A novel text message-based motivational interviewing intervention for college students who smoke cigarettes
Anna Jorayeva 1  
S. Lee Ridner 1
Lynne Hall 1
Ruth Staten 1
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University of Louisville
Anna Jorayeva   

University Of Louisville, 555 S Floyd St, 40202 Louisville, United States
Publication date: 2017-11-07
Submission date: 2017-05-28
Final revision date: 2017-10-08
Acceptance date: 2017-10-11
Tob. Prev. Cessation 2017;3(November):129
Tobacco use disorder is critical among people aged 16 to 25 years. College campuses are prime locations for smoking cessation interventions for young adults. The vast majority of the smoking research with college students has been epidemiological in nature. This study examined a novel motivational interviewing intervention designed for college students, and explored predictors of smoking behavior change.

A quasi-experimental one group pretest-posttest design with repeated measures was used to evaluate a novel text message-based brief motivational interviewing intervention. The data were collected from undergraduate students (N=33) who smoked cigarettes in Fall 2015.

Students’ level of autonomy and relatedness needs satisfaction, autonomous motivation, and smoking cessation self-efficacy increased (p < 0.05), and their rate of daily smoking declined (p <0 .05) over time. However, competence need satisfaction, readiness to quit smoking and severity of nicotine addiction remained unchanged. Smoking cessation self-efficacy was the strongest predictor of smoking behavior change in college students.

This study adds to the knowledge on smoking behavior among college students. Preliminary evidence indicates that text message-based motivational interviewing and smoking cessation self-efficacy may help guide successful smoking behavior interventions for college students.

World Health Organization. WHO report on the global tobacco epidemic, 2015: Raising taxes on tobacco. Available at: (accessed December 2016).
World Health Organization. WHO report on the global tobacco epidemic, 2013: Enforcing bans on tobacco advertising, promotion and sponsorship. Available at: (accessed December 2016).
Jamal Ahmed, King Brian A., Neff Linda J., Whitmill Jennifer, Babb Stephen D., Graffunder Corinne M. Current cigarette smoking among adults - United States, 2005 - 2015. MMWR Morb Mortal Wkly Rep. 2016;65(44):1205-1211. doi: 10.15585/mmwr.mm6544a2
Centers for Disease Control and Prevention. Health effects of cigarette smoking. Smoking & Tobacco Use. 2015. Available at: (accessed December 2016).
Campaign for Tobacco-Free Kids. Toll of Tobacco in the United States. 2016. Available from: https://www.tobaccofreekids.or... (accessed December 1, 2016).
United States Census Bureau. School Enrollment. 2015. Available from: (accessed December 2016).
American College Health Association. American College Health Association-National College Health Assessment II: Undergraduate students. Reference group executive summary, Fall 2015. Available at: (accessed December 1, 2016).
Rigotti N, Lee JE, Wechsler H. US college students' use of tobacco products: Results of a national survey. JAMA. 2000;284(6):699-705. doi:10.1001/jama.284.6.699.
Jha P, Ramasundarahettige C, Landsman V, et al. 21st-century hazards of smoking and benefits of cessation in the United States. N Engl J Med. 2013;368(4):341-350. doi: 10.1056/NEJMsa1211128.
Rollnick S, Miller WR, Butler CC. Motivational Interviewing in health care: Helping patients change behavior. New York, NY: The Guilford Press; 2008.
Griffin KW, Botvin GJ. Evidence-based interventions for preventing substance use disorders in adolescents. Child Adolesc Psychiatr Clin N Am. 2010;19(3):505-526. doi: 10.1016/j.chc.2010.03.005.
College Tobacco Prevention Resource. College Tobacco Facts. 2016. Available at: (accessed December 2016).
Suls JM, Luger TM, Curry SJ, Mermelstein RJ, Sporer AK, An LC. Efficacy of smoking-cessation interventions for young adults: A meta-analysis. Am J Prev Med. 2012;42(6):655-662. doi: 10.1016/j.amepre.2012.02.013.
