Cessation Worksheets

New subscribers get My Vaping Story FREE plus 15% OFF with every newsletter. Join the newsletter →

Category: Case Notes

  • “I’d Rather Smoke Than Gain Weight”: A Practice Note on Weight Worry After Quitting

    “I’d Rather Smoke Than Gain Weight”: A Practice Note on Weight Worry After Quitting

    A practice note for cessation coaches, counselors and therapists working with clients who fear weight gain after quitting.

    “I know smoking’s bad for me. I’m not stupid. But the last time I stopped, I went up two sizes before the summer. Nothing fitted. I stopped going to things because I didn’t want to be seen.

    And everyone said, well, at least you’re not smoking. As if that made it fine.

    So no. I’d rather smoke than go through that again. I’d honestly rather smoke than gain weight.”

    A woman sitting on the edge of her bed with a clipboard on her lap, one hand on her stomach, looking down at a bathroom scale on the carpet

    It sounds like a decision. It is really a fear with a history.

    The client has done the sum already, and the sum came out in favor of smoking. Not because they doubt the harm, but because the last quit cost them something no one around them took seriously: their clothes, their confidence, the parties they stopped going to. “At least you’re not smoking” told them their loss did not count.

    What is actually being asked

    Underneath the sentence is a question the client rarely says out loud: is there a way to stop that does not make me lose control of my body?

    And, just as quietly, a test of you. Will you take the weight seriously, or will you tell them it is the lesser evil? The person in front of you is not asking for permission to keep smoking. They are asking whether this time can be different.

    Why it is harder than it looks

    The sentence usually ends the conversation, and there are two easy ways to end it badly. The first is reassurance: the health benefits far outweigh a few pounds. That is often true, and it is exactly what the client has already heard. The second is a plan: calories, portions, a target. That turns a quit attempt into a diet, and many clients have tried both at once and lost both.

    Meanwhile the real drivers stay unnamed. Appetite and taste often change after quitting. Moments that used to end with a cigarette — after a meal, at the end of the workday, in front of the evening news — look for a new ending, and food is the one within reach. And underneath it all sits one belief: that a number on the scale means the quit was not worth it. As long as that belief stays unspoken, it wins.

    What to do with it in a session

    Start by taking it seriously. Not by agreeing that smoking is the answer, but by agreeing that the weight mattered. “That sounds like it cost you a lot last time” does more than any statistic.

    Then ask about last time in detail. Not how much, but when. Which moments turned into eating moments? The walk home? The kitchen at ten at night? Most clients I have seen can name three or four. Those moments are the plan, not the scale.

    Separate what the client feels in those moments. Some of it is hunger. Some of it is a cue: the time, the place, the hand looking for something to do. The two need different answers, and a client who can tell them apart has already taken back some of the control they were afraid of losing.

    Keep the scale out of it unless the client wants it in. If they would rather not weigh themselves for now, that is a reasonable boundary, not avoidance. And if body image or eating feels overwhelming, that is a conversation for a qualified professional, alongside the quit, not after it.

    The sentence underneath

    Before they leave, the belief goes on paper, in the client’s own words:

    • The thought, exactly as it sounds in their head, and how true it feels from 0 to 10.
    • What has actually happened, in two columns: the times it turned out that way, and the times it did not.
    • An answer they choose, one sentence that holds up against both columns, and how true the old thought feels now.

    The second number is often lower than the first. Not because you argued the client out of it, but because they looked at it.

    Practice takeaway

    When a client says they would rather smoke than gain weight, do not argue with the sum and do not hand them a diet. Take the last quit seriously, find the moments that turned into eating moments, separate hunger from cue, and put the one belief on paper where it can be tested. The goal is a quit the client can live with, not a number.

    The Smoke-Free Appetite & Scale Reset is built for this appointment. Page 1 explains what changes after quitting in plain language, page 4 helps the client tell hunger from a cue, and page 3, the Cognitive Weight Ledger, puts the belief on paper with a rating before and after — and a scale boundary the client chooses for now.

  • “I’ve Already Failed Stoptober”: A Practice Note on the Early Slip

    “I’ve Already Failed Stoptober”: A Practice Note on the Early Slip

    A practice note for cessation coaches, counselors and therapists working with clients who slip early in a month-long quit challenge.

    “I made it through Sunday. Four days. Then on Monday my brother came over, we stood outside by the back door, and I just took one from his pack. One. I didn’t even finish it.

    But that’s it now, isn’t it? Stoptober is 31 days in a row, and I broke it. The app went back to zero. So I thought, fine, I’ll try again in January.

    I only came today because the appointment was already booked.”

    A calendar on a fridge door in early October with four days crossed off and a hand holding a pen at the fifth

    It sounds like a question about starting over. It is really a question about what the four days were worth.

    The client has made a decision before the appointment: the month is broken, so the month is over. The cigarette on day five has become the verdict on days one to four. And January is not a plan. It is a way to stop thinking about it until then.

