Using content analysis of video-recorded consultations to identify smokers' "readiness" and "resistance" towards stopping smoking

Although physicians' brief advice against smoking is effective in helping s mokers to stop, very little is known about the process of counseling smoker s. We describe the development of a coding system for describing smokers' m otivation to stop smoking as judged by their behaviour when discussing smok ing with their family physician. We analysed video-recordings of consultati ons between 47 self-reported smokers and 29 family physicians where smoking was discussed. By a process of observing recordings, reading transcripts a nd discussion, we developed a coding system for describing smokers' levels of motivation to stop smoking. This consists of four behaviours thought to indicate "readiness" (higher motivation to stop) and four "resistance" (low er motivation to stop). Interobserver reliability between two observers was good (Kappa = 0.71 for readiness, 0.73 for resistance behaviours). We disc uss the relevance of our descriptions for clinicians and the possibility of developing this work further to enable systematic research into doctor-pat ient interactions where smokers are counseled to stop. (C) 2000 Elsevier Sc ience Ireland Ltd. All rights reserved.