Counseling About Smoking Cessation

A clinician can make a significant impact on a tobacco user. Clinicians can address the social, financial, and emotional issues surrounding tobacco use, in addition to the health impacts associated with use. Find information about why it's important to counsel tobacco users, as well as when and how to do so.

Note: Though the information below talks mostly about smoking, the information can be helpful for smokeless tobacco users as well.

Why Should You Counsel for Smoking Cessation?

  • Parental smoking is the main source of children's secondhand smoke exposure.
  • When parents quit smoking, adolescents are less likely to start.
  • Pediatric clinicians have direct contact with roughly 25% of the nation's smokers through child health visits.
  • Parental counseling by the child's physician increases rates of parents' attempts to quit.
  • Most parents see their child's provider more frequently than their own, with an average of 10 visits in the first two years of a child's life.
  • While many children are covered by Medicaid, their parents may be uninsured, so pediatric clinicians may be their only available source of counseling.

When Should You Counsel for Smoking Cessation?

  • If smoking, counsel adolescents and/or parents to quit tobacco use.
  • If smoking, counsel parents to prevent and reduce children's exposure to secondhand smoke.
  • If smoking or a former smoker, assist new parents in their efforts to avoid relapse following pregnancy.
  • If not smoking, counsel pre-adolescents and adolescents to prevent initiation of tobacco use.

How Should You Counsel for Smoking Cessation?

  • Brief counseling, delivered in as little as three minutes, can be effective.
  • Focus on the child as a primary beneficiary of smoking cessation.

Counseling Techniques

  • 2 As + R
    Physicians can also help patients who smoke to quit through an effective 30-second intervention, 2 As + R (Ask, Advise, Refer): Physicians Ask patients if they smoke, Advise them to quit, and Refer them to cessation services (1-800-QUIT NOW or to community/ internet quit resources).

    Information on the 2 As + R strategy can be found in the presentations listed on the Downloadable PowerPoint Presentations page.

  • 5 As
    The Agency for Healthcare Research and Quality has developed five major steps to intervention (the "5 As") for clinicians to provide counseling to tobacco users who want to quit.

  • Motivational Interviewing
    This Web site provides information on motivational interviewing. It includes details about this approach, other links, training resources, and current research.

    Motivational Interviewing videos- Effective Physician
    Motivational Interviewing videos- Ineffective Physician

  • Talk To Your Patients
    Don't Be Silent About Smoking is a social marketing campaign to encourage clinicians to take an active role in helping their smoking patients quit. This site includes counseling tips and advice.