Electronic Thesis and Dissertation Repository


Doctor of Philosophy


Health and Rehabilitation Sciences


Jennifer Irwin

2nd Supervisor

Don Morrow

Joint Supervisor


The purpose of this Motivational Interviewing (MI) via Co-Active Life Coaching (CALC) research program in tobacco control was to assess the effectiveness of this individualized, interactive intervention. This was achieved through a critical appraisal and literature review of the individual dimensions of MI currently used in cognitive-behavioural smoking cessation interventions, as well as MI applied via CALC intervention studies at both the individual- and population-levels.

Article 1 provides the critically appraised and systematic review of literature exploring three dimensions of MI (social support, motivation, and tailored interventions) which were implemented independently in cognitive-behavioural cessation interventions. The effectiveness of these dimensions at promoting cessation was assessed and yielded mixed results. The purpose of Article 2 was to assess the impact of MI-via-CALC on selected cessation outcomes among young adults (19-25 years) and found the immediate intervention group, compared to the waitlist group, had a significant reduction in smoking behaviours (number of cigarettes smoked per day and cigarette dependency) and significant increases in personal competency (self-esteem and self-efficacy). Additionally, at 12-months post-intervention a cessation rate of 31.4% was reported and biochemically verified. Lastly, Article 3 assessed the impact of a full-day application-based MI-via-CALC training on the perceived competency of employees of a national smokers’ telephone hotline to facilitate behaviour change among callers. Post- training participants described skill development, increased competency at facilitating behaviour change, and desire for additional training.

This research program was comprised of three unique studies. This was the first critical appraisal and literature review to assess cognitive-behavioural cessation interventions through an MI lens. The core components of MI-via-CALC are similar to components already utilized individually in cessation interventions; however, unique to MI-via-CALC is the incorporation of these components into one intervention. Moreover, this was the largest individual MI-via-CALC intervention tobacco study to date and the only one with a control group. Furthermore, the cessation rates observed in this intervention study are beyond those currently observed in other cognitive-behavioural interventions as well as nicotine replacement therapy studies. Lastly, the MI-via-CALC training offered to employees of a national smoker’s hotline was also a first, as the hotline typically does not allow outside researchers within their organization. Overwhelmingly, the training was well received, and the impact was self-reported behaviour change resulting in ameliorated client interactions to promote cessation. Together, the important findings of these ground-breaking studies underscore the need for continued investigation of MI-via-CALC as an intervention for tobacco control.