Abstract: Background　Smoking is a major risk factor for many chronic diseases. Motivational interviewing（MI）is a technique with solid theoretical basis and ease to operate.Objective　To evaluate the effectiveness of MI for smoking cessation in community health service centers.Methods　All subjects in this study were smoking patients from Balizhuang Community Health Service Center in Chaoyang District in Beijing. Blocked randomization was used.Totally 210 smoking patients were allocated into either intervention group or control group followed allocation concealment rules.All subjects were included from July 2016 to October 2016.We followed the Chinese Clinical Smoking Cessation Guideline（version 2015） to provide brief smoking cessation intervention in the control group. MI was used in the intervention group and was given by family physicians. The follow-up period was 3 and 6 month respectively. The outcomes include smoking prevalence abstinence，CO-oximetry value and nicotine dependency level.Results　 The baseline characteristics showed that there was no significant difference between the intervention group and control group with regard to gender，age，level of education，marriage，prevalence of chronic disease，years of smoking，knowledge of smoking ban in Beijing，CO-oximetry value and scores of Fagerstrom Test of Nicotine Dependence（FTND）（P>0.05）. Results from intention to treat analyses（ITT） showed that compared with control group，CO-oximetry value and FTND scores decreased significantly in the intervention group at the 3 and 6 month follow-up respectively（P<0.05）. Compared with control group，the 3 and 6 month smoking prevalence abstinence did not decreased significantly in the intervention group（P>0.05）. Results from per protocol set（PPS） showed that compared with control group，FTND scores decreased significantly in the intervention group at the 3 month follow-up（P<0.05）. Compared with control group，neither the smoking prevalence abstinence nor the CO-oximetry value decreased significantly in the intervention group at the 3 month follow-up（P>0.05）. Compared with control group, CO-oximetry value and FTND scores decreased significantly in the intervention group at the 6 month follow-up（P<0.05）. Compared with control group，the 6 month smoking prevalence abstinence did not decrease significantly in the intervention group（P>0.05）.Conclusion　Compared with brief smoking cessation intervention，MI is very likely to decrease the exhaled CO-oximetry value and nicotine dependence level for smokers，but may fail to decrease smoking cessation rate.

Key words: Motivational interviewing, Smoking cessation, Community health services, Randomized controlled trial

摘要： 背景　吸烟是多种慢性病的主要危险因素，动机性访谈（MI）应用于戒烟具有可靠的理论基础和易操作性。目的　探讨MI对社区卫生服务中心吸烟患者的戒烟效果。方法　选取北京市朝阳区八里庄社区卫生服务中心吸烟患者为研究对象。采用均衡随机化分组方式，采用分配隐匿的原则，将纳入的210例社区吸烟患者分配至对照组与干预组。研究对象纳入时间为2016年7—10月。对照组依据《中国临床戒烟指南（2015年版）》给予简短戒烟干预，干预组由全科医生给予MI戒烟干预。比较两组基线资料以及干预3个月和6个月时患者戒烟率、一氧化碳呼出检测等级和尼古丁依赖程度。结果　对照组与干预组吸烟患者基线特征，包括性别、年龄、文化程度、婚姻状况、慢性病患病情况、烟龄、北京最严禁烟令知晓率、一氧化碳呼出检测等级、尼古丁依赖检测量表（FTND）得分比较，差异均无统计学意义（P>0.05）。意向处理（ITT）分析结果显示，干预3、6个月时，对照组和干预组一氧化碳呼出检测等级、FTND分值比较，差异均有统计学意义（P<0.05）；对照组和干预组戒烟率比较，差异无统计学意义（P>0.05）。符合方案数据集（PPS）分析结果显示，干预3个月时，对照组和干预组FTND分值比较，差异有统计学意义（P<0.05）；戒烟率、一氧化碳呼出检测等级比较，差异无统计学意义（P>0.05）。干预6个月时，对照组和干预组一氧化碳呼出检测等级、FTND分值比较，差异有统计学意义（P<0.05）；戒烟率比较，差异无统计学意义（P>0.05）。结论　与简短戒烟干预方式相比，尚未发现MI更能有效降低戒烟率，但MI可降低吸烟患者一氧化碳呼出检测等级和尼古丁依赖程度。

关键词: 动机性访谈, 戒烟, 社区卫生服务, 随机对照试验