BMJ 1995;311:746 (16 September)

Letters

Advice on lifestyle dilutes important smoking message

EDITOR,--The debate about the benefits of changes in lifestyle in the prevention of coronary heart disease1 2 3 seems to ignore a potentially important issue--that is, the extent to which patients' compliance with advice to stop smoking is influenced by the advice they receive about making other changes to their lifestyle. I knew a cardiologist who sometimes avoided discussing issues such as physical exercise and diet with smokers, not because these issues were unimportant but because he believed that to do so would reduce the chance that the smokers would heed his advice to stop smoking. Like others,1 2 3 he recognised smoking to be by far the most important risk factor for ischaemic heart disease.

Advising smokers to change their lifestyle beyond stopping smoking may be counterproductive. Firstly, it dilutes the most important piece of advice with recommendations that may be of dubious value. Secondly, it may be perceived by the patient as . . . [Full text of this article]


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