How Much Motivation Do You Need?

In recognition of being blogrolled by The Rest of the Story, Tobacco News Analysis and Commentary, I’m introducing this paper recently published in the British Medical Journal about encouraging pregnant smokers to quit. The study evaluated the use of motivational interviewing, a behavioral therapy for addictive behaviors in a systematic manner. Standard health promotional materials were offered to both the control and intervention group. The intervention group was provided motivational interviewing at home by specially trained midwives. The outcomes measured were self-reported smoking cessation, verified by biological monitoring of cotinine (a nicotine metabolite).

Contrary to what the National Health Services argues, motivational interviewing did not result in an increase in the numbers of pregnant women who quit, and wasn’t as effective in getting pregnant smokers to cut down compared with just offering promotional materials.

These days, I struggle a bit with drawing the line between personal responsibility and corporate social responsibility in certain exposure settings. It’s abhorrent for cigarette manufacturers to continue marketing a product known to produce significant adverse health effects (we’re not left still wondering about this, as in the case of plasticizers or fire retardants – we know about tobacco smoking), and to continue their evasion in making full compensation for the harm caused by their product. But, can the smokers, particularly those who started after 1964 when the Surgeon General’s report came out, fairly say they weren’t warned?

The linkage with The Rest of the Story is important, beyond the value of developing a public health blog critical mass, because tobacco smoking is an environmental health issue (asbestos, asthma, chronic obstructive pulmonary disease from PM exposure, cadmium and polycyclic aromatic hydrocarbon exposure, and on and on). I look forward to returning from time to time.