Counseling Substance use

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

Provide basic information about smoking and successful quitting

  • Any smoking/drug use (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 or use drugs, and difficulty concentrating

Identify events, internal states, or activities that increase the risk of smoking or relapse

  • Negative affect
  • Being around other smokers
  • Using other drugs
  • Experiencing urges
  • Being under time pressure

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)

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.
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