The advices for the subjects are current smokers and want to quit smoking. They come for counseling. They have the desire to quit, there are favorable factors, but among them, there are many people try to quit more than once time but have not succeeded. It should be noted and analyze the experience to give effective advice. Consulting time should not less than 10 minute.
1. Adviser: Mostly are consultants in smoking cessation clinics. The medical staff in general also needs to know to apply when necessary in the short consultation.
2. Audience: Those who want to quit smoking
3. Goal: Help smokers quit smoking successfully
Step 1: Introduction and acquainted
– greet audience with considerate attitude, open, friendly atmosphere, and the trust of the audience before the start of consultation
– Introduce yourself and the purpose of work.
– Understanding the plight of patients: occupation, educational level to have appropriate approach
– Learn why patients come to health facilities for proper consultation
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Step 2: Learn and assess smoking status of the object: Ask and record smoking status of patients, including:
– Age started smoking, how long they smoke
– Reasons for smoking, why like smoke
– The view of patient attitudes toward their smoking habits
– The views of the surrounding attitudes towards smoking habits of patients
– Tried to quit yet and the cause of failure.
Review the dependence on nicotine
1. When does he (she) smoke first cigarette after waking up?
– During the first 5 minutes 3 point
– From 6-30 minutes 2 point
– From 31-60 minute 1 point
– After 60 minutes 0 point
2. He (she) may find it is difficult to refrain smoking in no-smoking places (theaters, libraries, churches …)?
– Yes 1
– No 0
3. Which cigarette of the day as he (she) felt the most excited?
– First smoke in the morning 1
– Others 0
4. How many cigarettes do you smoke per day?
– Under 10 0
– From 11-20 1
– 21-30 2
– On 30 3
5. In the first hours after waking up he (she) has smoke more than the other hours of the day?
– Yes 1
– No 0
6. If he (she) is sick, almost lie on the bed, does he (she) smoke?
– Yes 1
– No 0
0-2: little dependence;
3-4: less dependence;
5: average dependence;
8-10: heavy dependence
The assessment of nicotine dependence level of the patient can be measured by breath analyzer that the smoking cessation clinic should have. Objective evidence would have persuasive value with patient.
Step 3: Consolidate the wishes of patients: Ask patients about the harmful effects of tobacco whether they know or not. If they know, praise and add missing knowledge. If you do not know, talk about the harmful effects of tobacco. Special note about the situation and the status of health of the patient to a specific contact and create impressive.
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* Talk about the benefits of quitting smoking:
– Health will be improved
– Eating more delicious
– Saving money for other things
– Perception of yourself more comfortable
– Houses, clothes, utensils… not have bad smell
– No longer have to worry about quitting
– Create a good example to their children in the family
– Avoid the risk of respiratory diseases for children
– Not thinking about causing harm to others by smoke
– Work better, especially for the physical activity
– Reduces wrinkles and aging of skin…
* Based on the characteristics of the object to emphasize the unique benefits of object if quitting. For example, if the object has children, emphasizing the interests of the child. If you are sick, need to emphasize health benefits, efficacy will be improved if quitting.
* Affirming strong valid reasons for patients determined to quit: Please emphasize that the most important thing for their health is to quit smoking and permanent smoking cessation.
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Step 4: Evaluate the intentions of quitting
* Ask about the will to quit smoking: Verify that the object was aware of dertemination to quit smoking or not.
– If the object is ready and determined to quit, confirming the support.
– If the object is uncertain or hesitant, give the document and date back again.
* Encourage and affirm the support
– Affirmation of successful smoking cessation possibilities: half of those who smoke has quitted successfully
– Expressing confidence in the determination and energy of the object
– There are some health measures help quit
Step 5: Helping patients quit smoking: Now need to talk with patients, there are 4 stages of smoking cessation to be overcome:
1. Think about quitting
2. Prepare the elements needed to quit
4. Maintain the time totally not depend on tobacco
Stage 1: Think about quitting
– Many people think that if really determined to quit is sure can quit.
