Dustin K MacDonald

Menu
  • Home
  • About
  • Economic and Community Development
  • Nonprofit Management
    • Counselling and Service Delivery
    • Suicide Prevention / Crisis Intervention
  • Politics and Governance
  • Math and Statistics
  • Salesforce
Menu

Quit Smoking Counselling

Posted on September 19, 2016November 25, 2018 by Dustin

Table of Contents

Introduction

Counselling clients to quit smoking may be a part of your practice no matter what kind of therapy you do. While many clinicians may wish to refer clients to others for this work, learning the skills to handle smoking cessation may be a valuable addition to your work with clients in other areas and so is worth the time.

In Canada, about 1 in 5 individuals smoke (Statistics Canada, 2014) and this level has been going down, as it has in most western countries, for many years. Tobacco smoking often begins in the teen years (U.S. Department of Health and Human Services, 2012) with the Surgeon General noting that “vast majority of Americans who begin daily smoking during adolescence are addicted to nicotine by young adulthood.”

Smoking often affects the poor, mentally ill and other marginalized groups. (Passey & Bonevski, 2014) The mortality rate of both male and female smokers is three times higher than non-smokers and the rate of heart attack in middle aged men is four times higher. (CDC, n.d.)

Most individuals who attempt to quit smoking will require multiple attempts to quit, with sources citing between 5 and 30 (Chaiton, et. al., 2016).

Benefits of Quitting Smoking

The following list of health benefits comes from the World Health Organization (n.d.), and may help convince a smoker who believes that there is no point in quitting, to attempt to do so:

Within 20 minutes of your last cigarette, your heart rate and blood pressure drop.

Within 12 hours, the carbon monoxide level in your blood drops to normal.

2-12 weeks, your circulation improves and your lung function increases.

1-9 months, coughing and shortness of breath decrease.

1 year, your risk of coronary heart disease is about half that of a smoker’s.

5 years, your stroke risk is reduced to that of a nonsmoker 5 to 15 years after quitting.

10 years, your risk of lung cancer falls to about half that of a smoker and your risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decreases.

15 years, the risk of coronary heart disease is that of a nonsmoker’s.

The benefits are clear! But that doesn’t mean quitting smoking is easy.

Nicotine Withdrawal

When a client stops their regular smoking, they begin to experience withdrawal symptoms within about 2 hours (Medline, 2015) as the nicotine begins to leave their bloodstream. The Mood and Physical Symptoms Scale (West & Hajek, 2004) is a tool for measuring withdrawal symptoms. These symptoms can include depression, anxiety, irritability, restlessness, hunger, inability to concentrate, poor sleep and more.

Assessment of Smoking Behaviours

The Fagerstrom Test for Nicotine Dependence is a common measure of smoking-related behaviour. It asks six questions:

  1. How soon after waking do you smoke your first cigarette?
  2. Do you find it difficult to refrain from smoking in places where it is forbidden? E.g. Church, library
  3. Which cigarette would you hate to give up?
  4. How many cigarettes in a day do you smoke?
  5. Do you smoke more frequently in the morning?
  6. Do you smoke even if you are sick in bed most of the time?

See my article on assessments for substance use disorders for more information on the Fagerstrom Test.

Interventions to Quit Smoking

Nicotine Replacement Therapy (NRT)

Nicotine replacement therapy (NRT) includes products like patches, gum, inhalers and lozenges. Use of nicotine replacement therapy nearly doubled a client’s ability to quit smoking in a Cochrane review (Silagy, et. al., 2012) NRT is contraindicated  in the following groups (Department of Health, Western Australia, 2012):

  • Lactating women
  • Smokers under 12 years of age

As well, those:

  • Between 13 and 18
  • With severe heart problems

Should receive NRT under physician supervision. Additional recommendations (e.g. for people with diabetes, mental health issues or from specific cultural groups) are found in the Clinical Guidelines in the References. In general, clients should receive medical support from a GP who can properly monitor them when taking any medications, including NRT.

