-centre two-group parallel individual randomized controlled trial.
  
  
  METHODS
  Six primary care tuberculosis clinics in a South African township.
  
  
  METHODS
  Newly diagnosed adult TB patients identified as current smokers were randomized to brief motivational interviewing by a LHCW (intervention group, n = 205) or brief smoking cessation advice from a TB nurse (control group, n = 204).
  
  
  METHODS
  The primary outcome was self-reported sustained 6-month smoking abstinence. Exhaled carbon monoxide (CO) testing was offered to about half the participants. Secondary outcomes were sustained abstinence at 3 months; 7-day point prevalence abstinence at 1, 3 and 6 months; and quit attempts. Allocation was concealed. Primary analysis relied on intention to treat. Multi-level analysis accounted for site heterogeneity of effect.
  
  
  RESULTS
  Self-reported 6-month sustained abstinence was 21.5% for the intervention group versus 9.3% for the control group [relative risk (RR) = 2.29, 95% confidence interval (CI) = 1.34, 3.92]. Biochemically verified 6-month sustained abstinence was also higher in the intervention group (RR 2.21, 95% CI = 1.08, 4.51) for the 166 participants who were offered carbon monoxide testing. Self-reported 3-month sustained abstinence was 25.4% for the intervention group and 12.8% for the control group (RR = 1.98, 95% CI = 1.24, 3.18).
  
  
  CONCLUSIONS
  Motivational interviewing by lay counsellors to promote smoking cessation in tuberculosis patients in South Africa approximately doubled sustained smoking abstinence for at least 6 months compared with brief advice alone.
authors: School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa.
authors: Goedele M C
authors: GM
authors: Louwagie
authors: Kolawole S
authors: KS
authors: Okuyemi
authors: Olalekan A
authors: OA
authors: Ayo-Yusuf
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006268:Health Facilities; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D055361:Multilevel Analysis; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D013019:South Africa; D016896:Treatment Outcome; D014376:Tuberculosis / Q000628:therapy*
keywords: HIV; lay health-care worker; randomized controlled trial; tobacco; tobacco cessation; tuberculosis