An Adaptation of Motivational Interviewing Increases Quit Attempts in Smokers With Serious Mental Illness

Steinberg, Marc L.; Williams, Jill M.; Stahl, Naomi F.; Budsock, Patricia Dooley; Cooperman, Nina A.

doi:10.1093/ntr/ntv043

Cited by 35 publications

(46 citation statements)

References 51 publications

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“…Psychoeducational intervention (individual)3. ControlMotivational interviewing consisted of 1 × 40 minute session.Psychoeducation consisted of 1 × 40 minute sessionControl consisted of 1 5 min session.Expired CO at 1 week and 1 monthNumber of cigarettes per dayHeaviness of smokingContemplation ladderFTNDImportance of quittingConfidence in ability to quitSteinberg 2016 [36]RCT98 outpatients with DSM IV schizophrenia, schizoaffective disorder or Bipolar I 46% male, 61% white.1. Motivation interviewing 1 × 45 min personalised session2.…”

Section: Resultsmentioning

confidence: 99%

Smoking cessation in severe mental ill health: what works? an updated systematic review and meta-analysis

et al. 2017

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BackgroundPeople with severe mental ill health are more likely to smoke than those in the general population. It is therefore important that effective smoking cessation strategies are used to help people with severe mental ill health to stop smoking. This study aims to assess the effectiveness and cost –effectiveness of smoking cessation and reduction strategies in adults with severe mental ill health in both inpatient and outpatient settings.MethodsThis is an update of a previous systematic review. Electronic databases were searched during September 2016 for randomised controlled trials comparing smoking cessation interventions to each other, usual care, or placebo. Data was extracted on biochemically-verified, self-reported smoking cessation (primary outcome), as well as on smoking reduction, body weight, psychiatric symptom, and adverse events (secondary outcomes).ResultsWe included 26 trials of pharmacological and/or behavioural interventions. Eight trials comparing bupropion to placebo were pooled showing that bupropion improved quit rates significantly in the medium and long term but not the short term (short term RR = 6.42 95% CI 0.82–50.07; medium term RR = 2.93 95% CI 1.61–5.34; long term RR = 3.04 95% CI 1.10–8.42). Five trials comparing varenicline to placebo showed that that the addition of varenicline improved quit rates significantly in the medium term (RR = 4.13 95% CI 1.36–12.53). The results from five trials of specialised smoking cessation programmes were pooled and showed no evidence of benefit in the medium (RR = 1.32 95% CI 0.85–2.06) or long term (RR = 1.33 95% CI 0.85–2.08). There was insufficient data to allowing pooling for all time points for varenicline and trials of specialist smoking cessation programmes. Trials suggest few adverse events although safety data were not always reported. Only one pilot study reported cost effectiveness data.ConclusionsBupropion and varenicline, which have been shown to be effective in the general population, also work for people with severe mental ill health and their use in patients with stable psychiatric conditions. Despite good evidence for the effectiveness of smoking cessation interventions for people with severe mental ill health, the percentage of people with severe mental ill health who smoke remains higher than that for the general population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-017-1419-7) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Smoking cessation in severe mental ill health: what works? an updated systematic review and meta-analysis

et al. 2017

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“…Similarly, Ferron et al (Ferron, et al, 2016) reported a biochemically verified quit rate of 9% six months after a single use of a motivational decision support system. Steinberg et al, (Steinberg, et al, 2016) reported somewhat higher biochemically verified abstinence in both their motivational interview group (16.3%) and the interactive educational group (10.2%). However, they measured abstinence at 1-month follow-up.…”

Section: Discussionmentioning

confidence: 91%

“…He found MI resulted in more contacts to a tobacco dependence treatment provider and greater attendance at an initial counseling visit. Enhancing the interactivity of the educational intervention increased quit attempts and follow-ups on a referral for tobacco dependence treatment but did not increase abstinence at 1-month follow-up for smokers, who did not plan to quit in the next 30 days, receiving motivational interviewing compared to those receiving the educational intervention (Steinberg, Williams, Stahl, Budsock, & Cooperman, 2016). Brunette et al (Brunette et al, 2013; Brunette et al, 2011) had smokers with a severe mental illness use an electronic decision support tool that addressed risks of smoking, benefits of quitting, and evidence-based treatments.…”

Section: Introductionmentioning

confidence: 99%

Helping Smokers with Severe Mental Illness Who Do Not Want to Quit

Christiansen

Carbin

TerBeek

et al. 2017

Substance Use & Misuse

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Background People with a severe and persistent mental illness are far more likely to smoke than others. Importantly, a large portion of them would like to quit. Despite this desire, they are less likely to make quit attempts and succeed. Objective This study used an RCT to test an intervention designed to increase engagement in cessation treatment, quit attempts, and quitting in smokers who did not want to quit in the next 30 days. It also compared these smokers with those who were motivated to quit in the next 30 days. Methods Participants (N=222), smokers with significant mental illness receiving intensive outpatient care from Community Support Programs in Wisconsin who were not interested in quitting in the next 30 days, were randomly assigned to either an intervention group or an attention control group. The intervention, administered during four weekly sessions, included a motivational element, components designed to prepare the smoker for a quit attempt, and pre-quit nicotine patch. Additionally, 48 smokers motivated to quit in the next 30 days served as a comparison group. Results Compared to control participants, smokers receiving the intervention were more likely to be abstinent (7 day point prevalence) at the three month follow-up (biochemically verified, intent to treat, 8.5% vs. 1.0%, respectively, p=.01). They were also more likely to accept four more quitting preparation sessions (intent to treat, 50.8% vs 29.2%, respectively p<.001) but were not more likely to call a telephone tobacco quit line (intent to treat, 9.3% vs. 5.8%, respectively p=.45). Conclusion/Importance Brief motivational interventions increased engagement in cessation treatment and abstinence among smokers with signification mental illness.

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“…These have included studies of web-based interventions, demonstrating significant effects on treatment utilization and cessation outcomes (Brunette et al, 2013;Brunette, Ferron, Gottlieb, Devitt, & Rotondi, 2016;Brunette et al, 2011). Similarly, the utility of in-person brief motivational interventions has been demonstrated for enhancing treatment utilization and cessation outcomes in smokers with SMI (Steinberg, Williams, Stahl, Budsock, & Cooperman, 2016;Steinberg, Ziedonis, Krejci, & Brandon, 2004). Thus, prior evidence indicates that MIs hold promise for enhancing treatment engagement and utilization among TRHD smokers, including those with SMI.…”

Section: Introductionmentioning

confidence: 99%

Enhancing engagement in evidence-based tobacco cessation treatment for smokers with mental illness: A pilot randomized trial

Myers

Strong

Chen

et al. 2020

Journal of Substance Abuse Treatment

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An Adaptation of Motivational Interviewing Increases Quit Attempts in Smokers With Serious Mental Illness

Abstract: A brief adaptation of MI with personalized feedback appears to be a promising approach for increasing quit attempts in smokers with SMI, but future research is required to determine how to best help smokers with SMI to attain sustained abstinence.

Cited by 35 publications

References 51 publications

Smoking cessation in severe mental ill health: what works? an updated systematic review and meta-analysis

Smoking cessation in severe mental ill health: what works? an updated systematic review and meta-analysis

Helping Smokers with Severe Mental Illness Who Do Not Want to Quit

Enhancing engagement in evidence-based tobacco cessation treatment for smokers with mental illness: A pilot randomized trial

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