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Tobacco Dependency: Treatment Behavioral Solutions for Quitting
Tobacco Dependency continuing education social worker CEUs

Section 22
Appendix: Reproducible Client Worksheets

CEU Answer Booklet | Table of Contents
| Addictions
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs

The Why Test
Review CD Track 1 for more information regarding this technique.
Client reviews and implements the following procedure to understand why he or she smokes.
1.  Rate the following statements on a scale of 1 to 5.  (5=Always, 4=Most of the time, 3=Once in a while,                                               2=Rarely, 1=Never)

  1. I smoke to keep myself from slowing down.                                              ______
  2. Handling a cigarette is part of the enjoyment of smoking it.                         ______ 
  3. Smoking is pleasant and relaxing.                                                              ______
  4. I light up a cigarette when I feel angry about something.                             ______
  5. When I’m out of cigarettes, it’s near torture until I can get some more.       ______
  6. I smoke automatically, without even being aware of it.                               ______  
  7. I smoke when people around me are smoking.                                          ______
  8. I smoke to perk myself up.                                                                       ______
  9. Part of my enjoyment of smoking is preparing to light up.                          ______
  10. I get pleasure from smoking.                                                                    ______
  11. When I feel uncomfortable or upset, I light up a cigarette.                          ______
  12. When I’m not smoking a cigarette, I’m very much aware of the fact.          ______
  13. I often light up a cigarette when one is still burning in the ashtray.               ______
  14. I smoke cigarettes with friends when I’m having a good time.                    ______
  15. When I smoke, part of the enjoyment is watching the smoke as I exhale.   ______
  16. I want a cigarette most often when I am comfortable and relaxed.             ______
  17. I smoke when I’m blue and want to take my mind off what’s bothering me ______
  18. I get a real hunger for a cigarette when I haven’t had one in a while.           ______
  19. I’ve found a cigarette in my mouth and haven’t remembered it was there.   ______
  20. I always smoke when I am out with friends at a party or bar.                     ______
  21. I always smoke cigarettes to get a lift.                                                        ______

2.  Score yourself.  Transfer the numbers from above to the scorecard by matching the letters.  Then add each set of three scores to get the total for each category.  A score of 11 or more in a specific category indicates that your smoking may be influenced by that category. 
            Stimulation:
                        _____ A.     _____ H.     _____ U.
                        Stimulation Total:  ______
            Handling:
                        _____ B.     _____ I.     _____ O.
                        Handling Total:  ______
            Pleasure/Relaxation:
                        _____ C.     _____ J.     _____ P.
                        Pleasure/Relaxation Total:  ______
            Crutch/Tension:
                        _____D.     _____ K.     _____ Q.
                        Crutch/Tension Total:  ______
            Craving/Addiction:
                        _____ E.     _____ L.     _____ R.
                        Craving/Addiction Total:  ______
            Habit:
                        _____ F.     _____ M.     _____ S.
                        Habit Total:  ______
            Social Smoker:
                        _____ G.     _____ N.     _____ T.
                        Social Smoker Total:  ______

 The "Self Monitoring Smoking Habits" Technique
Review CD Track 3 for more information regarding this technique.
Client reviews and implements the following procedure to monitor smoking habits prior to quitting.
1.  Use a monitoring sheet to record your smoking habits.
            Example:
                        ACTIVITY CODES:
                        A = with alcohol                                    C = with coffee
                        T = with television                                 M = after a meal
                        P = while on the phone                          S = while socializing
                        D = while driving                                   W = while working
                        N = while doing nothing                          R = while relaxing
                        O = other

