Tuberc Respir Dis.  2014 Jun;76(6):276-283.

Effectiveness of Smoking Cessation Using Motivational Interviewing in Patients Consulting a Pulmonologist

  • 1Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.


We aimed to investigate the role of the physician in practice and the factors that influence the success rate of smoking cessation.
This study retrospectively analyzed 126 adult smokers who had visited the outpatient department of pulmonology, and received motivational interviewing with or without supplement drugs. The findings include continuous smoking abstinence rate, which was evaluated at 6, 12 and 24 weeks, and the factors associated with continuous abstinence for 6 months or longer.
The patients with only motivational interviewing accounted for 57.9%, while the nicotine patch therapy was applied to 30.2%; and varenicline was prescribed to 11.9%. The smoking cessation success rates of at 6, 12, and 24 weeks were 55.6%, 47.6%, and 33.3%, respectively. However, even in the failure group at six months, tobacco consumption was decreased under 10 cigarettes per day in 42.1% (53/126). In multivariate logistic regression analysis, degree of Fagerstom Test for Nicotine Dependence (p=0.034; odds ratio, 3.607; 95% confidence interval [CI], 1.102-1.807), the absence of smoking-related lung disease (p=0.008; odds ratio, 4.693; 95% CI, 1.497-14.707), and education level (p=0.001; odds ratio, 181.420; 95% CI, 8.414-3,911.502) were the predictors of successful smoking cessation.
An improved continuous smoking abstinence rate can be obtained by motivational interviewing, regardless of the association with pharmacotherapy.


Smoking Cessation; Tabacco Dependence; Motivational Interviewing

MeSH Terms

Drug Therapy
Logistic Models
Lung Diseases
Motivational Interviewing*
Odds Ratio
Pulmonary Medicine
Retrospective Studies
Smoking Cessation*
Tobacco Products
Tobacco Use
Tobacco Use Cessation Products
Tobacco Use Disorder


  • Figure 1 Intervention for smoking cessation of participants through the study. MI: motivational interviewing; NRT: nicotine patch therapy.

  • Figure 2 The main diagnosis of respiratory disease on enrollment. COPD: chronic obstructive pulmonary disease; TB: tuberculosis; ACOS: asthma COPD overlap syndrome; SPN: solitary pulmonary nodule; ILD: interstitial lung diseas.


1. Tonnesen P, Carrozzi L, Fagerstrom KO, Gratziou C, Jimenez-Ruiz C, Nardini S, et al. Smoking cessation in patients with respiratory diseases: a high priority, integral component of therapy. Eur Respir J. 2007; 29:390–417.
2. Ministry of Health and Welfare. Korea National Health and Nutrition Examination Survey (KNHANES V-3). Seoul: Korea Centers for Disease Control and Prevention;2012.
3. Lee JY, Kim MJ, Jun HJ, Kang M, Park AR, Oh DE, et al. Adherence to varenicline and abstinence rates for quitting smoking in a private health promotion center-based smoking cessation clinic. Tuberc Respir Dis. 2012; 72:426–432.
4. Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev. 2013; 5:CD000165.
5. Jeon K, Song JU, Um SW, Koh WJ, Suh GY, Chung MP, et al. Bronchoscopic findings of pulmonary paragonimiasis. Tuberc Respir Dis. 2009; 67:512–516.
6. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict. 1991; 86:1119–1127.
7. Perez-Rios M, Santiago-Perez MI, Alonso B, Malvar A, Hervada X, de Leon J. Fagerstrom test for nicotine dependence vs heavy smoking index in a general population survey. BMC Public Health. 2009; 9:493.
8. Myung SK, Seo HG, Park S, Kim Y, Kim DJ, Lee DH, et al. Sociodemographic and smoking behavioral predictors associated with smoking cessation according to follow-up periods: a randomized, double-blind, placebo-controlled trial of transdermal nicotine patches. J Korean Med Sci. 2007; 22:1065–1070.
9. Nakamura M, Oshima A, Fujimoto Y, Maruyama N, Ishibashi T, Reeves KR. Efficacy and tolerability of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, in a 12-week, randomized, placebo-controlled, dose-response study with 40-week follow-up for smoking cessation in Japanese smokers. Clin Ther. 2007; 29:1040–1056.
10. Tsai ST, Cho HJ, Cheng HS, Kim CH, Hsueh KC, Billing CB Jr, et al. A randomized, placebo-controlled trial of varenicline, a selective alpha4beta2 nicotinic acetylcholine receptor partial agonist, as a new therapy for smoking cessation in Asian smokers. Clin Ther. 2007; 29:1027–1039.
11. Wang C, Xiao D, Chan KP, Pothirat C, Garza D, Davies S. Varenicline for smoking cessation: a placebo-controlled, randomized study. Respirology. 2009; 14:384–392.
12. Hughes JR, Keely J, Naud S. Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction. 2004; 99:29–38.
13. Catley D, Harris KJ, Goggin K, Richter K, Williams K, Patten C, et al. Motivational Interviewing for encouraging quit attempts among unmotivated smokers: study protocol of a randomized, controlled, efficacy trial. BMC Public Health. 2012; 12:456.
14. Noordman J. Lifestyle counseling by physicians and practice nurses in primary care: an analysis of daily practice. Utrecht: Netherlands Institute for Health Services Research;2013.
15. Martins RK, McNeil DW. Review of motivational interviewing in promoting health behaviors. Clin Psychol Rev. 2009; 29:283–293.
16. Ojedokun J, Keane S, O'Connor K. Lung age bio-feedback using a portable lung age meter with brief advice during routine consultations promote smoking cessation? Know2quit multicenter randomized control trial. J Gen Pract. 2013; 1:123.
17. Borland R, Balmford J, Swift E. Effects of timing of initiation and planning on smoking cessation outcomes: study protocol for a randomised controlled trial. BMC Public Health. 2013; 13:235.
18. West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Health Education Authority. Thorax. 2000; 55:987–999.
19. Lancaster T, Stead L. Extended-duration transdermal nicotine therapy was more effective than standard-duration therapy for smoking cessation. Ann Intern Med. 2010; 152:JC4–JC8.
20. Gourlay SG, Forbes A, Marriner T, Pethica D, McNeil JJ. Prospective study of factors predicting outcome of transdermal nicotine treatment in smoking cessation. BMJ. 1994; 309:842–846.
21. Yeo CD, Kang HH, Kang JY, Kim SK, Kim MS, Kim SS, et al. A short-term effectiveness of smoking cessation intervention in outpatient department of pulmonology. Tuberc Respir Dis. 2011; 71:114–119.
22. Balmford J, Leifert JA, Schulz C, Elze M, Jaehne A. Implementation and effectiveness of a hospital smoking cessation service in Germany. Patient Educ Couns. 2014; 94:103–109.
23. Raupach T, Brown J, Herbec A, Brose L, West R. A systematic review of studies assessing the association between adherence to smoking cessation medication and treatment success. Addiction. 2014; 109:35–43.
24. Shah SD, Wilken LA, Winkler SR, Lin SJ. Systematic review and meta-analysis of combination therapy for smoking cessation. J Am Pharm Assoc (2003). 2008; 48:659–665.
25. Tashkin D, Kanner R, Bailey W, Buist S, Anderson P, Nides M, et al. Smoking cessation in patients with chronic obstructive pulmonary disease: a double-blind, placebo-controlled, randomised trial. Lancet. 2001; 357:1571–1575.
Full Text Links
  • TRD
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2023 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: