Smoking Cessation

Tufts Family Medicine

22 Smoking Cessation

Visnuth Keo: Smoking Cessation

Case

Visnuth Keo is a 35 yo Cambodian-American male who works as a nurse in a nearby nursing home. His work requires that he be screened for tuberculosis annually. He comes today to get that done.

The medical assistant in the office identifies Visnuth as a current smoker on the Electronic Health Record (EHR).

Questions to Consider

What do you say to the patient about his current smoking status?
Using the Prochaska Model of Lifestyle Modification, what stage is Mr. Keo in?
How do you bring Mr. Keo from his current stage to the next stage?
How do you quantify how much Mr. Keo is addicted to nicotine?

Learning Objectives

By the end of the session, the active participant will be able to:

Explain how office systems can help a physician more efficiently and effectively screen for cigarette use and counsel on smoking cessation.
Assess what stage a patient is in using the Prochaska Model of Lifestyle Modification and be able to use this model to counsel patients on other subjects.
Describe the multiple modalities available to assist a patient in quitting smoking.

Handout: Smoking Cessation Therapy

Smoking Cessation Worksheet/Contract

TIMES OF THE DAY I AM MOST TEMPTED TO SMOKE	WHAT I CAN DO INSTEAD OF SMOKING DURING THOSE TIME
1	1
2	2
3	3
4	4
5	5


Quit Date:	Today’s Date:
Signature:	Provider’s Signature

Example:

Must Have Cigs	Things I Can Do Other Than Smoke!!
1. First thing in the morning	a. Sit ups b. Read c. Have sex
2. Riding into work	a. Think about the kids b. Plan my work better c. Picture my life without cigs d. Write a song
3. Breaks at work	a. Go outside
4. After dinner	a. Play with the kids b. Ride my bike c. Do yard work d. Play guitar
5. At night after kids go to bed	a. Read b. Play guitar c. Work out d. Have sex