Comparing primary care physicians' smoking cessation counseling techniques to motivational interviewing

James J. Werner, Peter J. Lawson, Vanessa Panaite, Mary M. Step, Susan A. Flocke

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objectives: This study examined the degree of similarity between motivational interviewing (MI) methods and smoking cessation techniques that are routinely used by primary care physicians. Its purpose was to inform the development of more effective MI-based health behavior change training programs for primary care physicians. Methods: Visits to primary care physicians were audio-recorded in northeast Ohio from 2005 to 2008. Doctor-patient talk about smoking cessation (n = 73) was analyzed for adherence to MI using the Motivational Interviewing Skills Code (MISC) version 2.1 behavioral coding system. Participating physicians were not provided with MI training as part of the study and were blinded as to the study's purpose. Results: Physicians displayed MI adherent behaviors in 56% of discussions and MI nonadherent behaviors in 57%. The most common MI adherent statements involved affirming the patient; least common were requests for the patient's permission before raising concerns. The most frequent MI nonadherent behaviors were directing, confronting, and warning the patient. Physicians made simple reflections and complex reflections in 36% and 25% of visits, respectively. Conclusions: Physicians used bothMI adherent andMI nonadherent behaviors in approximately equal proportions, suggesting a base of MI adherent smoking cessation counseling skills upon which additional MI skills can be built. Efforts to improve smoking-cessation effectiveness may involve providing training in brief MI models and additional MI skills, while reinforcing physicians' current use of MI adherent methods.

Original languageEnglish (US)
Pages (from-to)139-142
Number of pages4
JournalJournal of addiction medicine
Issue number2
StatePublished - Mar 2013
Externally publishedYes


  • Cancer prevention
  • Health behavior change
  • MISC
  • Motivational interviewing
  • Motivational interviewing skills code
  • Primary care
  • Smoking cessation
  • Smoking cessation counselling

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)


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