Orr JA, King RJ. Mobile phone SMS messages can enhance healthy behaviour: a meta-analysis of randomised controlled trials. Health psychology review. 2015;9(4):397-416. doi: 10.1080/17437199.2015.1022847.
Butler KM, Fallin A, Ridner SL. Evidence-based smoking cessation for college students. Nurs Clin North Am. 2012;47(1):21-30. doi: 10.1016/j.cnur.2011.10.007
Miller WR, Rollnick S. Motivational Interviewing: Preparing people for change 2ed. New York: The Guilford Press; 2002.
Bock BC, Heron KE, Jennings EG, Magee JC, Morrow KM. User preferences for a text message-based smoking cessation intervention. Health Educ Behav. 2013;40(2):152-159. doi: 10.1177/1090198112463020.
Devries KM, Kenward MG, Free CJ. Preventing smoking relapse using text messages: Analysis of data from the txt2stop trial. Nicotine & tobacco research. 2013;15(1):77-82. doi: 10.1093/ntr/nts086
Free C, Knight R, Robertson S, et al. Smoking cessation support delivered via mobile phone text messaging (txt2stop): A single-blind, randomised trial. Lancet. 2011;378(9785):49-55. doi: 10.1016/S0140-6736(11)60701-0
Gritz ER, Danysh HE, Fletcher FE, et al. Long-term outcomes of a cell phone-delivered intervention for smokers living with HIV/AIDS. Clin Infect Dis. 2013;57(4):608-615 doi: 10.1093/cid/cit349.
Scott-Sheldon LAJ, Lantini R, Jennings EG, et al. Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis. Bars M, ed. JMIR mHealth and uHealth. 2016;4(2):e49. doi:10.2196/mhealth.5436.
Militello LK, Kelly SA, Melnyk BM. Systematic review of text-messaging interventions to promote healthy behaviors in pediatric and adolescent populations: Implications for clinical practice and research. Worldviews on evidence-based nursing. 2012;9(2):66-77. doi: 10.1111/j.1741-6787.2011.00239.x.
Whittaker R, McRobbie H, Bullen C, Borland R, Rodgers A, Gu Y. Mobile phone-based interventions for smoking cessation. Cochrane database of systematic reviews. 2012;11:CD006611. doi: 10.1002/14651858.CD006611.pub4.
Ybarra ML, Holtrop JS, Prescott TL, Rahbar MH, Strong D. Pilot RCT results of Stop My Smoking USA: A text messaging-based smoking cessation program for young adults. Nicotine & tobacco research. 2013;15(8):1388-1399. doi: 10.1093/ntr/nts339.
Miranda JAR, Ruiz CAJ, Rebollo JCS. Smoking Cessation. Clinical Pulmonary Medicine. 2013;20(3):129-136. doi: 10.1097/CPM.0b013e31828fda4c
Heckman CJ, Egleston BL, Hofmann MT. Efficacy of motivational interviewing for smoking cessation: a systematic review and meta-analysis. Tob control. 2010;19(5):410-416. doi: 10.1136/tc.2009.033175.
Mason MJ, Campbell L, Way T, Keyser-Marcus L, Benotsch E, Mennis J, ... & Stembridge DR. Development and outcomes of a text messaging tobacco cessation intervention with urban adolescents. Substance Abuse.2015; 36(4), 500-506. doi:10.1080/08897077.2014.987946
Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68-78. doi: 10.1037//0003-066x.55.1.68
Ryan RM, Patrick H, Deci EL, Williams GC. Facilitating health behaviour change and its maintenance: Interventions based on Self-Determination Theory. European Health Psychologist. 2008;10(1):2-5.
Deci E, Ryan R. The "What" and "Why" of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry. 2000;11(4):227-268. doi:10.1207/ S15327965PLI1104_01
Miller WR, Rollnick S. Motivational Interviewing: Helping people change. 3 ed. New York: The Guilford Press; 2013.
