108. Treatment Recommendations: Counseling (Continued)

Treating Tobacco Use and Dependence: 2008 Update

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Practical counseling (problem solving/ skills training) treatment component	Examples
Recognize danger situations—Identify events, internal states, or activities that increase the risk of smoking or relapse.	Negative affect and stress. Being around other tobacco users. Drinking alcohol. Experiencing urges. Smoking cues and availability of cigarettes.
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 and trigger situations. Learning cognitive strategies that will reduce negative moods. Accomplishing lifestyle changes that reduce stress, improve quality of life, and reduce exposure to smoking cues. Learning cognitive and behavioral activities to cope with smoking urges (e.g., distracting attention; changing routines).
Provide basic information—provide basic information about smoking and successful quitting.	The fact that any smoking (even a single puff) increases the likelihood of a full relapse. Withdrawal symptoms typically peak within 1-2 weeks after quitting but may persist for months. These symptoms include negative mood, urges to smoke, and difficulty concentrating. The addictive nature of smoking.