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Table 1 Protocol for the ‘Cut Down to Stop’ Service

From: A ‘Cut-Down-To-Stop’ intervention for smokers who find it hard to quit: a qualitative evaluation

Session Description
1–3
Standard SSS Model
▪ Discuss, explain and assess nicotine dependency
▪ Explain CO-monitoring and take first CO-reading
▪ Discuss options for medication
▪ Set a quit date
▪ Discuss withdrawal symptoms and dealing with cravings
▪ Discuss main motivation to quit
4
Clients who are still smoking 2 weeks after quit date
▪ Provide advice and guidance on ‘Kick It’ CDTS intervention
▪ Assess client’s goal to reduce tobacco and establish readiness to change
▪ Advise on ultimate goal and benefits of total abstinence
▪ Provide information on support and treatment available
▪ Discuss withdrawal symptoms and dealing with cravings
▪ Assess current smoking behaviour, clarify amount smoked
▪ Look at previous attempts of reducing
▪ Explain approach and importance of thinking about moving on to quit altogether
▪ Measure CO reading
▪ Agree schedule to cut down
▪ Discuss preparation process and provide a summary
5 ▪ Review progress and confirm goals and agree cut down schedule
▪ Assess current smoking behaviour, clarify amount smoked
▪ Confirm client has sufficient supply of quit smoking pharmacotherapy (NRT, varenicline, bupropion) is using enough of it, and understands how to use etc.
▪ Advice on changing routine and re-setting goal to reduce consumption further
▪ Address tactics for managing smoking frequency and pattern
▪ Measure CO reading
▪ Review readiness for abrupt cessation
▪ Develop commitment from client
▪ Discuss plans and provide a summary
6 ▪ Check on progress
▪ Measure CO
▪ Review use of medication and supply with client
▪ Discuss withdrawal symptoms and dealing with cravings
▪ Discuss coping strategies for difficult situations with the client
▪ Review gradual quitting program
▪ Discuss coping strategy with regard to any high risk potential situations
▪ Discuss the transition to complete cessation, discuss setting quit date
▪ Provide a summary
7+ ▪ Clients contacted 12 weeks after quit date to find out how client is doing.
▪ Clients who have not succeeded with full session and who are ready to set a quit date are offered an additional 6 session of support.