A Motivational Intervention to Reduce Cigarette Smoking among College Students: Overview and Exploratory Investigation. (Research)
Herman, Keith C., Fahnlander, Beth, Journal of College Counseling
College counselors can play an important role in implementing brief strategies that will motivate students to stop smoking cigarettes. The authors provide an overview of motivational interviewing, a specific protocol that can be applied to college student smoking. The authors also present preliminary evidence of the success of this approach in promoting abstinence from smoking and a desire to change among college smokers.
Each day, more than 5,000 people smoke their first cigarette (Centers for Disease Control and Prevention [CDC], 1998). Of these individuals, more than two thirds (more than 3,000) are teenagers who are not even old enough to legally purchase cigarettes (CDC, 1998). Even for those who are only experimenting with cigarettes, the risk of addiction is overwhelming. According to the CDC (1998), 55% of individuals who smoke more than 100 cigarettes will continue smoking until the year of their death.
Despite known health risks, smoking prevalence remains high across all age groups. At least 23% of adults in the United States smoke cigarettes (CDC, 1998). Moreover, a recent report issued by the CDC (2000) indicated that the smoking rate among high school students had risen from 27.5% in 1991 to 34.8% in 1999. Similarly, from 1993 to 1997, the smoking rate among college students increased from 22.3% to 2 8.5%. This increase was seen across all student subgroups regardless of gender, race/ethnicity, and year in school (Wechsler, Rigotti, Gledhill-Hoyt, & Lee, 1998).
Although there have been advances in smoking cessation treatment during the past decade, treatment success rates remain discouragingly low. Even comprehensive, multimodal treatment approaches yield 6-month abstinence rates of 40% or less (see Ockene et al., 2000, for a review of treatment approaches). One bright spot regarding treatment innovations has been the success of time-limited interventions in helping people alter substance use patterns (see Bien, Miller, & Boroughs, 1993; Bien, Miller, & Tonigan, 1993; Miller, 1995).
Brief interventions have been among the most promising treatments for reducing problematic substance use, including alcohol and smoking, among college students (Borsari & Carey, 2000; Marlatt et al., 1998). In a recent study, for example, Borsari and Carey investigated the efficacy of a one-session intervention in reducing substance use among binge drinkers. Compared to a no-treatment control group, participants who received the one-session intervention reported a lower number of drinks consumed per week, fewer drinking occasions per month, and fewer binge drinking episodes at 6-week follow-up. Borsari and Carey concluded that the 1-hour intervention significantly reduced both the frequency of drinking and the amount of alcohol consumed.
Brief interventions may also help to reduce cigarette smoking among adults and adolescents (Colby et al., 1998; Rollnick, Butler, & Stott, 1997; Rollnick & Heather, 1992). Rollnick et al. (1997) described, but did not evaluate, a promising brief motivational interview that was designed to reduce smoking among adults in a general medical practice. Similarly, Colby et al. reported some success in administering a single motivational interview to adolescents in a hospital setting. Twice as many participants in the treatment group reported abstinence at 1-month follow-up, as compared with participants who received brief advice to quit smoking. However, the effect was small (effect size [ES] = .28), and no other comparisons were significant. The researchers concluded that motivational interviewing warrants further investigation as a treatment for reducing smoking among adolescents, a conclusion echoed in a recent meta-analysis of motivational interviewing outcome studies (Burke, Arkowitz, & Dunn, 2002).
In addition to studying brief motivational interventions, finding ways to disrupt the common progression from teenage experimentation to lifelong cigarette smoking holds promise for reducing societal smoking rates (McNeill, 1991). …