32. Lundahl B, Burke BL. The effectiveness and applicability of motivational interviewing: A practice-friendly review of four meta-analyses. J Clin Psychol. 2009;65(11):1232-1245. doi: 10.1002/jclp.20638
Vodopivec-Jamsek V, de Jongh T, Gurol-Urganci I, Atun R, Car J. Mobile phone messaging for preventive health care. Cochrane Database of Systematic Reviews. 2012;12:CD007457. doi: 10.1002/14651858.CD007457.pub2.
Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods. 2007;39(2):175-191. doi: 10.3758/BF03193146.
Villanti AC, McKay HS, Abrams DB, Holtgrave DR, Bowie JV. Smoking-cessation interventions for U.S. young adults: A systematic review. Am J Prev Med. 2010;39(6):564-574. doi: 10.1016/j.amepre.2010.08.009.
Gagné M. The Role of autonomy support and autonomy orientation in prosocial behavior Engagement. Motivation and Emotion. 2003;27(3):199-223.36. doi: 10.1023/A:1025007614869
Johnston MM, Finney SJ. Measuring basic needs satisfaction: Evaluating previous research and conducting new psychometric evaluations of the Basic Needs Satisfaction in General Scale. Contemporary Educational Psychology. 2010;35(4):280-296. doi: 10.1016/j.cedpsych.2010.04.003.
Molix LA, Nichols CP. Satisfaction of basic psychological needs as a mediator of the relationship between community esteem and wellbeing. International Journal of Wellbeing. 2013;3(1):20-34. doi:10.5502/ijw.v3i1.2.
Williams GC, Gagné M, Ryan RM, Deci EL. Facilitating autonomous motivation for smoking cessation. Health Psychol. 2002;21(1):40-50. doi: 10.1037//0278-6133.21.1.40
Levesque CS, Williams GC, Elliot D, Pickering MA, Bodenhamer B, Finley PJ. Validating the theoretical structure of the Treatment Self-Regulation Questionnaire (TSRQ) across three different health behaviors. Health education research. 2007;22(5):691-702. doi: 10.1093/her/cyl148.
Williams GC, Niemiec CP, Patrick H, Ryan RM, Deci EL. The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence. Ann Behav Med. 2009;37(3):315-324. doi: 10.1007/s12160-009-9090-y.
Williams GC, McGregor H, Sharp D, et al. A self-determination multiple risk intervention trial to improve smokers' health. J Gen Intern Med. 2006;21(12):1288-1294. doi: 10.1111/j.1525-1497.2006.00621.x.
Etter JF, Bergman MM, Humair JP, Perneger TV. Development and validation of a scale measuring self-efficacy of current and former smokers. Addiction. 2000;95(6):901-913. doi: 10.1046/j.1360-0443.2000.9569017.x.
Biener L, Abrams DB. The Contemplation Ladder: Validation of a measure of readiness to consider smoking cessation. Health Psychol. 1991;10(5):360-365. doi: 10.1037/0278-6133.10.5.360
Amodei N, Lamb RJ. Convergent and concurrent validity of the Contemplation Ladder and URICA scales. Drug Alcohol Depend. 2004;73(3):301-306. doi: 10.1016/j.drugalcdep.2003.11.005.
Abrams DB, Herzog TA, Emmons KM, Linnan L. Stages of change versus addiction: A replication and extension. Nicotine & tobacco research. 2000;2(3):223-229. doi: 10.1080/14622200050147484.
Herzog TA, Blagg CO. Are most precontemplators contemplating smoking cessation? Assessing the validity of the stages of change. Health Psychol. 2007;26(2):222-231. doi: 10.1037/0278-6133.26.2.222.
Martin RA, Rohsenow DJ, MacKinnon SV, Abrams DB, Monti PM. Correlates of motivation to quit smoking among alcohol dependent patients in residential treatment. Drug Alcohol Depend. 2006;83(1):73-78. doi: 10.1016/j.drugalcdep.2005.10.013.
