Ethics & Law · patient case question
What is the first step in a structured smoking cessation intervention once the patient is willing to quit?
Patient case: Behaviour, communication and quitting
demo: Adult patient in a health-promotion consultation
chief: Attends for a check-up and mentions he would like to stop smoking.
history: Smokes 15 cigarettes a day and has done so for twenty years. He has tried to quit twice before without support.
meds: None.
findings: Generalised staining and halitosis. No mucosal lesions on careful examination.
Show answer and explanation
Correct answer: B. Set a specific quit date
- A. Referral is appropriate as part of Arrange, providing follow-up and specialist support, but it comes after a quit plan exists.
- B. Correct. Within the 5 A's framework of Ask, Advise, Assess, Assist and Arrange, the first concrete action once willingness is established is to agree a quit date, ideally within the next two weeks. A specific date converts intention into a plan, and preparation such as removing cigarettes and telling family is organised around it.
- C. Abrupt cessation on a set date is more effective than indefinite gradual reduction, which tends to stall.
- D. Pharmacotherapy is offered as part of Assist, but it supports the plan rather than replacing it.