Motivational Interviewing

Motivational interviewing (MI) is a brief intervention that aims to highlight and amplify intrinsic motivation and intent to quit smoking that already exists in clients. (Rollnick & Allison, 2001) Some elements of motivational interviewing include (Sciacca, 2009):

  • Change and sustain talk, messages from the client that indicate either a willingness to change or a desire to keep things the way they are
  • Rolling with resistance, and recognizing a client’s desire not to change may be the result of the clinician’s approach, the client’s unreadiness or both
  • Ensuring empathy to build a strong relationship
  • Identifying discrepancies, for instance where a client’s values (“I want to be there for my children”) conflict with their behaviours (“My daughter had to wait in the rain so I could have a smoke”)

There is a large body of research (e.g. the metareview by Lundahl & Burke, 2009) supporting the effectiveness of motivational interviewing in helping clients to quit smoking or using other substances.

The 5 A’s of Quitting Smoking

The 5 A’s describe simple set of steps for a brief tobacco intervention, they come from MDQuit (2012).

  1. Ask – It’s important to ask the patient about their smoking. Do they smoke at all?
  2. Assess – If they do smoke, how much do they smoke. You may wish to use the Fagerstrom criteria for this (see above, Assessment for Substance Use Disorders)
  3. Assist – Help the client make an informed decision about their smoking behaviour if they wish to cut down.
  4. Advice – Provide information on the risks of continuing and the benefits of quitting.
  5. Arrange – Finally, arrange some form of followup if possible to check on their progress.

Quit Smoking Training

The Government of Western Australia has produced the Brief Tobacco Intervention Training Program designed to teach basic cessation skills to clinicians (nurses and doctors) in advising clients on how to quit smoking. It is available freely online and takes about 2 hours to complete.

The California Smokers Helpline provides a number of free courses and online webinars covering a variety of smoking cessation-related topics that may be eligible for Continuing Education (CE) credits.

In Canada, the Centre for Addiction and Mental Health provides the Training Enhancement in Applied Cessation Counselling and Health (TEACH) program, comprised of online and in-person workshops to teach clinicians skills in smoking cessation.

References

Centers for Disease Control and Prevention. (n.d.) “CDC – Fact Sheet – Tobacco-Related Mortality – Smoking & Tobacco Use”. Retrieved on August 11, 2016 from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/

Chaiton, M., Diemert, L., Cohen, J., Bondy, S., Selby, P., Philipneri, A., & Schwartz, R. (2016). Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers. BMJ Open, 6(6), doi:10.1136/bmjopen-2016-011045

Department of Health, Western Australia. (2011) Clinical guidelines and procedures for the management of nicotine dependent inpatients. Perth: Smoke Free WA Health Working Party, Health Networks Branch, Department of Health, Western Australia; Retrieved on August 11, 2016 from http://www.health.wa.gov.au/smokefree/docs/Clinical_guidelines.pdf

Lundahl, B., & Burke, B. L. (2009). The effectiveness and applicability of motivational interviewing: a practice-friendly review of four meta-analyses. Journal Of Clinical Psychology, 65(11), 1232-1245. doi:10.1002/jclp.20638

Medline. (2015). Martin, L.J. “Nicotine and tobacco” Retrieved on August 11, 2016 from https://medlineplus.gov/ency/article/000953.htm

MDQuit. (2012) “Brief Interventions & 5 A’s | MDQuit.org” Retrieved on August 11, 2016 from http://mdquit.org/cessation-programs/brief-interventions-5

Passey, M., & Bonevski, B. (2014). The importance of tobacco research focusing on marginalized groups. Addiction, 109(7), 1049-1051. doi:10.1111/add.12548

Rollnick S., & Allison J. (2001) Motivational interviewing. In: Heather, N., Peters, T.J, & Stockwell T. International handbook of alcohol dependence and problems. New York, NY: Wiley; pp. 593-603.

Sciacca, K. (2009) “MOTIVATIONAL INTERVIEWING –MI, GLOSSARY & FACT SHEET” Retrieved on August 11, 2016 from http://www.motivationalinterview.net/miglossary.pdf

Silagy, C., Lancaster, T., Stead, L., Mant, D. & Fowler, G. (2007) Nicotine replacement therapy for smoking cessation (Review). The Cochrane Library. (3)

Statistics Canada. (2014) “Smoking, 2014”, Retrieved on August 11, 2016 from http://www.statcan.gc.ca/pub/82-625-x/2015001/article/14190-eng.htm

U.S. Department of Health and Human Services. (2012) Preventing Tobacco Use Among
Youth and Young Adults: A Report of the Surgeon General. Retrieved on August 11, 2016 from http://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf

West, R. & Hajek, P. (2004). Evaluation of the mood and physical symptoms scale (MPSS) to assess cigarette withdrawal Psychopharmacology, 177, 195-199.

