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Hukkanen et al 34 found that smokers will self-titrate their nicotine intake from cigarettes through puff frequency, intensity, and duration

Clinical Tips : Use the 5As or Ask, Advise, Help model: Ask about tobacco and vaping at every visit Advise on risks and benefits of quitting Help with cessation plan, referrals, and follow-ups Address Barriers: Normalize relapse and provide non-judgmental support Consider co-existing mental health needs Offer carbon monoxide (CO) monitoring as a motivational tool Include family/partner in cessation plans when possible Behavioural Counseling and Brief Interventions Key Clinical Takeaways Behavioural counselling is first-line treatment for nicotine cessation in pregnancy