[Behavioral and cognitive therapies in smoking cessation: What tools for the pulmonologist?]

Abstract

Behavioral therapies have been developed from Pavlov and Skinner's theories on learning. They have been enriched with knowledge about the processing of information, a process organizing the perception of events. For these two reasons they are called behavioral and cognitive therapies (CBT). CBTs take place in four stages: therapeutic alliance, functional analysis, behavioral and cognitive methods, and evaluation. Seven techniques allow the pulmonologist to increase motivation in patients, particularly at the contemplation stage: the motivational interviewing, the decision-making balance technique, recognition of vicious circles and their substitution by constructive circles, short and long-term evaluation of life, the "I owe it", being the Devil's advocate and the letter of rupture. The analysis of the literature highlights the effectiveness of CBT techniques, especially when they are combined with pharmacological treatments for smoking cessation (dual nicotine replacement therapy, bupropion or varenicline).

Keywords: Behavioral and cognitive therapies; Entretien motivationnel; Motivational interviewing; Prevention smoking relapse; Prévention de la reprise tabagique; Sevrage tabagique; Smoking cessation; Tabagisme; Thérapies comportementales et cognitives; Tobacco smoking.