1. Motivational Interviewing (MI) is effective and efficient for fostering health behavior change, and the elicitation of “change talk” (CT: i.e., any expression of interest or desire to change) is a hypothesized mechanism through which MI has its effects. Purpose – To examine the relationship between explicit statements of desire to change (Desire CT) during baseline counseling sessions and quit attempts (QA) at follow-up in a randomized controlled trial evaluating MI vs. Health Education (HE) for inducing quit attempts among adult smokers. Introduction Desire CT at baseline approximately doubles the odds of a quit attempt at W12 and W26, independent of treatment group, cigarettes per day and nicotine dependence. Expressions of interest in change may be related to behavior change consistent with hypothesized mechanisms of MI. Additional research should establish whether or not Desire CT is merely a reflection of underlying motivation or if expression of CT has a causal relationship with outcomes. ACKNOWLEDGEMENT: Supported by the National Cancer Institute (5R01 CA133068-04). Varenicline (Chantix ®) was provided by Pfizer through Investigator Initiated Research Support (No. WS759405). Methods Discussion Results (cont.) Participants Participants (N = 202) were recruited from a large metro-area and were primarily African-American (66%), male (56%), with a high school degree or less (84%), and with a mean age of 45.8 (SD = 11.0). Eligibility criteria included smoking at least 1 cigarette per day, and having low motivation (< 7 out of 10) and readiness (no plan within 2 weeks) to quit. Assessments Self-reported QA (any serious QA lasting at least 24 hours) were assessed at week 12 (W12) and week 26 (W26). Smoking characteristics assessed at baseline included: cigarettes smoked per day, and Nicotine Dependence assessed using the Severity of Dependence Scale (SDS) Participant expression Desire CT to quit was assessed with the Motivational Interviewing Skill Code (MISC v. 2.1). Coders identified the first instance of any statement directly expressing a desire to quit smoking that included words such as “want,” “like,” or “desire.” [ [ Talking about change: The relationship between verbal expressions of desire to quit smoking and quitting outcomes in smokers who are not yet ready to quit Jose L. Moreno 1, Lindsey Green 1, Fei Wu 1, Saige Stortz 1, Christopher Khaleel 1, Andrea Bradley-Ewing 2, Daniel Folk 1, Kari Jo Harris 3, Kathy Goggin 2,5, Kimber Richter 4, Karen Williams 5, Christi Patten 6, and Delwyn Catley 1 1 Department of Psychology, University of Missouri - Kansas City; 2 Children’s Mercy Hospitals and Clinics; 3 The University of Montana; 4 University of Kansas Medical Center; 5 University of Missouri – Kansas City School of Medicine; 6 Mayo Clinic Table 1. Tx Group and Smoking Characteristics by Desire CT No-Desire CT (n=119) Desire CT (n=83) Total (n=202) Treatment Group HE: N (%)* 72 (72.0)28 (28.0)100 Treatment Group MI: N (%)* 47 (46.1)55 (53.9)102 QA W12: N (% YES)* 35 (31.2)36 (45.6)71 (37.2) QA W26: N (% YES)* 48 (44.9)50 (65.8)98 (53.6) Cigarettes per Day: M (SD)16.3 (9.2)16.5 (8.9)16.4 (9.1) Nicotine Dependence: M (SD)*6.0 (3.3)7.7 (2.9)6.7 (3.3) Note: QA: Quit Attempts; TX group significantly different at baseline χ2 (1) = 14.02, p <.001; QA W12: n= 191; QA W26: n = 183 *= p<.05 Table 2. Results of Logistic Regression Predicting QA at W12 and W26 with Desire CT, Treatment Group, and Smoking Variables Week 12Week 26 OR95% CIpOR95% CIp Constant.584.231.802.621 Desire CT2.141.11-4.13.0232.411.24-4.68.010 Cigarettes per Day0.990.99-1.00.765.9980.99-1.00.332 Nicotine Dependence 1.010.92-1.11.8771.070.98-1.18.149 Treatment Group.5640.30-1.06.075.6600.35-1.24.198 R 2 (Nagelkerke) =.052; R 2 (Cox & Snell) =.038; -2LL = 244.627 χ 2 (4) = 7.44, p =.114 R 2 (Nagelkerke) =.090; R 2 (Cox & Snell) =.067; -2LL = 240.001 χ 2 (4) = 12.766, p =.012 Reference group: Health Education; Desire CT (No Stmnt Made) Results Participant descriptive characteristics are presented by the occurrence of Desire CT in Table 1. Table 2 displays the results of the logistic regression models in which Desire CT was used to predict QA at W12 and W26 while adjusting for covariates.