Brief intervention

Brief intervention (see Box 1) is accepted as an effective approach which increases quit rates in motivated individuals. This approach has been found to be most effective when combined with other interventions such as behavioural support, and nicotine replacement therapy (NRT). Although it is usually delivered in a one-to-one situation, increasing access to brief intervention training is an important and effective part of a population health promotion approach. This is because:

  • simple advice delivered in the right way can have a significant effect on smoking cessation
  • increasing the number of people in different organisations trained in brief interventions will increase our capacity to tackle smoking rates.

Box 1: What is a brief intervention?

Brief intervention makes the most of any opportunity to raise awareness, share knowledge and get someone to think about making changes to improve their health and behaviours. Brief intervention uses counselling skills such as motivational interviewing and goal setting. An understanding of the stages of behaviour change is also important. Brief intervention takes as little as 3 minutes and is usually carried out in a one-to-one situation. The 5As for smoking cessation for health professionals is an international smoking cessation framework used in brief intervention that has been shown to be very effective in encouraging and supporting smoking cessation. More information about the 5As can be found in this podcast developed for the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people featuring Professor David Thomas.

Specific barriers to the use of brief intervention with Aboriginal and Torres Strait Islander clients have been identified.

These include:

  • the high rate of smoking among Aboriginal and Torres Strait Islander Health Workers
  • the assumption by health workers that individuals will not be able to quit
  • cultural ways of being which value autonomy and seek to avoid confrontation.

Cultural beliefs are particularly important, as they mean that brief intervention is often seen to be inappropriately telling people how to behave.

The Queensland Government developed a brief intervention training program, SmokeCheck, for Aboriginal and Torres Strait Islander Health Workers and other health professionals who work with Aboriginal and Torres Strait Islander health clients and communities, which addressed these barriers.  It included culturally sensitive materials and approaches for brief intervention. Evaluation found that SmokeCheck increases health workers confidence when:

  • talking about health issues
  • offering quit advice
  • assessing readiness to quit and
  • initiating a conversation about smoking.

Health workers also reported offering more advice about nicotine replacement therapy and reducing tobacco use after training, suggesting a change in behaviour as well as confidence.

A recent study which included SmokeCheck training as part of a multi-component community project, found that while health workers spoke positively about the training. No-one implemented the intervention as they had been shown. Rather they adapted their approach using only some of the components. No evidence is available yet on how this affected client responses to the intervention – it may have been that these adaptations were appropriate responses to individual need.

See:

A guide to the SmokeCheck brief intervention with clients at the various stages of change.

SmokeCheck and other brief intervention training packages designed specifically for working with Aboriginal and Torres Strait Islanders (e.g. Quitskills) are available in most States and Territories. More information on workforce training for brief intervention can be found here.

Because of the opportunistic nature of brief intervention, it is important that anyone who has contact with smokers from Aboriginal and Torres Strait Islander communities has culturally appropriate brief intervention training. In many organisations only health professionals, such as Aboriginal and Torres Strait Islander Health Workers, nurses, doctors, and dentists are trained to do brief interventions. However, because brief intervention is focused on motivation and education, not therapy, you do not need a health background to do this training. They are also opportunistic, meaning that they do not need to take place in a medical setting. This means anyone can do brief intervention training, including:

  • staff from health organisations, who are the first point of contact for clients (e.g receptionists and drivers)
  • staff from non-health organisations that have regular contact with Aboriginal and Torres Strait Islander clients
  • smoke-free ambassadors or other volunteers who work on community events/outreach activities.

Further reading