Table 3.

Common elements of practical counseling

Component	Examples
Problem solving/skills training
Recognize danger situations – Identify events, internal states, or activities that increase the risk of smoking or relapse.	Negative affect and stress. Being around other tobacco users. Drinking alcohol. Experiencing urges. Smoking cues and availability of cigarettes
Develop coping skills – Identify and practice coping or problem-solving skills. Typically, these skills are intended to cope with danger situations.	Learning to anticipate and avoid temptation and trigger situations. Learning cognitive strategies that will reduce negative moods. Accomplishing lifestyle changes that reduce stress, improve quality of life, and reduce exposure to smoking cues. Learning cognitive and behavioral activities to cope with smoking urges (e.g., distracting attention; changing routines).
Provide basic information – provide basic information about smoking and successful quitting.	The fact that any smoking (even a single puff) increases the likelihood of a full relapse. Withdrawal symptoms typically peak within 1–2 weeks after quitting but may persist for months. These symptoms include negative mood, urges to smoke, and difficulty concentrating. The addictive nature of smoking.
Supportive treatment
Encourage the patient in the quit attempt.	Note that effective tobacco-dependence treatments are now available. Note that one half of all people who have ever smoked have now quit. Communicate belief in patient’s ability to quit.
Communicate caring and concern.	Ask how patient feels about quitting. Directly express concern and willingness to help as often as needed. Ask about the patient’s fears and ambivalence regarding quitting.
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.