    What is actually being asked

    Underneath “I’ve already failed” is a narrower question: do the days before still count?

    If the answer is no, stopping is logical. If the answer is yes, one cigarette is something that happened in the month, not the end of it. The person in front of you is not asking for permission to give up. They are asking whether continuing still counts.

    Why it is harder than it looks

    A challenge built on days in a row carries a hidden rule: one slip, and the count goes back to zero. The client did not invent that rule. The counter on their phone applied it for them.

    And all-or-nothing thinking is persuasive because it brings relief. If the month is already lost, there is nothing left to hold on to tonight. That relief is what makes the next cigarette easier than the first.

    Reassurance alone often slides off. “It’s only one” can sound as if you are lowering the bar. What helps more is looking at the slip closely enough that it becomes information instead of a verdict.

    What to do with it in a session

    Start with the four days, not the one cigarette. What got them through Thursday to Sunday? Those answers are a plan they already have.

    Then look at the slip the same way. Not why they failed, but what happened: where they were, who was there, what came just before, what they needed in that moment. In this story: the back door, the brother, a pack within reach, and no plan for that hour.

    The next box

    Before they leave, three things go on paper:

    • One change for tomorrow, small enough to actually do. Not “try harder”, but “when my brother comes over, we stay inside”, or “I tell him before he lights up”.
    • The number of tomorrow’s box. Not day one again: day six.
    • One person they tell today, before it feels less awkward.

    The month keeps its numbering. A slip on day five is still day five. Tomorrow is day six.

    Practice takeaway

    When a client says “I’ve already failed”, the first question is not why they smoked but what the days before it were made of. Count the kept days with them, look at the slip as one moment with a before and an after, and close with the number of tomorrow’s box. The work is to keep the month going, not to restart it.

    Page 3 of The 31-Day Freedom Challenge Practice Set, One Day Does Not Undo the Month, is built for this exact appointment. It helps the client map what happened before the slip, what they needed in that moment, one realistic change for tomorrow, tomorrow’s box number, and the days already kept. It keeps the month moving instead of sending the client back to zero.

  • “I Don’t Even Know When I Do It”: A Practice Note on Automatic Smoking

    “I Don’t Even Know When I Do It”: A Practice Note on Automatic Smoking

    A practice note for cessation coaches, counselors and therapists working with clients whose smoking has moved into the background.

    “I’m not one of those people who’s smoking all day. I’m not. I have one with my coffee and one after dinner, and those are the ones I like. The rest just — happen. I’ll be on the phone with my sister, and we’ll hang up, and there’s one in my hand. I didn’t decide that. I didn’t even want it. I’ll pull up outside the house and I’ve lit one before the engine’s off.

    And then I count the pack at night and there’s fifteen gone. Fifteen. And I can tell you about two of them.

    So how am I supposed to stop something I don’t even know I’m doing?”

    A driver's hand turning the key out of the ignition in a parked car at dusk, a lit porch light on the house outside

    It sounds like a question about willpower. It is really a question about sight.

    What they are describing is a day with cigarettes in it that they cannot account for. They can name the first one and the one they look forward to. The rest have gone quiet. They happen, and the client finds out afterwards, counting the pack.

    And underneath, the part that makes them hesitate before the quit date: if I can’t see them coming, I’ll lose to them again.

    What is actually being asked

    The temptation is to start with the date. Pick a day, clear the house, go.

    But a quit date asks the client to fight every cigarette at once, including the ones they have never noticed. The person in front of you is not asking for more resolve. They are asking how to find the cigarettes they can’t see.

    That is a much smaller question, and it has an answer.

    Why it is harder than it looks

    The cigarettes a client can name are the ones attached to a feeling. Stress, a craving, the one with coffee. Those at least announce themselves.

    The unnoticed ones are attached to something else: the end of things. The end of a phone call. The engine turned off. The laptop closed. The last plate in the rack. The cigarette has become a full stop, and the hand reaches for it before the thought arrives.

    This is why “just resist it” fails. There is nothing to resist. By the time the client notices, the moment has already passed. What looks like weak willpower is a routine that has moved so far into the background that it no longer asks permission.

    What to do with it in a session

    One week of noticing.

    They are not asked to cut down that week. The task is to observe before trying to change. Before each cigarette, they stop for three seconds and write down two things. Where are my hands? What happened just before?

    Not how many. Not whether they should have. Just where, and what came right before it.

    What comes back often surprises the client more than it surprises you. The unaccounted-for cigarettes cluster. Many of them sit at the same few transitions, day after day. Once the client sees that, the question changes. It is no longer why can’t I stop? It becomes which of these do I take on first?

    The first moment

    They pick one ending, the one that happens most often and looks the clearest on the page. The car is a common one.

    Before the next session, that moment gets a different full stop. Keys in the pocket. One slow breath with the window down. Walk to the door. The pause comes first, before anything else changes.

