Counsellors' Manual for Commercial Tobacco Cessation Treatment

Session
1
Screening and Assessment
This session is designed to give people personalized feedback about their
tobacco use and how it is affecting other areas of their lives. An emphasis is
placed on ensuring that assessment information is used clinically to enhance a
person’s motivation and readiness to change.
T
obacco dependence can be a challenging topic to raise with people, particularly when they
are seeking help for some other issue. Even opening a conversation about commercial
tobacco use can be a challenge if the person has been accustomed to being “lectured” by
health practitioners, family, friends and the media. Adopting a motivational stance is
important in raising the issue in a non-confrontational, matter-of-fact way. This means:
Avoiding arguing
Expressing empathy
Developing discrepancies between a person’s goals and their use of commercial tobacco
Rolling with resistance
Supporting self-efficacy (confidence that they can achieve their goals).
For example, asking the person, “What is the most unusual thing you’ve ever done to make sure
you’d have cigarettes for the next morning” can elicit responses that are very helpful in
developing a discrepancy between how a person regards him- or herself, and his or her behaviour.
Examples we have heard in our practice include ordering pizza in order to get cigarettes delivered,
picking cigarettes off the ground, stealing and sifting through cigarette butts in an ashtray. The
important thing is to give people an opportunity to explore and resolve their ambivalence around
changing their use of commercial tobacco. Helpers should strive to avoid attempts to persuade or
confront people about their tobacco use, as this can lead to resistance and disengagement.
The tools in this section can be used in a variety of ways:
Brief screening tools used in conjunction with other intake or assessment instruments in
your program or service