motivational interviewing trainer and healthy communications consultant
integrative psychiatry and addiction medicine private practice

combination of counseling and pharmacotherapy has 30-40% 3-4 month efficacy
    physician advice alone = 5%

patient handouts & education
smoking counseling (20-30% efficacy, if used alone), 2x as likely to quit with 
tobacco pharmacotherapies (5-15% efficacy, if used alone)

behavioral approaches
  • rx for change, ucsf resource for teaching clinicians how to counsel pts to quit smoking.
  • smoking and gps, free pdf article that offers practical application of motivational interviewing strategies to smoking
  • quitting smoking strategieshandout
  • smoking cost calculator, compare cost of cigs patient currently pays to the $4-6 cost per day for OTC nicotine replacement therapies
  • confidence scale, motivational interviewing tool to assess the low self-efficacy that most smokers feel about quitting. 
    • "How confident from 0-10 do you feel that you can quit smoking?..."Why did you choose 3 and not 1?"... "What would it take for you to go from 3 to 8?"
  • jar in the kitchen, have patient put in the amount that they would've spent that day on cigarettes
    • at agreed upon intervals, the patient can then use the money to reward themselves
  • smoking diary, have your patient keep a smoking diary with this pdf; this simple act may get them to cut-back or quit
  • tapering strategies
    • purchase a different brand of cigarettes, the different taste can help the patient who is beginning to taper
    • remove cigarettes for day from package, place on countertop
    • put cigarettes in a different container, each time the patient leaves home; don't return it to the pack
    • taper by 1 less cigarette every 2 days
  • quit day, throw away ash trays, matches, lighters; replace household items that retain a cigarette smell (bedspread, curtains)