Etter JF, Le Houezec J, Perneger TV. A self-administered questionnaire to measure dependence on cigarettes: The Cigarette Dependence Scale. Neuropsychopharmacology. 2003;28(2):359-370. doi: 10.1038/sj.npp.1300030.
Etter JF. Comparing the validity of the Cigarette Dependence Scale and the Fagerstrom Test for Nicotine Dependence. Drug Alcohol Depend. 2008;95(1-2):152-159. doi: 10.1016/j.drugalcdep.2008.01.017.
Etter JF, Le Houezec J, Huguelet P, Etter M. Testing the Cigarette Dependence Scale in 4 samples of daily smokers: Psychiatric clinics, smoking cessation clinics, a smoking cessation website and in the general population. Addict Behav. 2009;34(5):446-450. doi: 10.1016/j.addbeh.2008.12.002.
Stavem K, Rogeberg OJ, Olsen JA, Boe J. Properties of the Cigarette Dependence Scale and the Fagerstrom Test of Nicotine Dependence in a representative sample of smokers in Norway. Addiction. 2008;103(9):1441-1449. doi: 10.1111/j.1360-0443.2008.02278.x.
Villanti AC, McKay HS, Abrams DB, Holtgrave DR, Bowie JV. Smoking-cessation interventions for U.S. young adults: A systematic review. Am J Prev Med. 2010; 39(6), 564-574. doi: 10.1016/j.amepre.2010.08.009.
Orr JA, King, RJ. Mobile phone SMS messages can enhance healthy behaviour: a meta-analysis of randomised controlled trials. Health Psychology Review. 2015; 9(4), 397-416. doi: 10.1080/17437199.2015.1022847.
Kentucky Cabinet for Health and Family Services. Quit Now Kentucky. 2013. Available at: (accessed December 2016).
JPMorgan Chase & Co. Chase Person-to-Person Quick Pay. 2013. Available at: (accessed December 2016).
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap) - a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of biomedical informatics. 2009;42(2):377-381. doi: 10.1016/j.jbi.2008.08.010.
IBM®. SPSS® software 2013. Available at: (accessed December 2016).
Brown J. A review of the evidence on technology-based interventions for the treatment of tobacco dependence in college health. Worldviews on evidence-based nursing. 2013;10(3):150-162. doi: 10.1111/wvn.12000.
Mee S. Self-efficacy: A mediator of smoking behavior and depression among college students. Pediatric Nursing. 2014;40(1):9-15, 37.
Kim N-J, Hong H-S. Influence of stress, self-efficacy for smoking cessation, smoking temptation and nicotine dependency in male college students who smoke. Journal of Korean Biological Nursing Science. 2016;18(1):1-8. doi: 10.7586/jkbns.2016.18.1.1.
Burns RJ, Rothman AJ, Fu SS, Lindgren B, Vock DM, Joseph AM. Longitudinal care improves cessation in smokers who do not initially respond to treatment by increasing cessation self-efficacy, satisfaction, and readiness to quit: A mediated moderation analysis. Ann Behav Med. 2016;50(1):58-69. doi: 10.1007/s12160-015-9732-1.
McClure JB, Heffner J, Hohl S, Klasnja P, Catz SL. Design Considerations for mHealth Programs Targeting Smokers Not Yet Ready to Quit: Results of a Sequential Mixed-Methods Study. JMIR mHealth and uHealth. 2017;5(3):e31. doi: 10.2196/mhealth.6845.
Polit DF, Beck TB. Nursing Research: Generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2012.
Shadish WR, Cook TD, Campbell DT. Experimental and quasi-experimental designs for generalized causal inference. Boston, MA: Houghton Mifflin; 2002.
Moore CG, Carter RE, Nietert PJ, Stewart PW. Recommendations for planning pilot studies in clinical and translational research. Clin Transl Sci.2011; 4(5): 332-337. doi: 10.1111/j.1752-8062.2011.00347.x.