[Smoking cessation counseling based on behavioral science: theory and practice].

"Cigarettes and other forms of tobacco are addictive due to nicotine in tobacco smoke." That is the conclusion of a report issued in 1988 by the Surgeon General of the U.S.A. It is the physician's responsibility to treat patients with nicotine dependence just like those with dependence on narcotic drugs or alcohol. Cigarette smoking is "the cause of the single, biggest preventable disease" in Japan, and it is estimated that about 110,000 people die yearly from cigarette smoking. As physicians, we can contribute to society by helping our patients to quit smoking, which will decrease smoking-related illnesses. However, physicians do not now provide adequate guidance, either because of limited time or a lack of educational materials. Prompted by this situation, we developed a step-by-step smoking cessation program for use by physicians and their co-workers in outpatient clinics. The program, called "The Smokebusters Program," is based on the recognition that smokers are at different stages of readiness to change. It has the following components designed to move the patient to the next stage in the process of becoming a non-smoker: an instructor's manual, six self-help guides for patients at various stages, a smoking habit questionnaire, a cessation counseling record for instructors, and stickers for the patient's file to show progress in quitting smoking. This paper begins by describing the need for smoking cessation counseling. Second, theoretical models and effective counseling methods for smoking cessation based on behavioral science and pharmacology are described. Finally, the details of The Smokebusters Program and the procedures for smoking cessation counseling are presented.