To promote academic exchange and advance oncology nursing practice, the Academic Express column invites ISNCC members to share their latest research achievements with the global cancer nursing community. In recognition of World No Tobacco Day on May 31, this issue highlights a recent multicentre randomized controlled trial led by William Ho Cheung Li from The Nethersole School of Nursing, The Chinese University of Hong Kong, which explores the use of mobile instant messaging to deliver brief motivational interviewing with individualized motivational support for smoking cessation among patients with noncommunicable diseases who had no intention to quit smoking. This study provides valuable insights into how digital, patient-centred interventions can support health behaviour change and strengthen the role of nurses in cancer prevention, chronic disease management, and equitable care.
Smoking remains one of the most significant yet preventable contributors to poor health outcomes among people living with noncommunicable diseases (NCDs), including cancer. A recent multicenter randomized controlled trial titled Instant messaging delivered brief motivational interviewing for noncommunicable disease patients with no intention to quit smoking provides timely and compelling evidence that patients who initially have no intention of quitting can still be engaged through innovative and patient centered digital interventions.
A defining strength of this trial is its focus on a population often overlooked in smoking cessation research and clinical practice. Smokers with NCD who report no intention to quit are frequently perceived as non-receptive and therefore excluded from conventional cessation programs. Yet this group represents a substantial proportion of patients encountered in oncology and chronic disease settings. In this trial, 728 adults with NCDs, including cancer, were randomized to receive either usual care or a novel intervention combining a single ten-minute face-to-face brief motivational interviewing (MI) session with individualized motivational support delivered via mobile instant messaging over six months. Participants in the intervention group were approximately three times more likely to achieve biochemically validated smoking abstinence at six and twelve months compared with those receiving usual care.
One particularly notable feature of the intervention is its pragmatic and respectful design. Rather than requiring participants to focus immediately on smoking, individuals were first encouraged to select another unhealthy behavior, such as diet, physical inactivity, or alcohol use, that they were more willing to address. This foot-in-the-door approach aligns closely with MI principles by respecting patient autonomy and readiness to change while reducing psychological resistance. Such flexibility is especially relevant in cancer care, where patients often face substantial physical, emotional, and cognitive burdens related to diagnosis and treatment.
The implications for cancer care are substantial. Tobacco use remains a major modifiable risk factor for cancer progression, treatment complications, disease recurrence, second primary cancer, and mortality. Continued smoking has been associated with reduced treatment effectiveness and poorer survival outcomes, whereas cessation after a cancer diagnosis may improve treatment response, reduce treatment-related adverse effects, and enhance quality of life. Despite this strong evidence base, many people living with cancer continue to smoke and frequently express ambivalence or no intention to quit. The intervention tested in this trial offers a feasible and compassionate way to engage this challenging group without provoking disengagement or resistance.
From an oncology nursing perspective, the intervention model is practical and scalable. It requires minimal time, limited resources, and can be delivered effectively by trained nurses within routine clinical workflows. The use of mobile instant messaging enables timely, real-time, personalized communication that extends professional support beyond clinical settings. For patients undergoing cancer treatment, who may experience fatigue, frequent appointments, and psychosocial stress, this flexible mode of care is particularly valuable.
In conclusion, this trial highlights the pivotal role of oncology nurses in delivering digitally enabled brief MI and demonstrates how nurse-led innovation can advance person-centered and equitable cancer care worldwide.
Source：
Ho, L. L. K., Chan, D. N. S., Chung, J. O. K., Choi, K. C., Xia, W., & Li, W. H. C. (2026). Instant messaging-delivered brief motivational interviewing for noncommunicable disease patients with no intention to quit smoking. NPJ digital medicine, 10.1038/s41746-026-02578-6. Advance online publication. https://doi.org/10.1038/s41746-026-02578-6
Prof. William Ho Cheung Li
