Psychotherapy for Quitting Smoking

“Smoking cessation represents the single most important step that smokers can take to enhance the length and quality of their lives,” according to the U.S. Surgeon General. Smokers live about 14 years less than nonsmokers, are at increased risk for a laundry list of health problems, and are facing increasing social pressure to quit smoking. However, nicotine’s addictive properties make quitting difficult. Nicotine, a naturally occurring chemical in tobacco, is as addictive as cocaine and heroine, leading to a physical and psychological dependence on smoking. Psychotherapy has been shown to be among the most effective approaches for reducing these dependencies and helping smokers quit for good.

How Can Psychotherapy Help You Quit Smoking?

Whether delivered one-on-one, in a group, or as part of a self-help approach, psychotherapy provides a powerful tool to quit smoking. Since smokers are more likely than nonsmokers to also have depression or other mental-health concerns, psychotherapy can assist in resolving these contributing underlying issues as well. Psychotherapy can help correct misconceptions about smoking and a person’s ability to quit, change behaviors that encourage smoking, and provide the support needed to undertake the process of quitting. There are specific qualities that professional organizations suggest to improve the effectiveness of psychotherapy for quitting smoking. According to the American Cancer Society (ACS), the more intense the psychotherapy intervention is, the better the chance for success. In one-on-one or group therapy sessions, ACS recommends programs of four to seven sessions over at least two weeks, with at least 20 to 30 minutes per session.

Why Use Psychotherapy to Quit Smoking?

While only some smokers become physically addicted to the nicotine in cigarettes, nearly all smokers have some level of psychological dependency on the habit. Emotional and social motivations for starting and continuing to smoke can be quite powerful. It seems intuitive to approach these issues with psychotherapy. Smokers are more likely to also have depression or other mental-health issues that compound the tendency for nicotine use.

Most conventional approaches to quitting smoking use a combination of talk therapy and behavioral modification—components of psychotherapy. There is a reason for this: studies have shown the most effective stop-smoking programs have either one-on-one or group counseling as a central tool in the fight to quit. Nicotine replacement or other prescription medications also have a role in reducing withdrawal effects and cravings, but these only address physical dependency. Alternative approaches, including hypnosis, acupuncture, and meditation, play a role in quitting smoking, but may not be effective enough on their own. However, starting with some form of psychotherapy can build a foundation that can be enhanced and individualized by medications and/or complementary approaches to quitting smoking.

What Health Consequences Can Smoking Cause?

Smoking increases the risk for lung cancer, heart disease, stroke, emphysema, chronic obstructive pulmonary disease (a lung disease), blood clots, vascular diseases, additional cancers, and many other conditions. It causes skin wrinkling, bad breath, yellowing of the teeth and fingernails, and can contribute to vision loss. Smoking while pregnant increases the risk for miscarriage, low birth weight, and learning and other medical problems. These risks can be attributed to the more than 4,000 chemicals in cigarette smoke, including carcinogens (cancer-causing chemicals) and other toxins.

What is Psychotherapy?

Psychotherapy, sometimes simply called “counseling” or “talk therapy,” is a guided communication process between an individual and a trained therapist. It emphasizes becoming aware of one’s motives, perspectives, thoughts, and feelings and how these translate into behaviors and life experience. It can provide support and constructive healing when navigating a difficult life experience, such as quitting smoking. It is a participatory activity, a dialogue with a credentialed professional who can help uncover patterns and suggests pathways for change.

Psychotherapy is not simply receiving advice or unconditional acceptance. It is more aimed at producing insight that can empower constructive change within an individual.

Psychotherapy can involve many various methods and approaches, including, but not limited to, the following:

• Behavioral therapy to understand how behavior changes can influence feelings
• Cognitive therapy to adjust incorrect or unhelpful thought processes
• Interpersonal therapy, a relationship-centered approach to depression treatment
• Psychodynamic therapy, focused on unconscious processes that influence behavior
• Individual, family, or group therapy

How to Find a Psychotherapist

You can begin by asking family, friends, or your doctor for referrals to professionals with which they are familiar and trust. Human resources departments or employee-assistance programs are other resources, as well as the yellow pages. Professional organizations offer a reliable source for finding local credentialed professionals. The specific training of professionals may be less important than their experience with smoking cessation and your own comfort with the therapeutic relationship.

Various mental-health providers can offer psychotherapy, including psychologists, psychiatrists, psychiatric nurses, clinical social workers, marriage and family therapists, substance abuse counselors, or other licensed professional counselors. Additionally, while specifically seeing a professional for psychotherapy is one approach, many self-help tools make use of psychotherapy techniques as well. The resources section below offers many options to access psychotherapy in your effort to quit smoking.

Additional Resources

American Cancer Society offers online information about smoking cessation and referrals to local resources. Call 1-800-ACS-2345.

Medline Plus Health Topic: Smoking Cessation has numerous useful links from reputable sources on quitting smoking.

Nicotine Anonymous offers a free 12-step program in many areas.

Prochaska, Judith J., et. al. “Addressing Nicotine Dependence in Psychodynamic Psychotherapy: Perspectives From Residency Training.” February 2007. Acad Psychiatry 31:8-14.

Psych Central, a website by mental-health professionals with numerous related resources and information.

Smoking Cessation with Bonnie J. Spring, Ph.D. is a video that is part of the Behavioral Health and Health Counseling APA Psychotherapy Video Series. Target audience: mental-health providers.