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Counseling Patients To Quit

Treating Tobacco Use and Dependence: PHS Clinical Practice Guideline

Effective smoking cessation counseling can be divided into practical and supportive counseling advice.

Practical counseling advice
(problem-solving/skills training)		 Examples
Recognize danger situations.
Identify events, internal states, or activities that increase the risk of smoking or relapse.
  • Negative affect.
  • Being around other smokers.
  • Drinking alcohol.
  • Experiencing urges.
  • Being under time pressure.
Develop coping skills.
Identify and practice coping or problem-solving skills. Typically, these skills are intended to cope with danger situations.
  • Learning to anticipate and avoid temptation.
  • Learning cognitive strategies that will reduce negative moods.
  • Accomplishing lifestyle changes that reduce stress, improve quality of life, or produce pleasure.
  • Learning cognitive and behavioral activities to cope with smoking urges (e.g., distracting attention).
Provide basic information.
Provide basic information about smoking and successful quitting.
  • Any smoking (even a single puff) increases the likelihood of full relapse.
  • Withdrawal typically peaks within 1-3 weeks after quitting.
  • Withdrawal symptoms include negative mood, urges to smoke, and difficulty concentrating.
  • Smoking is addictive.

 

Supportive counseling advice Examples
Encourage the patient in the quit attempt.
  • Communicate belief in the patient's ability to quit.
  • Note that effective tobacco dependence treatments are now available.
  • Note that half of all people who have ever smoked have now quit.
Communicate caring and concern.
  • Ask how the patient feels about quitting.
  • Directly express concern and willingness to help.
  • Be open to the patient's expression of fears of quitting, difficulties experienced, and ambivalent feelings.
Encourage the patient to talk about the quitting process.

Ask about:

  • Reasons the patient wants to quit.
  • Concerns or worries about quitting.
  • Success the patient has achieved.
  • Difficulties encountered while quitting.

Internet Citation:

Counseling Patients To Quit. U.S. Public Health Service. Agency for Healthcare Research and Quality. Rockville, MD. http://www.ahrq.gov/clinic/tobacco/counsel.htm

 
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