3.3.2 Coping Strategies for Cravings

Assess patient coping profile across problem-focused, emotion-focused, and avoidant dimensions

The tripartite coping model - problem-focused, emotion-focused, and avoidant - provides a clinically useful framework for assessing patient readiness in the preparation stage.¹ Patients with predominantly avoidant coping styles or narrow coping repertoires are at elevated relapse risk and benefit from targeted skills training before quit day. Zou et al. (2024) found that negative coping styles significantly mediate the relationship between stress and smoking relapse.² Assessment at this stage allows for personalised strategy selection rather than a one-size-fits-all approach.

Actively recommend psychological support for patients with high emotional dependence

For patients presenting high emotional dependence on nicotine (using smoking primarily as affect regulation), referral to a psychologist or trained cessation counsellor significantly improves outcomes.¹ Intensive behavioural support combined with pharmacotherapy is the gold standard.² Preparation-stage patients are uniquely receptive to this recommendation because they have already committed to quitting - the question is not 'if' but 'how.' Frame professional help as optimisation, not remediation.

Use freed-up time as a positive motivator and plan behavioural substitutes that address the patient's primary function of smoking

Behavioural substitution is most effective when the replacement activity addresses the same psychological function as the original behaviour.¹ Before prescribing generic alternatives (water, breathing), assess the patient's primary smoking function: stimulation, relaxation, social bonding, oral fixation, or boredom relief. A patient who smokes primarily for social reasons needs social substitutes; one who smokes to manage alertness may benefit from structured activity planning. The freed-time reframe is also a positive motivational tool - distinct from fear-based messaging - and is particularly effective for patients with low intrinsic motivation.²