5:00 ____         8:00 ____         11:00 ____       2:00 ____         5:00 ____         8:00 ____         11:00 ____
5:15 ____         8:15 ____         11:15 ____       2:15 ____         5:15 ____         8:15 ____         11:15 ____
5:30 ____         8:30 ____         11:30 ____       2:30 ____         5:30 ____         8:30 ____         11:30 ____
5:45 ____         8:45 ____         11:45 ____       2:45 ____         5:45 ____         8:45 ____         11:45 ____
6:00 ____         9:00 ____         12:00 ____       3:00 ____         6:00 ____         9:00 ____         12:00 ____
 6:15 ____         9:15 ____         12:15 ____       3:15 ____         6:15 ____         9:15 ____         12:15 ____
6:30 ____         9:30 ____         12:30 ____       3:30 ____         6:30 ____         9:30 ____         12:30 ____                   6:45 ____         9:45 ____         12:45 ____       3:45 ____         6:45 ____         9:45 ____         12:45 ____
7:00 ____         10:00 ____       1:00 ____         4:00 ____         7:00 ____         10:00 ____       1:00 ____
7:15 ____         10:15 ____       1:15 ____         4:15 ____         7:15 ____         10:15 ____       1:15 ____
7:30 ____         10:30 ____       1:30 ____         4:30 ____         7:30 ____         10:30 ____       1:30 ____
7:45 ____         10:45 ____       1:45 ____         4:45 ____         7:45 ____         10:45 ____       1:45 ____

                                                                                                                                                After 2 a.m. ____
            Total: _____

2.  During the first week, try not to alter your smoking habits.
3.  During the second week, try to decrease your intake 50%.

Devising a Quitting Plan
Review CD Track 3 for more information regarding this technique.
Client reviews and implements the following procedure to identify a combination of methods for quitting smoking.
1.  Choose how you will quit, cold turkey or cutting down.
2.  Choose a quit date.
3.  Commit to that date as your quit date.
4.  Brainstorm alternatives to smoking.
5.  Ask a few close friends and family members for help and support.

The SALES Approach
Review CD Track 4 for more information regarding this technique.
Client reviews and implements the following procedure to maximize the benefits of a quitting partner.
1.  Speak to your quitting partner on a daily basis.
2.  Abstain from complaining to one another about how bad quitting is.
3.  Link together as a partnership and understand the other person’s success can be influenced by your actions.
4.  Empathize, but don’t sympathize, with your partner.
5.  Solve problems by working together toward solutions.

Techniques for Avoiding Triggers
Review CD Track 5 for more information regarding this technique.
Client reviews and implements the following procedure to avoid triggers.
1.  Avoid places that make you want to smoke.  If you smoke at home at home, consider throwing away the ashtrays, rearranging the furniture, or sitting in a different room. 
2.  Avoid people that make you want to smoke. 
3.  Through self monitoring your smoking habits, identify the time of day in which you smoke the most.  Think of other things to do with that time instead of smoking.
4.  Compete with smoking by finding activities which are not conducive to smoking.
5.  Don’t try to reward yourself with a cigarette.

The "Empty Pack" Technique
Review CD Track 5 for more information regarding this technique.
Client reviews and implements the following procedure to avoid relapse due to emotional triggers.
1.  Carry an empty pack of cigarettes with you. 
2.  Write the date and time of your last cigarette on a small piece of paper and put it inside the pack. 
3.  Whenever the urge comes to light up, take out the paper. 
4.  Focus on how long it’s been since you last smoked. 
5.  Use positive self talk to reassure yourself that if you’ve gone that long, you can keep go longer. 
6.  Then, smell the inside of the pack.  It’ll smell like stale tobacco and remind you of the way you used to smell

The Three Rules of Relapse
Review CD Track 6 for more information regarding this technique.
Client reviews and implements the following procedure to prevent relapse.
1.  Never smoke a cigarette that is given to you.
2.  Never buy cigarettes in the place where you are about to relapse.
3.  After buying a pack of cigarettes and smoking one, throw the rest of the pack away.

Coping with Cravings
Review CD Track 7 for more information regarding this technique.
Client reviews and implements the following procedure to cope with cravings.
1.  Never forget why you quit smoking
2.  Know when you’re rationalizing. 
3.  Don’t get cocky. 
4.  Think positive. 
5.  Relax. 

 

CEU Answer Booklet for this course | Addictions
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