Dealing with Devoted Tobacco Users

State: " We only have a limited amount of time today. We want everyone to have a chance. Let's use the time wisely and talk about specific cessation related problems".
Help the person determine what he/she really wants to say. Many times the talkative person is afraid to say what is truly the problem so they circle around it forever with meaningless trivia.
Keep the conversation focused on smoking cessation issues. "How does that relate to quitting smoking?"
Brake in with sympathetic phrases.
If there are other issues that do need to be addressed suggest that the group member talk to a friend, relative, or clergyman.

This person usually wants you to provide some magic pill to "cure" them of smoking. All other information/suggestions are rejected with a "Yes...but".
Make it clear to this person that there is no magic pill that will cure them.
Help them understand that you cannot make them quit. Only they can do that.
Explain the concept of alternatives (there is always something else that you can do or think in every situation that does not involve smoking).
Give this person clear, simple to use coping strategies to start. Then build more complicated techniques.
If a suggestion is rejected, use someone else in the group who has successfully used this strategy as an example. "This worked for…. It just might work for you."
If the person persists in rejecting your/the group's suggestions, give the individual sincere feedback about their behavior.

Acknowledge their difficulties but remind them that sometimes quitters actually make quitting a lot more difficult than it is. Explore what they are doing that is making the process so difficult. Are they creating a ready excuse to continue smoking?
Focus on accomplishments, even if it is only an increase in self-knowledge.
Emphasize that quitting is a process that occurs over time. Help them to see this attempt, no matter what has happened, as a positive step in this process.
Create a specific plan to deal with the situations that are contributing to the individual's frustration.
If they do not already have a strong support system, suggest that they create one.

Acknowledge the person's difficulty and frustration.
Let the person know that the purpose of the group is to work through these issues and to find solutions.
Be clear that the role of the group is to provide support and strategies about quitting smoking and nothing else.
If the person appears to need help/information beyond the scope of the group refer him/her to the appropriate healthcare professional.

Other than your smoking history, be very judicious in revealing your own story. You may occasionally use a personal anecdote to illustrate a point but save that for times when doing so will really "pack a punch."
If someone asks you personal questions simply say, "This group is not about me, it is about you. It is not appropriate for me to discuss my personal life."
Understand that turning the attention to you may simply be a way for group members to avoid talking about themselves.

Be especially cognizant of symptoms of depression. Because of the lack of the stimulating effect of nicotine many individuals become somewhat depressed when they quit. If you notice these symptoms or if the individual is reporting symptomatic behavior outside of the group, take this person aside during a break and determine if a referral is necessary.
If this individual is not already using it, Zyban may be helpful not only for quitting but for dealing with the depression.