– Some people can quit easily, some are very difficult.
– Think and listed in your head all the reasons to decide to quit smoking.
– Think of the family members, friends and colleagues who will help you quit
– The reason why you don’t want to quit?
– If the object had to quit but failed, ask: What helped objects “forget” smoking before, what makes objects smoke back
Stage 2: Preparing to quit
– Select a date to quit. Ideally, within two weeks of being consulted. On the day doesn’t have too many problems to solve in order to focus on quitting.
– Seek help: Inform with family, friends and colleagues about your determination to quit and seek for help.
– For those who are smokers in the family, friends or at work, you should encourage them to quit with you. If not, suggest they do not invite or smoke in front of you. If possible try to find someone who has successfully quit smoking in order to share experiences in the process of smoking cessation.
– Completely remove items relevant to tobacco such as drug package, lighters, ashtrays … makes smoking become difficult and avoid smoking in areas as home, work…
– Prepare thought that maybe have challenges:
• The lure of other smokers, environment
• The pressures of work (Stress)
• The symptoms of the “hungry” drugs (occurring within the first 1-3 weeks):
. Dizziness and headache
. quick to anger, restlessness
. Digestive disorders
. Difficulty concentrating
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– Preparing to deal with the cravings by buying a few things instead of smoking: Toothpick, gum, melon seeds … or something to eat in home and work, but remember that not too sweet and less energy. Advising patients choose the appropriate thing to avoid gain weight. You can make your hands busy by preparing two balls to rotate while sitting on cars, or the pencil to write.
– Dealing with the different challenges by arranging reasonable time to quit, eat more fruits and vegetables, drink plenty of water to avoid constipation…
– Especially advised patients to prepare a reward for this important event. A gift should not be the kind of expensive but meaningful to them. The cost is about equal to the money saved from not buying cigarettes is the best.
– Choose how to give:
Quit ASAP: This is the best way, easy to quit, advice patients to choose.
Skip slowly: Reduce the number of cigarettes smoked a day and choose a date to stop
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Phase 3: quitting definitively
The evening before quitting: Clean the entire tobacco including ashtrays, matches … instead prepared: Toothpick, gum, 2 small balls for mouth and hands. Say to yourself again: “quiting is the right strategy, you can do it! “. Smoke a final cigarette like to say goodbye to the “enemy” of yours.
Important dates: This is a special day – day to quit smoking. Let that day relatively comfortably, can sleep a little later than usual, drink a glass of fruit juice. Be prepared to end a day without smoking as a first success.
The next day: Do not think that will never smoke again but tell yourself is: “I do not smoke and do not smoke today! “ Feel proud and successful at end of each day. Your goal is each day that passes does not smoke.
Avoid any temptation: Create a non-smoking environment around you, spend a lot of time talking with non-smokers. Avoid contact with people who smoke. During the first 2 weeks avoid alcohol, beer, coffee or something you use when smoking.
Dealing with cravings: Always mention the reasons for your decision to quit smoking. Told yourself: “This can be very difficult but I do, do not smoke anymore, stop!”
Use your imagination to “say yourself”: When you start to think of the excitement with a cigarette, let’s think about your lungs are black by smoke. You can also imagine the people around will be disappointed when you smoke back.
Can do the following 5 to escape cravings:
a. Drink 8 to 10 cups of water per day
b. Deep breathing: Breathe slowly, deeply through your nose and hold your breath then inhale, count to four and then slowly exhale through your mouth. Doing it until you feel more comfortable.
c. Do something else like do not sit at the table long after eating but instead is taking a walk or toothpaste or something else.
d. Chat with friends, especially with people who used to quit smoking will make your feelings more comfortable. You can also call the hotline, if smoking cessation clinic organized this service.
Be delay cravings. The cravings will go away after a few minutes. When you too craving, you count to 100 or recite a poem, song … That feeling will pass.