Motivational interviewing & smoking cessation

22-markMark Wallace-Bell
Canterbury University
22-flag New Zealand
11 Apr 2014


Tell us about your work with tobacco dependence treatment:

I have been working as a nurse, psychologist and an educator in the field of health psychology and addictions for over 10 years.  Over recent years I have noticed a change in how we address smoking and nicotine dependence in mental health and addiction treatment settings.  The advent of smoke-free policies and more and more restrictions on smoking in mental health hospitals and community centres has forced the workforce and their clients to think differently about tobacco smoking and nicotine addiction.

We can no longer view smoking as a normal activity or worse as a therapeutic adjunct to therapy.  In the 1980’s when I nursed on acute mental health wards it was “normal” to smoke with clients and to allow clients to smoke in their rooms.  Goodness knows what impact this had on their health and the health of the staff.  We can no longer see smoking in that way.  Nicotine addiction is like other addictions.  We need to recognise it as a mental health problem and help people to be smoke free so that they can improve their mental health and their general well-being.

Please discuss in some detail what Motivational Interviewing techniques are and how they relate to smoking cessation:

More recently I have been researching and using Motivational Interviewing in my work.  I am a member of the Motivational Interviewing Network of Trainers (MINT).  This connects me with a global community of people using Motivational Interviewing in their work and training others to use Motivational Interviewing in wide range of settings.

The research supports the use of Motivational Interviewing in smoking cessation.  It is evident that Motivational Interviewing can help people resolve their ambivalence about stopping smoking and can help them strengthen their confidence to quit smoking.

Motivational Interviewing involves a strong relational component and is also focused on strengthening a client’s motivation to stop smoking.  This is done by paying attention to the language of change or “change talk.”  For the Motivational Interviewing practitioner this means having a strong relational quality to the intervention as well as reflecting client’s speech that points towards change and reinforcing this language.  The theory says that when people talk change and this talk is strong they are more likely to act on it.

Motivational Interviewing is not a stand alone intervention.  Sometimes it is enough but other times when Motivational Interviewing is combined with other therapies it can be more effective.  So, I see Motivational Interviewing as being an important set of skills for nurses to have that compliments their work and should lead to better outcomes for the clients if it is done well.

How long have you been working in this area?

I have been involved in practice, research and education for over 10 years in the UK and now in New Zealand.

What was the reason you got involved with this type of work?

This was not a life plan.  I did not wake up one morning as a young man and think “that’s what I want to do.”  I suppose it’s been a mixture of following my interests, a bit of luck and a bit of bad luck.  I started nursing after a time in hospital when I had a motorcycle accident, that lead me to start nurse training which led me to study psychology and eventually a PhD in psychology in 2001. I enjoy the challenge that helping people with addictions brings. We don’t have the full picture yet and we are still finding new ways to help people.  On reflection, it is the clients I meet and being involved in helping them that is the main reason I do this work.