Counseling Patients To Quit
Effective smoking cessation counseling can be divided into practical and supportive counseling advice.
Practical counseling advice (problem-solving/skills training)
Recognize danger situations.
Identify events, internal states, or activities that increase the risk of smoking or relapse.
Examples
- 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.
Examples
- 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.
Examples
- 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
Encourage the patient in the quit attempt.
Examples
- 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.
Examples
- 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.
Examples
Ask about:
- Reasons the patient wants to quit.
- Concerns or worries about quitting.
- Success the patient has achieved.
- Difficulties encountered while quitting.
