Quit Without the Fight: A Therapist Guide to a Third-Wave Protocol for Stopping Nicotine and Vaping

Behavioural Addiction · Practice-informed · Practice-informed

A six-session third-wave protocol for adults who want to stop smoking or vaping, delivered alongside medical stop-smoking support. It runs from a shared nicotine map through meeting the urge with the body first, a kind coach for slips, a values and willingness session and a craving toolkit, ending with a plan for staying quit. Each approach carries a colour-coded evidence rating, and an appendix records what was considered and not added, including box breathing and bilateral stimulation.

Underlying mechanism: Third-Wave Protocol for Nicotine and Vaping Cessation: CBT-Informed Mapping, Mindfulness of Urges, CFT, ACT and DBT Skills Alongside Medical Support

What it helps with

  • Giving clinicians a short structure that sits beside medication and stop smoking services and adds the psychological work around urges, habits and shame.
  • Teaching clients to ride an urge with the body first, so the urge can pass without a fight and without obeying it.
  • Replacing self-attack after a slip with a kind and honest coach, so a slip becomes information and not a reason to give up.
  • Connecting quitting to what matters to the client, and planning in advance for the moments when nicotine usually appears.
  • Showing plainly which parts are well supported and which come from practice, so clients and supervisors can judge them.

How clinicians use it

  • Confirm medical support is in place, screen for risk and agree how you will coordinate with the GP or stop smoking service.
  • Map the nicotine habit and its pairings at Session 1, set the quit date and arrange a tracker.
  • Teach nose-low-slow breathing and urge surfing at Session 2. Resonance breathing is optional and later. Do not use breath holds or box breathing.
  • Keep the kind coach session (3) before the values session (4) by design. The order is clinical judgement and has not been tested.
  • Use Session 6 to plan for slips and staying quit, and offer the optional future-self worksheet only if the client likes imagery.

Clinical Implementation Guide

  1. Confirm medical support, screen for risk and set the quit date at Session 1 or 2.
  2. Run the sessions in order and keep the kind coach session before the values session.
  3. Track days without nicotine, strongest craving and slips, and review them each week.

What the worksheet looks like

Therapist Guide: Quit Without the Fight — worked example
SessionFocusWorksheet(s)
1Map and plan: the jobs nicotine does, its pairings and the quit dateW1
2Meet the urge: nose-low-slow breathing and urge surfingW2
3The kind coach (CFT), before the values session on purposeW3
4What am I quitting for: values, willingness and defusion (ACT)W4, optional W7
5Craving toolkit: if-then plans and breaking the chain (DBT and CBT)W5, W2
6Slips and staying quit: tracker, rewards and a slip planW6, W3

Clinical cautions

Use alongside, and not instead of, medical stop-smoking support. Medication and nicotine replacement decisions belong to the client with their GP, pharmacist or stop smoking service. If the client reports hopelessness, self-harm or suicidal thoughts, follow local risk procedures. Take complex cases, pregnancy, serious mental illness and under-18s to supervision. Breathwork is optional: stop for dizziness, tingling, panic or a flashback, never use breath holds or fast deep breathing, never practise while driving or cycling, and take extra care with asthma, panic disorder and breathing-linked trauma. Compassion work can briefly raise distress for people who fear kindness, so go slowly. Future-self imagery is optional and should stop if it brings distress or a sharp craving. Check licensing before using any named measure.

References

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Copyright and use in research

© 2026 Dr Richard Pomfret and Third Wave Therapy Tools. May be used in research with the author and site cited. Version 1.0, approved 12 October 2026, revised as the evidence develops.

Suggested citation (APA 7th edition): Pomfret, R. (2026). Quit Without the Fight: A third-wave protocol for stopping nicotine and vaping (Version 1.0) [Therapist guide and worksheets]. Third Wave Therapy Tools. https://thirdwavetherapytools.com/

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