Behavioral prescription writing in smoking cessation counseling: a new use for a familiar tool

Tobacco use, a self-inflicted epidemic, causes more than 390,000 deaths in the United States each year. Smoking is a habit perpetuated by both physiologic and psychosocial mechanisms. Physician use of behavioral prescriptions is a practical, familiar, and efficient method for achieving smoking cessation. Physicians should ask patients if they want to quit smoking, take a smoking history, motivate patients to quit by personalizing risks, set a quit date, and then follow the behavioral prescription. Behavioral prescription involves writing prescriptions based on a plan that leads the patient through five successive weeks of behavioral modification, culminating in complete cessation of cigarette use. Physician time involved is minimal, since the approach requires only two meetings in person--one at an initial patient visit, and a second at a follow-up appointment.