Contemplation to Action: Using a Motivational Interviewing Approach to Help Patients Quit Smoking

Contemplation to Action: Using a Motivational Interviewing Approach to Help Patients Quit Smoking

January 24, 2017

It’s that time of year again – when many people are contemplating making changes as they ring in the new year with hopeful plans for what 2017 will bring. “I am going to quit tobacco,” is on the top of many lists. Most providers hear patients make these well-intentioned plans, and most know that new years’ resolutions generally resolve themselves after a few weeks.

When it comes to helping patients quit tobacco, ‘tis the season. There is no better time to counsel patients who want to quit. Providers can use the tried-and-true 5 A’s (Ask, Advise, Assess, Assist, and Arrange) to ensure that patients have everything they need to quit.

For providers who want to ensure they are providing this counseling in a non-judgmental, patient-centered way, consider motivational interviewing. Not only is motivational interviewing non-confrontational, it also relies on the Stages of Change model, which accepts that people move through a personal series of stages when modifying behavior.

For patients who are contemplating quitting, but who haven’t started preparing to quit, this technique can be used to help highlight ambivalence. Also, this method allows the provider to identify barriers the patient has to quitting and can help by providing support, resources, and nicotine replacement therapy (NRT) when the patient is ready. To remember the basics of motivational interviewing, simply remember the acronym OARS. The letters represent key components of motivational interviewing:

  • Ask Open ended questions.
  • Affirm what the patient is saying.
  • Listen Reflectively to the patient.
  • Summarize what you are hearing.

Motivational interviewing training and resources are widely available online. Other examples can be found in the form of YouTube clips including short videos or what not to do. Here is an example of a provider who uses motivational interviewing correctly to talk to a patient about quitting tobacco. Notice that the provider is non-confrontational and “meets the patient where he is” instead of trying to convince the patient to quit. The provider empathizes and remains non-judgmental and because of this the provider leaves the door open for the patient to come back when he is ready to quit.

When it comes to new year’s resolutions, many won’t last long, but with help from providers, patients who are ready to quit tobacco might surprise you, and themselves!

For more information about what Spokane Regional Health District is doing to prevent tobacco use and to increase cessation, contact Paige McGowan at or 509.324.1504.


It’s important that providers ask all patients about their tobacco use and advise them to quit if they admit to using tobacco, but how can providers help move patients from a stage of pre-contemplation to contemplation, or better yet, from contemplation to action?