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Counselling Techniques to Help your Patients to Quit Smoking

Less than 3 minutes can increase a smoker’s chance of quitting by 40%1

Your intervention can increase cessation rates even for patients who are not ready to quit

A meta-analysis showed that a physician’s advice of 3 minutes or less:

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  • Increased the likelihood of smoking cessation by 30%
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  • Increased the likelihood of abstinence by 29%2
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9 out of 10 patients said they welcomed counselling advice from their physician on quitting smoking.3

What is Quick Counselling?

A type of counselling called Quick Counselling (QC) has been proven to help smokers quit.2

Quick Counselling is very short advice for all patients who smoke, regardless of their current motivation level to quit.1

The 3 A’s of QC: Ask, Advise, Act

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Step 1: Ask

  • “Have you used any tobacco products in the past week/month/3 months?”
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Step 2: Advise

  • Offer advice in an encouraging, supporting, empathetic manner:
    “Quitting on your own can be tough. We now know that counselling combined with treatment can improve your chances of success.”
  • Advise that the best results are typically achieved with pharmacotherapy and support
See how this step can improve outcomes
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Step 3: Act

  • Refer to counselling, internet programs and telephone quit lines
  • Offer examples of where patients can get support, such as a smoking cessation counsellor, a nurse at a clinic, the Canadian Cancer Society Smokers’ helpline:
    “You may want to contact the Canadian Smokers’ helpline. They can help you get started. Here’s their number.”
  • Consider nicotine replacement therapy
  • Let patients know help is available when they are ready to quit.

Tips to help patients trying to quit5

Manage expectations: quitting often takes several attempts

Be persistent: try not to be discouraged by a relapse; use it as a learning experience for both of you

Make repeated contacts: every visit is an opportunity to counsel your patients

Help your patients take the next step: encourage your patients to take the next step towards quitting smoking

Bolster self-efficacy and motivation: encourage your patients to believe in themselves and their ability to quit

Match your strategy to the patient’s stage of change (e.g., motivating vs. creating a plan)

Tips for being motivational

Focus on providing:

  • Appropriate empathy
  • Non-judgmental advice
  • Personalized feedback (reflected back to patients)
  • Positive reinforcement

Motivational strategies can:

  • Support self-efficacy
  • Promote autonomy
  • Be applied when patients are unready, unwilling, or unable to quit smoking

Learn about the FASTeR Approach with Mike Boivin

Download these tips

Tailored approaches to help your patients quit

Pre-cessation
(Before target quit date)

1

Pre-cessation NRT
Patients use NRT prior to target quit date6

Learn more

2

REDUCE TO QUIT®
Patients use NRT as they reduce smoking cigarettes7

Learn more

Post-cessation
(After fixed quit date)

3

Monotherapy
Patients use one NRT format

Learn more

4

Combination therapy
Patients use patch + additional NRT format7,8

Learn more

References

1. Fiore MC, Jaén CR, Baker TB, et al. A Clinical Practice Guideline for Treating Tobacco Use and Dependence: 2008 Update. Am J Prev Med 2000;35(2):158-176.

2. Fiore MC, Jaén CR, Baker TB, et al. Clinical Practice Guideline: Treating Tobacco Use and Dependence: 2008 Update.

3. West, R. Enhancing Motivation to Stop Smoking: From Theory to Practice. Cancer Research UK. UK Centre for Tobacco Control Studies: A UKCRC Public Health Centre of Excellence. August, 2014.

4. West R. The science, economics and politics of tobacco control. University College London clinical presentation 2013. Available: http://www.uksbm.org.uk/wp-content/uploads/2014/07/robert-west.pdf.

5. MDQuit.org. Module 3: The Stages of Change. Available at: http://mdquit.org/fax-to-assist/module-3. Accessed May 11, 2015.

6. Shiffman S, Ferguson SG. Nicotine patch therapy prior to quitting smoking: a meta-analysis. Addiction 2008:103(4):557-63.

7. Reid R, et al. Managing smoking cessation. CMAJ 2016 188(17-18).

8. Cahill L, et al. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev 2013; Issue 5.

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