Effectiveness of motivational interviewing versus simple brief advice for smokers in health insurance clinics in Ismailia, Egypt

الملخص EN

Introduction : At some point in the second decade of the 21st century, annual deaths from tobacco will average 10 million a year.

It is estimated that 40 % of smokers make some form of attempt to quit in response to advice from general practitioners.

Studies of effectiveness of smoking cessation advice by health care providers in developing countries are scarce.

Study Objective : This study has been conducted to compare the effectiveness of a motivational method for smoking cessation with a simple brief advice.

Subjects and Methods : 176 smokers aged 18 to 60 years old, attending the health Insurance clinics, and consenting to participate in the study were randomly allocated to one of two groups : one group exposed to motivational consulting method and the other to simple brief advice.

A sample size of 176 was calculated to detect a 15 % difference in quitting rate at (level of 0.05 and 80 % power.

Outcome Measures : Smoking status at follow up, trying to quit smoking during the period of follow up, cutting down cigarettes at follow up, change in subjects! stage of change, degrees of motivation and confidence.

Results : There were insignificant differences between the two groups regarding age (35.5 v 4.8), marital status, mean age at starting smoking (17.8 v 17.2), mean number of cigarette / Day (18.7 v 19.0), number of giving up attempts and longest period of quitting attempt.

There was no statistical sfgnificunt differences between the motivational consulting and the brief advice groups regarding smoking status at 6 months follow up (p = 0.62), different stage of readiness to change (p = 0.97).

The odds ratio for the relation between the stage of readiness and trying to quit smoking was 2.04 for the intervention group and 1.28 for the brief advice group.

Logistic regression analysis model for the stage of change and the trying to quit showed that motivation, age and perceived seriousness were the independent significant variables that can be used for prediction (p < 0.01).

Conclusion : Effectiveness of the motivational consulting in its generic form for smoking cessation compared with the simple brief advice is not supported by the findings from the present study in term of abstinence rate.

The use of motivational consulting of smokers based on the stage of readiness to change model in everyday practice may be helpful to dictate the nature of the subsequent sessions with smokers.