    Some days the pause is not enough, and that is part of it. Some days it is, and the moment passes on its own.

    That is the first cigarette they have skipped by choice rather than by accident. After that, it is no longer a cigarette they don’t know about. It is a moment, and a moment can be planned for.

    Practice takeaway

    When a client says, “I don’t even know when I do it,” the first intervention may not be a quit date. It may be a map. Ask them to notice the hands, the transition and the moment just before the cigarette. Once the pattern is visible, the work becomes smaller, clearer and more realistic.

    The first page of My Smoking Story has ten everyday moments for the client to tick and a line for the one hardest to imagine giving up — a place to start the map before the first appointment.

  • “I Want to Quit, But My Partner Still Smokes”: A Practice Note on Quitting in a Smoking Household

    “I Want to Quit, But My Partner Still Smokes”: A Practice Note on Quitting in a Smoking Household

    A practice note for cessation coaches, counselors and therapists working with clients who are quitting while a partner or housemate still smokes.

    “I’d done twelve days. Twelve. And on Thursday she came in from the yard and hung her coat over the chair, and I smelled it from where I was sitting. And I sat there thinking, that’s it, that’s what I want, that’s the only thing I want. She didn’t do anything. She didn’t offer me one. She just hung up her coat.

    And I hated her. Not for a second, not a flash. All evening. Through dinner, through the telly, still there when I went up. My own wife, and I was sat at my own table hating her over a coat. And I thought, this isn’t me. I’m not this person.

    And I thought, I’ve earned this. Twelve days I’ve gone without. Twelve days of it, and she does nothing. She just carries on like normal. It isn’t fair.

    So I had one. And then I had four more.”

    A man sits at a kitchen table while a woman stands smoking in the open doorway, both looking away from each other

    It sounds like a practical problem. Smoking in the house, someone on the balcony, an ashtray on the table, the smell after dinner.

    It is never only practical.

    What they are also saying, most of the time, is that they are afraid this will not work, and that they will have to watch it not work from three feet away. That they are doing the hard part alone, in a house with someone who is not doing it. That they are becoming a person who counts other people’s smoking, and they do not like that person much.

    And underneath that, the one nobody says out loud on the first visit: I am starting to resent her, and I do not know where to put that.

    What is actually being asked

    The temptation is to treat this as a relationship problem, or to make the partner the obstacle. Neither helps in the twenty minutes you have.

    The person in front of you is not asking their partner to become someone else. They are asking whether this house can be made survivable for the next few weeks.

    That is a much smaller question, and it has answers.

    Why it is harder than it looks

    In a house where one person quits and the other does not, tobacco is not just available. It is visible, on a schedule, attached to the day.

    Coffee in the morning. The walk to the car. After dinner. Before bed. The old rhythm keeps running in the same room, performed by someone they love.

    Several things arrive at once, and they do not arrive politely.

    There is craving, triggered before there is time to think. There is envy, because the other person looks calm while they feel raw. There is resentment: I am doing the hard part and you are making it harder. And then, close behind, guilt for feeling any of it.

    Underneath there is often something they will not name unless you ask. Smoking may have been a shared thing. Fifteen minutes outside together, twice a day, for years. Quitting removes that before anything has replaced it. What looks like craving is sometimes loss.

    This is why “just ignore it” fails. They are not resisting tobacco. They are resisting the shape of their own evening.

    What to do with it in a session

    Three requests, not a conversation about the relationship.

    Ask them to name specific, physical changes in the house. Outside only. Out of sight. Never offered, not even as a joke. Hands washed before close contact.

    Each one is about the room, not about the person. That distinction is what makes it possible to ask.

    Then do the part most people skip: plan for no.

    Ask directly. What will you do if they say no, or say yes and forget by Thursday? If the plan depends on someone else keeping a promise, the plan is not theirs.

    What holds instead is small and theirs alone. Ten minutes in another room. Something in the hands. A sentence practiced in advance for when it is offered. And one rule that saves more attempts than any other: do not start the big conversation during a craving.

    The single conversation

    The bigger talk is worth having once. Not mid-craving, not after an argument, not while the partner is standing there smoking.

    They pick a moment. Three requests. And one line that makes the whole thing possible to hear:

    I am not asking you to quit. I am asking for a few things in the house so I can get through this.

    After that, they watch what actually happens, and they build around what they see rather than what they hoped for.

    Practice takeaway

    When a client says their partner still smokes, the first question is not how to change the partner. It is whether the house can be made survivable for the next few weeks. Three requests about the room rather than the person, a plan for when the answer is no, and one conversation held once, never during a craving. After that, build around what actually happens, not around what was promised.

    I built the Mixed-Habit Household Plan for exactly this: house boundaries, a plan for no, the ten-minute move, prepared responses, and a thought record for the weeks when the story about the partner takes over.

    Four printable, fillable worksheets, in A4 and US Letter, with a practice license included.

    See the practice set