Version May 2024
| Action | Strategies for implementation |
| Help the patient with a quit plan | Set a quit date. Ideally, the quit date should be within 2 weeks. For patients who have difficulty with this type of "all-or-nothing" approach, it is reasonable to develop a strategy of cutting down gradually, in anticipation of a quit date further in the future. |
| Tell family, friends, and coworkers about quitting and request understanding and support. | |
| Anticipate challenges to the planned quit attempt, particularly during the critical first few weeks. These include nicotine withdrawal symptoms. | |
| Remove tobacco and vaping products and devices from your environment. Prior to quitting, avoid smoking or vaping in places where you spend a lot of time (eg, work, home, car). | |
| Provide practical counseling (problem-solving/training) | Abstinence – Total abstinence is essential. "Not even a single puff after the quit date." |
| Past quit experience – Review past quit attempts, including identification of what helped during the quit attempt and what factors contributed to relapse. | |
| Anticipate triggers or challenges in the upcoming attempt – Discuss challenges/triggers (such as school pressures, parties, or feelings of boredom or depression) and how the patient will successfully overcome them. | |
| Alcohol, marijuana, and other drugs – Because these can cause relapse, the patient should consider limiting/abstaining from their use while quitting. Health care providers should discuss the use/abuse of these substances and plans for changing behavior. | |
| Other people who smoke or vape in the household – Quitting is more difficult when there is another smoker or vaper in the household. Patients should encourage family members or roommates to quit with them or not use these products in their presence. | |
| Provide intratreatment social support | Provide a supportive clinical environment while encouraging the patient in their quit attempt. "My office staff and I are available to assist you." |
| Help the patient obtain extratreatment social support | Help the patient develop social support for their quit attempt in their environment outside of treatment. "Ask your boyfriend/girlfriend, friends, and family to support you in your quit attempt." |
| Recommend the use of approved pharmacotherapy, except in special circumstances | Recommend the use of pharmacotherapies found to be effective. Explain how these medications increase smoking cessation success and reduce withdrawal symptoms. Discuss the proper use of these medications; review their use at future visits. |
| Provide supplementary materials | Sources – Federal agencies, nonprofit agencies, or local/state health departments (eg, 1-800-QUITNOW [smokefree.gov] or www.tobaccofree.org/children.htm). |
| Type – Have printed materials on hand in clinical setting; provide website addresses or quit line phone numbers. Materials should be culturally, racially, educationally, and age-appropriate for the patient. |
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