Effect of Motivational Enhancement Therapy on Tobacco Cessation in Patients with Schizophrenia: An Interventional Study

Introduction: Tobacco use remains disproportionately high among individuals with schizophrenia, leading to increased morbidity, altered antipsychotic metabolism, and poorer psychiatric outcomes. Motivational enhancement therapy (MET), a client-centered approach designed to resolve ambivalence toward behavioral change, may help address this public health concern, yet evidence from Indian populations remains limited. Materials and Methods: This randomized interventional study was conducted at Acharya Vinoba Bhave Rural Hospital, Wardha, Maharashtra, India, among 95 patients with schizophrenia who used tobacco. Participants were randomized into two groups: the intervention group received structured, multisession MET, whereas the control group received a single-session psychoeducation. Assessments included the Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF), and Fagerström Test for Nicotine Dependence–Smokeless Tobacco (FTND-ST). Data were analyzed using SPSS v28, with significance set at P < 0.05. Results: MET produced a significant reduction in nicotine dependence (FTND-ST mean reduction = −0.94; P = 0.017), whereas GAF scores remained unchanged, and negative PANSS symptoms showed mild worsening ( P = 0.032). Correlation analysis revealed that greater reductions in nicotine dependence were associated with improvements in negative, general, and total PANSS domains. Conclusion: MET effectively reduced nicotine dependence among patients with schizophrenia, although its impact on psychiatric symptoms and functional outcomes was limited. Integration of MET with pharmacological aids and long-term psychosocial support is recommended for sustained tobacco cessation and overall clinical improvement.