Motivational Interviewing: The Conversation That Helps Smokers Quit—Without Telling Them To
Motivational interviewing is a counseling technique that helps smokers resolve their ambivalence about quitting—without pressure, without judgment, without 'you should.' The evidence for MI is strong. Its use in routine care is minimal.
The doctor says: 'You should quit smoking.' The smoker hears judgment and resists. The motivational interviewer says: 'Tell me about your smoking—what do you like about it, and what concerns you?' The smoker explores their own ambivalence and finds their own reasons to change. **Motivational interviewing is evidence-based, effective, and almost never used in routine healthcare. It takes more time than 'you should quit'—and it works better. The barrier is not evidence. It's the structure of healthcare, which rewards efficiency over effectiveness.**