Cite this article as: MacDonald, D.K., (2016), "Quit Smoking Counselling," retrieved on November 30, 2023 from https://dustinkmacdonald.com/quit-smoking-counselling/.

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Privacy Policy

See here for our privacy policy. This site uses affiliate links and Adsense ads to provide targeted advertising.

Tags

analytical technique assessment communication community development counselling crisis chat crisis intervention data science eastern university economic development education empathy evaluation forecasting fundraising governance information technology intelligence intelligence analysis keokuk county language learning legal management peer support personal development phd politics professional development protective factors psychosocial risk factors safety planning salesforce sigourney social media statistics suicide suicide assessment suicide risk assessment technology terrorism training university of the cumberlands violence risk assessment youth

Recommended Posts

  • Conducting Psychosocial Assessments
  • DCIB Model of Suicide Risk Assessment
  • ABC Model of Crisis Intervention
  • My Friend is Suicidal - What do I do?

Recent Posts

  • ITS833 Information Governance
  • Enhanced Care Management (ECM) with Salesforce
  • ITS835 Enterprise Risk Management
  • Glorifind Christian Search Engine
  • Sigourney Iowa Election Results, 2023

Archives

  • November 2023 (6)
  • October 2023 (1)
  • September 2023 (3)
  • August 2023 (1)
  • July 2023 (1)
  • May 2023 (1)
  • March 2023 (1)
  • February 2023 (2)
  • January 2023 (4)
  • December 2022 (2)
  • May 2022 (1)
  • April 2022 (2)
  • March 2022 (1)
  • February 2022 (1)
  • December 2021 (1)
  • October 2021 (1)
  • August 2021 (2)
  • May 2021 (3)
  • December 2020 (1)
  • November 2020 (4)
  • July 2020 (1)
  • June 2020 (1)
  • April 2020 (1)
  • March 2020 (4)
  • February 2020 (7)
  • January 2020 (1)
  • November 2019 (1)
  • October 2019 (2)
  • September 2019 (4)
  • August 2019 (2)
  • March 2019 (1)
  • February 2019 (1)
  • January 2019 (1)
  • December 2018 (4)
  • November 2018 (3)
  • October 2018 (3)
  • September 2018 (19)
  • October 2017 (2)
  • September 2017 (2)
  • August 2017 (1)
  • July 2017 (39)
  • May 2017 (3)
  • April 2017 (4)
  • March 2017 (4)
  • February 2017 (4)
  • January 2017 (5)
  • December 2016 (4)
  • November 2016 (4)
  • October 2016 (5)
  • September 2016 (4)
  • August 2016 (5)
  • July 2016 (5)
  • June 2016 (5)
  • May 2016 (3)
  • April 2016 (2)
  • March 2016 (2)
  • February 2016 (2)
  • January 2016 (4)
  • December 2015 (2)
  • November 2015 (2)
  • October 2015 (2)
  • September 2015 (2)
  • August 2015 (1)
  • June 2015 (2)
  • May 2015 (5)
  • April 2015 (3)
  • March 2015 (8)
  • February 2015 (12)
  • January 2015 (28)

Meta

  • Log in
  • Entries feed
  • Comments feed
  • WordPress.org

Recent Comments

  • Dustin on Starting a Crisis Line or Hotline
  • HAPPINESSHEALTHCOURAGE, LLC on Starting a Crisis Line or Hotline
  • ITS833 Information Governance - Dustin K MacDonald on University of the Cumberlands PhD in Information Technology
  • Elected Officials in Sigourney, Iowa - Dustin K MacDonald on Sigourney Iowa Election Results, 2023
  • ITS 835 Enterprise Risk Management - Dustin K MacDonald on University of the Cumberlands PhD in Information Technology

Tags

analytical technique assessment communication community development counselling crisis chat crisis intervention data science eastern university economic development education empathy evaluation forecasting fundraising governance information technology intelligence intelligence analysis keokuk county language learning legal management peer support personal development phd politics professional development protective factors psychosocial risk factors safety planning salesforce sigourney social media statistics suicide suicide assessment suicide risk assessment technology terrorism training university of the cumberlands violence risk assessment youth
© 2023 Dustin K MacDonald | Powered by Minimalist Blog WordPress Theme