Riding the Urge: A Free Urge Surfing and Slow Breathing Worksheet for Stopping Smoking and Vaping

Behavioural Addiction · Practice-informed · Practice-informed

A six-step guide to riding an urge as a wave that rises, peaks and passes. It teaches the client to notice and name the urge, find it in the body, rate it, breathe nose-low-slow, watch the wave and choose the next step. A log records ratings before and after two and five minutes. Resonance breathing is an optional later practice for calm times, and there are no breath holds.

Underlying mechanism: Mindfulness of Craving (Urge Surfing) with Slow Nasal Breathing for Nicotine and Vaping Cessation

What it helps with

  • Changing the response to an urge, which studies suggest weakens the link between craving and smoking.
  • Giving the client something to do in the first difficult days other than fight or obey the urge.
  • Using the body first, with gentle breathing, so the urge can be watched and not argued with.
  • Showing over a few minutes that an urge rises, peaks and passes.

How clinicians use it

  • Teach it at Session 2 and practise one urge together in the room.
  • Start with nose-low-slow breathing only, and offer resonance breathing later and as optional.
  • Explain that the number may not drop quickly and that the skill is choosing the next step.
  • Do not use breath holds, and stop for dizziness, tingling, panic or a flashback.

Clinical Implementation Guide

  1. Teach the six steps and practise one urge together.
  2. Start with nose-low-slow breathing and keep resonance breathing optional.
  3. Review the log and name what changed over five minutes.

What the worksheet looks like

Riding the Urge — worked example
Date and timeWhat set it offBefore (0-10)After 2 minAfter 5 minWhat I noticed
Tue 3pmStressful email864It grew, then eased in my chest

Clinical cautions

Stop any breathing practice for dizziness, tingling, panic or a flashback, and take extra care with asthma, panic disorder and breathing-linked trauma. Never practise while driving or cycling. Never use breath holds or fast deep breathing. Urge surfing changes the response to an urge and may not shrink it, so do not promise that urges will fade on cue. 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.

References

  1. Bowen, S., & Marlatt, A. (2009). Surfing the urge: Brief mindfulness-based intervention for college student smokers. Psychology of Addictive Behaviors, 23(4), 666-671. https://doi.org/10.1037/a0017127
  2. Garrison, K. A., Pal, P., O'Malley, S. S., et al. (2020). Craving to Quit: A randomized controlled trial of smartphone app-based mindfulness training for smoking cessation. Nicotine & Tobacco Research, 22(3), 324-331. https://doi.org/10.1093/ntr/nty126
  3. Roos, C. R., Harp, N. R., Vafaie, N., et al. (2023). Randomized trial of mindfulness- and reappraisal-based regulation of craving training among daily cigarette smokers. Psychology of Addictive Behaviors, 37(7), 829-840. https://doi.org/10.1037/adb0000940
  4. Jackson, S., Brown, J., Norris, E., Livingstone-Banks, J., Hayes, E., & Lindson, N. (2022). Mindfulness for smoking cessation. Cochrane Database of Systematic Reviews, 2022(4), CD013696. https://doi.org/10.1002/14651858.CD013696.pub2
  5. Laborde, S., Allen, M. S., Borges, U., et al. (2022). Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis. Neuroscience & Biobehavioral Reviews, 138, 104711. https://doi.org/10.1016/j.neubiorev.2022.104711
  6. Lehrer, P. M., & Gevirtz, R. (2014). Heart rate variability biofeedback: How and why does it work? Frontiers in Psychology, 5, 756. https://doi.org/10.3389/fpsyg.2014.00756
  7. Marchant, J., Khazan, I., Cressman, M., & Steffen, P. (2025). Comparing the effects of square, 4-7-8, and 6 breaths-per-minute breathing conditions on heart rate variability, CO2 levels, and mood. Applied Psychophysiology and Biofeedback, 50(2), 261-276. https://doi.org/10.1007/s10484-025-09688-z
  8. Balban, M. Y., Neri, E., Kogon, M. M., Weed, L., et al. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1), 100895. https://doi.org/10.1016/j.xcrm.2022.100895

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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