Smoking cessation

doi:10.1136/bmj.39248.531748.47

BMJ 2008;336:217 (26 January), doi:10.1136/bmj.39248.531748.47

Practice

10-Minute Consultation

Smoking cessation

Kate E Koplan, senior medicine resident¹, Sean P David, assistant professor of family medicine², Nancy A Rigotti, associate professor of medicine³

¹ Harvard Medical School, Brigham and Women’s Hospital, Boston, MA 01225, USA , ² Brown Medical School, Brown University Centre for Primary Care and Prevention, Providence, RI, USA, ³ Harvard Medical School, Massachusetts General Hospital, Boston, MA

Correspondence to: K E Koplan kkoplan@partners.org

The first 150 words of the full text of this article appear below.

A 52 year old man with asthma, hyperlipidaemia, and a familyhistory of early onset heart disease comes to see you becauseof increased wheezing and dyspnoea. He has smoked a pack perday for 36 years. He tried quitting "cold turkey" but felt irritableand couldn’t concentrate; he tried nicotine gum but itdidn’t work. He is willing to try stopping smoking againbut wonders if it is too late for him to benefit from quittingand if he ever can quit.

The patient’s smoking should be tackled as a standardpart of treating his presenting problem, an asthma flare. Tobaccouse should be attended to at all patient visits, but respiratoryor cardiac symptoms provide a special opportunity. Specificsymptoms that can be attributed to tobacco use, rather thanrisk of future disease, can motivate smokers to change behaviour.In this case, stopping smoking will improve the patient’s. . . [Full text of this article]

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