14 studies there was a relation between counseling intensity and outcome, with patients doing better if they received 2 or more sessions (vs. 1), and if the sessions lasted more than 20 minutes. The 2008 PHS Guideline3 used motivational interviewing components to construct an abbreviated clinical motivational intervention that can be used when time or training needs do not permit motivational interviewing. This “5 Rs” counseling focuses on personally Relevant reasons to quit, Risks of continued smoking, Rewards for quitting, Roadblocks to successful quitting, with Repetition of the counseling at subsequent clinic visits. Such counseling was shown in one randomized controlled trial24 to increase 6-month quit rates when paired with a later offer of nicotine replacement therapy (NRT) (24% of those getting the 5-R’s had quit, vs. 4% of the no-treatment controls).
