Online cognitive bias modification and motivational interviewing in Chinese smokers: a single-case experimental study

Abstract

Background: Empirically validated smoking interventions are urgently needed in China. Relatively automatic action tendencies toward smoking-related cues have been related to smoking behavior. Re-training of addiction-related action tendencies using Cognitive Bias Modification (CBM) has been shown promising clinical effects, when participants are motivated to change. The aim of this study was to evaluate a smoking intervention where web-based CBM was combined with face-to-face Motivational Interviewing (MI) for Chinese smokers with a single-case experimental design. Methods: After a pre-assessment, four Chinese smokers received 4-6 sessions of CBM combined with 2 sessions of MI (two received real CBM and other two received placebo CBM). A post-assessment took place directly after the intervention followed by a three-month follow-up assessment. Ecological Momentary Assessment was used to assess daily cigarette consumption (DCC) throughout the study. Several other aspects of smoking behavior were assessed along with Carbon Monoxide (CO) assessment. Results: Compared with the DCC during the pre-assessment, smoking significantly decreased for the two participants receiving the real CBM in the short term (at the end of the intervention or/and two weeks after the intervention); and significantly decreased for one of the two participants receiving the placebo CBM both in the short term and long term (three months after the intervention). Additionally, CO levels, heaviness of smoking, and craving greatly decreased after the intervention for all four participants. Conclusions: CBM may help Chinese smokers who are motivated to change, but more research is needed to understand the working mechanisms in smoking interventions targeting Chinese populations.