ABSTRACT
Chapters 3 and 4 offer specific guidelines for developing a treatment plan and deciding on the appropriate cessation medication for smokers to use. Once patients have quit they will have to contend with perhaps the most difficult aspect of cessation, the effects of nicotine withdrawal. Withdrawal can vary in severity among patients, but here we will describe the symptoms and time course that practitioners and patients can generally expect, and suggest methods for assessing withdrawal and strategies for coping with it. Patients will also need to know what to do if they experience a brief lapse in abstinence (i.e., if they “give in” and smoke a cigarette). Recall that any smoking at all, even a few puffs, in the first few weeks after quitting is highly associated with eventual relapse and is to be strongly discouraged. However, relapse, or a total return to smoking, is not a foregone conclusion if a lapse occurs. In this chapter we offer techniques for helping patients who lapse return to abstinence before they fully relapse. To illustrate the techniques covered in this chapter, we will periodically revisit Leah, the single 27-year-old smoker who, in chapter 3, initiated a quit attempt.
