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General principles that will help you support a smoker

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 A third of smokers will resume smoking within a week and another third will relapse within 4 weeks. It is important to recognise this fact and provide on-going support in a non-judgemental way.
  • Routinely offer a follow up appointment within 7 days of the smoker's quit date to explore an individual's success and any relapse behaviour
  • Affirm success when you next see the patient and they have remained quit.
  • If someone has been successful at quitting, it is helpful to provide reinforcing, positive feedback to help sustain smoking cessation.
  • Don't talk about 'failure', recognise that 'relapse' is very common and help the patient work out 'what went wrong this time' and how they prevent a relapse next time.
  • Encourage the smoker to recruit support from family and friends.

How to use the Cycle of Change to help smokers quit