Targeting hardcore smokers: the effects of an online tailored intervention, based on motivational interviewing techniques.

Objectives: Hardcore smokers have smoked for many years and do not intend to quit. They also seem unreceptive to information about smoking cessation. We developed a 30-min, tailored web-based intervention that includes motivational interviewing principles. It aims to increase hardcore smokers’ intention to quit and their receptivity to information about smoking cessation. Design: In a two-arm experiment, we compared outcome scores of the experimental intervention (n = 346) with those of a control intervention (n = 411). Methods: Our main outcomes were receptivity to information about quitting, intention to quit, quitting self-efficacy, and interest in a subsequent online intervention. Our secondary outcomes were cigarettes smoked per day and quit attempts. All outcomes were measured directly post-experiment (t1), after 2 weeks (t2), and after 2 months (t3). Results: At t1, hardcore smokers in the intervention condition were more receptive to information about quitting than controls. At both t2 and t3, those in the experimental group had reduced the number of cigarettes more than those in the control group. At t2, but not t3, more participants in the experimental group had reduced their cigarette consumption by at least 50% than among controls. We found no significant differences in intention to quit, quitting self-efficacy, interest in a subsequent online quitting intervention, and number of quit attempts. Conclusions: The intervention increased hardcore smokers’ receptivity to information about smoking cessation and decreased their cigarette consumption by about 1 cigarette per day. Although the results are positive, the clinical relevance may be limited. We recommend further developing this intervention for practical use in health care settings. Statement of contribution What is already known on this subject? Hardcore smokers have smoked for many years and do not intend to quit. There are currently no online interventions for hardcore smokers. What does this study add? This study tested an online intervention for hardcore smokers. The intervention increased hardcore smokers’ receptivity to information about quitting. It also helped to reduce the number of cigarettes per day