Version June 2024
| Intervention | Technique |
| Relapse prevention | |
| Every ex-tobacco user undergoing relapse prevention should receive congratulations on any success and strong encouragement to remain abstinent. When encountering a recent quitter, use open-ended questions designed to initiate patient problem-solving (eg, "How has stopping tobacco use helped you?"). | |
| The clinician should encourage the patient's active discussion of the topics below: | |
| The benefits, including potential health benefits, that the patient may derive from cessation | |
| Any success the patient has had in quitting (duration of abstinence, reduction in withdrawal, etc) | |
| The problems encountered or anticipated threats to maintaining abstinence (eg, depression, weight gain, alcohol, other tobacco users in the household) | |
| Management of relapse | |
| Lack of support for cessation | Schedule follow-up visits or telephone calls with the patient |
| Help the patient identify sources of support within their environment | |
| Refer the patient to an appropriate organization that offers cessation counseling or support | |
| Negative mood or depression | If significant, provide counseling, prescribe appropriate medications, or refer the patient to a specialist |
| Strong or prolonged withdrawal symptoms | If the patient reports prolonged craving or other withdrawal symptoms, consider extending the use of an approved pharmacotherapy or adding/combining pharmacologic medication to reduce strong withdrawal symptoms |
| Weight gain | Recommend starting or increasing physical activity; discourage strict dieting |
| Reassure the patient that some weight gain after quitting is common and appears to be self-limiting | |
| Emphasize the importance of a healthy diet | |
| Maintain the patient on pharmacotherapy known to delay weight gain (eg, bupropion sustained release; nicotine-replacement pharmacotherapies, particularly nicotine gum) | |
| Refer the patient to a specialist or program | |
| Flagging motivation/feeling deprived | Reassure the patient that these feelings are common |
| Recommend rewarding activities | |
| Probe to ensure that the patient is not engaged in periodic tobacco use | |
| Emphasize that beginning to smoke (even a puff) will increase urges and make quitting more difficult | |
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