Figure D-4. Brief Strategies for Smoking Cessation

ActionStrategies for Implementation
Help the client with a quit plan.A client's preparations for quitting
S et a quit date—ideally, the quit date should be within 2 weeks.
T ell family, friends, and coworkers about quitting and request understanding and support.
A nticipate challenges to planned quit attempt, particularly during the critical first few weeks. These include nicotine withdrawal symptoms.
R emove tobacco products from your environment. Prior to quitting, avoid smoking in places where you spend a lot of time (e.g., work, home, car).
Provide practical counseling (problem solving/skills training). Abstinence—Total abstinence is essential. “Not even a single puff after the quit date.”
Past quit experience—Identify what helped and what hurt in previous quit attempts.
Anticipate triggers or challenges in upcoming attempt—Discuss challenges/triggers and how client will successfully overcome them.
Alcohol—Since alcohol can cause relapse, the client should consider abstaining from alcohol while quitting.
Other smokers in the household—Quitting is more difficult when there is another smoker in the household. Clients should encourage housemates to quit with them or not smoke in their presence.
Provide intra-treatment social support.Provide a supportive clinical environment while encouraging the client in his or her quit attempt. “My office staff and I are available to assist you.”
Help client obtain extra-treatment social support.Help client develop social support for his or her quit attempt in his or her environments outside of treatment. Have the client ask his or her spouse/partner, friends, and coworkers to support the client in the quit attempt.
Recommend the use of approved pharmacotherapy, except in special circumstances.Recommend the use of pharmacotherapies found to be effective in this guideline. Explain how these medications increase smoking cessation success and reduce withdrawal symptoms. The first-line pharmacotherapy medications include bupropion SR, nicotine gum, nicotine inhaler, nicotine nasal spray, and nicotine patch.
Provide supplementary materials. Sources—Federal agencies, nonprofit agencies, or local/State health departments.
Type—Culturally/racially/educationally/age appropriate for the client.
Location—Readily available at every clinician's workstation.

From: Appendix D: Specific Mental Disorders: Additional Guidance for the Counselor

Cover of Substance Abuse Treatment for Persons With Co-Occurring Disorders
Substance Abuse Treatment for Persons With Co-Occurring Disorders.
Treatment Improvement Protocol (TIP) Series, No. 42.
Center for Substance Abuse Treatment.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.