Practices and Perceptions of Counselors in Addressing Smoking Cessation

Introduction: Rates of cigarette smoking are much higher in adults with mental health issues. Research indicates that use of the 5 As for smoking cessation as brief interventions with individuals with mental illnesses increases quit rates, although it is not heavily utilized by health care providers who work with this population. This study examined mental health counselors' use of smoking cessation activities with their clients.

Methods: A nationally representative random sample of 700 mental health counselors was mailed a valid and reliable four-page survey on counselors' placement in the Stages of Change, use of the 5 As, preparation and confidence in addressing smoking cessation, and efficacy and outcome expectations. Frequency analyses and statistical analyses measuring associations and relationships will be reported.

Results: 330 (54%) counselors responded to the survey. The majority (60%) were in precontemplation stage for asking clients about smoking status. Regarding the 5 As, counselors most frequently used “assisting” (53%) and “arranging” follow-up through referral to outside agencies (53%). The majority felt very prepared (40%) or somewhat prepared (36%) to assist their clients in quitting smoking, and most reported learning their skills through clients who smoke (41%) or continuing education programs (36%). The majority (74%) did not feel that training programs in counseling prepared them to address smoking cessation.

Conclusion: Although the majority of counselors feel they are prepared to address smoking cessation with their clients, formal professional training is lacking. This results in counselors not being adequately prepared to assist their clients with smoking cessation activities.