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Behavioral Treatments

Behavioral counseling is typically provided by specialists in smoking cessation for four to eight sessions. Both in-person and telephone counseling have been found beneficial for patients who are also using cessation medications. A variety of approaches to smoking cessation counseling are available.

Cognitive Behavioral Therapy (CBT)

CBT helps patients identify triggers—the people, places, and things that spur behavior—and teaches them relapse-prevention skills (e.g., relaxation techniques) and effective coping strategies to avoid smoking in the face of stressful situations and triggers.

A study found that among smokers trying to quit with the nicotine replacement therapy (NRT) patch, patients who participated in six sessions of intensive group CBT had better quit rates than those who received six sessions of general health education.

Motivational Interviewing (MI)

In MI, counselors help patients explore and resolve their ambivalence about quitting smoking and enhance their motivation to make healthy changes. MI is patient-focused and nonconfrontational, and providers point out discrepancies between patients’ goals or values and their current behaviors. They adjust to patients’ resistance to change and support self-efficacy and optimism.

Studies of MI suggest that this intervention results in higher quit rates than brief advice to stop smoking or usual care.


In mindfulness-based smoking cessation treatments, patients learn to increase awareness of and detachment from sensations, thoughts, and cravings that may lead to relapse. In this therapy, patients purposely attend to the thoughts that trigger cravings and urges for tobacco and cognitively reframe them as expected and tolerable. Patients learn techniques that help them tolerate negative emotions—including stress and cravings—without returning to tobacco use or other unhealthy behaviors.

Interest in mindfulness-based treatments has increased during the past decade, and studies show that this approach benefits overall mental health and can help prevent relapse to smoking. However, well-controlled clinical trials are needed.

Telephone Support & Quitlines

All states offer toll-free telephone numbers (or quitlines) with smoking cessation counselors who provide information and support. Studies indicate that smokers who call quitlines benefit from these services, particularly when a counselor calls them back for multiple sessions. There is limited evidence on the optimal number of calls needed, but smokers who participated in three or more calls had a greater likelihood of quitting, compared with those who only received educational materials, brief advice, or pharmacotherapy alone. Quitlines have also been shown to help smokeless tobacco cessation.

The U.S. Department of Health and Human Services provides a Smoking Quitline (877-44U-QUIT or 877-448-7848), as well as more information and tools for quitting (including text messages and other telephone-based support) at

Contact the CT Quitline for Free Help & Information to Quit

Services are available in English, Spanish, and other languages.

Text Messaging, Web-Based Services, & Social Media Support

Technology, including mobile phones, internet, and social media platforms can be used to provide smoking cessation interventions. These technologies have the power to increase access to care by extending the work of counselors and overcoming the geographical barriers that may deter people from entering treatment.

The Become an EX online program is available to help you re-learn life without cigarettes or vapes.