In addition, the clinician can use interviewing techniques to facilitate and engage intrinsic motivation within the patient to facilitate smoking cessation. Patients who are interested in quitting smoking should be offered behavioral approaches to tobacco cessation.301 Behavioral approaches to smoking cessation can be provided in a variety of formats, including direct patient-clinician encounters, telephone calls, computer programs, text messag- ing, or group-based sessions. A meta-analysis of 25 random- ized trials found that intensive counseling, which consisted of at least 1 contact during the hospital stay with continued sup- port for at least 1 month after discharge, increased the likeli- hood of smoking cessation.302 A point of emphasis in behavioral approaches to smoking cessation is having the patient set a quit day. A follow-up encounter, either in person or on the telephone scheduled soon after the patient s quit day, can strengthen the significance of the quit day and provide greater motivation for the patient to quit. In a systematic review of 10 randomized trials, no dif- ference was observed in abstinence rates between those who reduced smoking before the quit date and those who quit Thus, patients should be given the choice to reduce smoking before a quit date or to stop smoking abruptly on the quit date. In combination with counseling, nicotine replacement ther- apy can be an important adjunctive strategy to help achieve smoking cessation. 