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Smoking Cessation Advice (posted 6/1/09)
 
Q: How do you encourage a person to quit smoking who has been smoking since the age of 16? (Posted on http://forum.physicianspractice.com/)
 
A: How old are they now? My latest “teaching moment” for smokers is to use a Framingham cardiovascular risk calculator that I have on my iPhone. I show them their baseline risk as a smoker then change to nonsmoker and they can see that their risk of MI, CVA, and death decreases by 50 percent.

Chantix is also worth trying with the caveat that they want to quit and have no depression. Also data on file at the FDA shows that 0.5 mg bid is as effective as 1 mg bid with less nausea and CNS effects (but lower Pfizer profits) so try that dose after 0.5 mg daily for a week.

Be sure the family is supportive and encourages the quitter to stay off cigs. There was also a study I cite (no reference, just my memory) that took two sets of photos of women and asked study participants to guess their age. The photos of the smokers were consistently guessed to be 5-10 years older than their true age, whereas the nonsmokers were guessed at their true age. So vanity is another method to convince patients of the benefits of quitting.
 
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