Instant messaging-delivered brief motivational interviewing for noncommunicable disease patients with no intention to quit smoking

Most noncommunicable disease patients who continue smoking are chronic users with no intention to quit. This multicentre randomised controlled trial evaluated the effectiveness of brief motivational interviewing (MI) delivered using mobile instant messaging on smoking abstinence in this population. Overall, 728 adults were recruited and randomised (1:1) to the intervention or control group. Intervention group received a face-to-face brief MI session followed by instant messaging-delivered brief MI for 6 months. Control group received a face-to-face health advice consultation and a self-help booklet. Follow-ups were conducted at 3, 6, and 12 months. The primary outcome was biochemically validated smoking abstinence at 12 months, defined as self-reported abstinence from smoking in the last 7 days confirmed by exhaled carbon monoxide <4 ppm and saliva cotinine <15 ng/mL. At 12 months, 4.1% of participants in the intervention group met the primary outcome, compared with 1.4% in the control group (rate ratio [RR], 3.00; 95% confidence interval [CI], 1.10-8.17; P = 0.03). Secondary outcomes were also significantly higher in the intervention group, including validated abstinence at 6 months (4.7% vs 1.4%; RR, 3.40; 95% CI, 1.27-9.12; P = 0.02) and intention to quit at both 3 months (30.8% vs 18.9%; RR, 1.63; 95% CI, 1.25-2.13; P < 0.001) and 6 months (33.7% vs 24.1%; RR, 1.40; 95% CI, 1.10-1.79; P = 0.01). The intervention could be easily integrated into existing smoking cessation services, effectively motivating individuals who had no intention of quitting to quit-addressing one of the major challenges in tobacco control.