Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department


Major Professor

Jack Darkes, Ph.D.

Co-Major Professor

Thomas Brandon, Ph.D.

Committee Member

Jaime Winn, Ph.D.

Committee Member

David Drobes, Ph.D.

Committee Member

Ming Ji, Ph.D.

Committee Member

Joseph Vandello, Ph.D.


Intervention, Cigarette smoking, Treatment engagement, Motivation


Smoking remains the single most preventable cause of death worldwide and primary cause of several types of cancer, cardiovascular disease, and respiratory illness (USDHHS, 2014). Although the prevalence of smoking among the general population continues to decline, the prevalence of smoking among the veteran population remains high. In addition, the prevalence of smoking among veterans with substance and alcohol use disorders is 2 to 3 times higher than in the general population. Over the years, the VA has implemented empirically-based treatments for smoking cessation to address the cigarette smoking epidemic. These services, however, are greatly underutilized. Motivational interviewing (MI) has traditionally been used to treat alcohol dependence; however, its efficacy for smoking cessation has been mixed. There is some evidence, however, suggesting that MI could be used to motivate smokers to seek treatment. The purpose of this study was to use a brief MI intervention to motivate veteran smokers undergoing treatment for substance use to seek smoking cessation services at the VA. We recruited 60 veterans undergoing substance and alcohol use treatment at the Substance Use Disorders/Intensive Outpatient Program (SUDs/IOP) at the James A. Haley VA. Participants were randomized to one of two groups: MI vs. active control. We hypothesized that veterans in the MI condition would be more likely to seek services for smoking cessation compared to those in the control condition. Our findings supported our hypothesis: 40% of participants in the MI condition sought treatment to quit smoking after the intervention compared to 23% of participants in the control condition (p = .03, controlling for baseline differences in cessation motivation). In addition, we found that the MI intervention was most beneficial for individuals with lower baseline motivation to quit smoking. Although we did not find significant mediators of the effect of the intervention on our primary outcome, this study showed that a brief MI intervention can promote seeking of smoking cessation resources.