Psychological counseling provided by a healthcare professional

Cognitive-behavioral therapies

This is a form of psychological support that helps smokers change their behavior. It can help them resist the urge to smoke when around other smokers, stop associating cigarettes with coffee, for example, and manage stress in ways other than smoking.

Motivational interviewing

aims to spark or reinforce the patient’s motivation and thus help them change their behavior. It is based on a partnership between the healthcare professional and the patient. Cooperative and collaborative, this approach encourages discussion of change and expected benefits while promoting autonomy. It avoids confrontation or persuasion.

Compared to minimal smoking cessation counseling, motivational interviewing increases the likelihood of quitting smoking

Nicotine replacement therapies

Their principle is to provide nicotine so that the smoker does not experience physical withdrawal symptoms. Gradually, the craving diminishes until it no longer occurs (on average, treatment can last 3 to 6 months and can be extended if necessary). There are two main categories that can be used alone or in combination:

• Substitutes that provide a continuous dose of nicotine. These include patches applied to the skin. The nicotine then passes through the skin into the bloodstream.

• Fast-acting substitutes. These include oral forms—chewing gum, tablets, inhalers—or nasal sprays. Nicotine passes through the oral (mouth) or nasal mucosa to enter the bloodstream.

Regardless of their form, nicotine replacement therapies come in different nicotine strengths. Healthcare professionals are best suited to advise on the appropriate strength based on the degree of dependence. Nicotine
replacement therapies are covered by Medicare. A prescription can be issued by a physician, dentist, midwife, physical therapist, or nurse.

Remote support: Tabac Info Service

• The 39 89 hotline (free service + cost of a call), available Monday through Saturday from 8 a.m. to 8 p.m., offers support from the same tobacco specialist throughout the smoking cessation process via phone appointments.

• A personalized e-coaching program allows you to receive advice from tobacco specialists through notifications and by completing activities. E-coaching is available in app stores and as a desktop version

• The website www.tabac-info-service.fr provides information on smoking, its consequences, and treatments, as well as the opportunity to ask a tobacco specialist a question and access a directory of tobacco specialists.

• A Facebook page (www.facebook.com/tabacinfoservice) allows you to connect with a supportive community of former smokers and smokers who want to quit.

Self-help tools

Some smokers quit without professional help or treatment.
Self-help tools (structured resources designed to assist with quitting attempts or maintaining abstinence without direct contact with a professional or group support) increase the likelihood of quitting in the absence of professional intervention.

E-cigarettes

The use of e-cigarettes has spread significantly since the early 2010s. Despite generally encouraging feedback from the field by smoking cessation professionals, there is still a lack of perspective and robust scientific data on their effects in terms of aiding smoking cessation, their safety, and their potential role as a “gateway” to smoking, particularly among young people.In 2016, the High Council for Public Health updated its opinion on the subject, concluding that e-cigarettes:

• can be considered a smoking cessation aid for smokers wishing to quit

• constitute, when used exclusively, a tool for reducing the risks of smoking (for users who use both tobacco and e-cigarettes, the debate remains open)

• could serve as a gateway to smoking (a risk that would be offset by the fact that e-cigarettes could delay the onset of smoking)

• poses a risk of renormalizing tobacco use given the positive image conveyed by its marketing and its visibility in public spaces.

Treatments that act on the central nervous system

Bupropion LP and varenicline help smokers quit by preventing them from experiencing tobacco cravings. They are available only by prescription and are not recommended for pregnant or breastfeeding women, or for smokers under the age of 18. These treatments are recommended when other methods have failed to help the smoker quit. Only varenicline is covered by Medicare.

Other methods, such as hypnosis or acupuncture, may be used by some people. However, the effectiveness of these methods is not recognized.

To learn more about treatments to quit smoking