Tobacco Cessation and Cognitive Behavioral Therapy

CBT is a type of psychotherapy that’s problem oriented. It may help your patients learn how to change unhelpful or unhealthy ways of thinking, feeling and behaving especially when related to tobacco cessation. CBT can be useful in helping individuals to learn cognitive coping skills required to manage negative moods or urges to quit tobacco use.

Key CBT skills for tobacco cessation include problem-solving, changing thought patterns, understanding the quitting process, identifying triggers and motivational cues, aversion therapy, and social support. These skills empower users to exercise self-control, restructure their thinking, establish goals (e.g., setting a quit date), self-monitor habits and receive rewards and skill training to resist tobacco urges.

CBT is often used alongside other treatments to support patients facing depression, anxiety or other mental health challenges during tobacco cessation. It offers valuable resources for addressing both underlying and acute symptoms that may arise during withdrawal and treatment.

CBT can also be provided via telehealth. Generally, any provider who is eligible to bill Medicare for their professional services is eligible to bill for telehealth during this period. Federally qualified health centers and rural health clinics can provide telehealth services to patients wherever they are located—including in their homes. This includes coverage for certain audio-only telephone evaluation and management services.

Providers must ensure all performed services are claimed and supported by complete documentation. Smoking cessation documentation should reflect:

• Type or method of tobacco use (cigarettes, vaping device, chewing tobacco, etc.)
• Amount of use (assess if the use qualifies as dependence)
• Impact (personal, family, friends, health, social, financial, etc.)
• Methods and skills for cessation
• Resources available
• Willingness to attempt to quit - If the patient is willing to attempt to quit, agreement on plan of approach
• Implementation date
• Method of follow-up
• Documentation of exact time spent in face-to-face counseling with the patient

Visit the National Government Services Telehealth Services web page for more details.

Posted 3/17/2025