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A motivational, non-judgemental style during consultations is more likely to engage patients than a judgemental, directional style.[47][48][49] Playing the role of an interested partner who asks and explores a smoker's determination to quit is likely to be helpful. Motivational interviewing uses empathy rather than confrontation and acknowledges that the patient, not the doctor, is responsible for changing behaviour.

There are four key principles

  1. regard the person's behaviour as their personal choice
  2. let the patient decide how much of a problem they have
  3. avoid argumentation and confrontation
  4. encourage the patient to discuss the advantages and disadvantages of making a quit attempt.[50] (See Motivational tension

 ASK about smoking status to open up a discussion about quitting smoking

 ASSESS how motivated a smoker is to the idea of quitting and their degree of nicotine dependence

 ADVISE on coping strategies to support the quit attempt

 ASSIST the quit attempt

 ARRANGE follow-up to provide continued support

Q Here are some questions that can help open up a discussion about smoking:

  • How do you feel about your smoking?
  • Have you thought about quitting? What would be the hardest thing about quitting?
  • Are you ready to quit now?
  • Have you tried to quit before?
  • What helped when you quit before?
  • What led to any relapse?
  • What challenges do you see in succeeding in giving up smoking?

How to use the Cycle of Change to help smokers quit

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