Race moderates the effects of Motivational Interviewing on smoking cessation induction.

The study was a secondary analysis and was not designed or powered to test race by treatment interactions. The main quit-attempt interaction was not statistically significant (p = 0.099), so the broader pattern should not be treated as proof. Many outcomes and analyses were examined, raising the chance of false positive findings. The sample was older adults with lower socioeconomic status, smokers not ready to quit, and treatment was delivered by female counselors outside a medical setting, so it may not generalize. Only African American versus Non-Black categories were examined, and the authors caution that race was a proxy, not a cause. Abstinence, usually the most important smoking outcome, did not show interaction findings. Treatment fidelity was coded only for a subset of sessions, so small delivery differences cannot be fully ruled out.

The manuscript is based on a secondary analysis supported by National Cancer Institute Grants R01 CA133068. Pfizer provided varenicline through Investigator-Initiated Research Support. Catley, Goggin, and Resnicow received fees for providing motivational interviewing training, and Catley received non-financial support from Pfizer.

Do not conclude that African American smokers should be given health education instead of motivational interviewing. The main quit-attempt interaction was not statistically clear (p = 0.099), the analysis was exploratory, and controlling for relationship status and communication preference removed most of the race effect.