Mental health articles

How to deal with tobacco use Questions to ask the person who uses tobacco

• How often do you chew tobacco/smoke a cigarette? This will give you an estimate of the severity of the dependence.

• How has the tobacco use affected your health? Ask specifically about breathing difficulties and repeated coughs. • Do you drink alcohol? These problems may be linked, so that the person smokes while drinking.

• Would you like to stop? Many tobacco users would like to stop smoking and welcome any help or advice on how they can do so.

• Who else in the family uses tobacco? It is usually harder for someone to give up the habit if others in the home are also smoking. It may help to try and get all the smokers to kick the habit at the same time. What to do immediately Educate the person about the health risks of smoking or chewing tobacco. For people who are willing to stop now:

• Set a definite date to quit; this should be in the near future.

• Identify particular situations or times when the person smokes, such as with friends, in a bar, after a meal. Encourage her to find alternative things to do at these times, such as avoid the bar or friends who smoke, or chew a sweet after a meal.

• Reassure the person that giving up the dependence is difficult for all users but that nearly all people who want to quit can do so. For people who relapse or do not want to stop immediately:

• Do not reject them.

• Continue to see them in the clinic to monitor their health. At each visit, discuss the smoking habit.

• Try to get the person to reduce the use, say from two packets a day to one. The positive effects on health this will produce may be a useful motivation for the person to give up altogether.

• If the person agrees to a reduction, help him plan how and when he will smoke. If he can reduce, his confidence will improve and help him stop later. When to refer Refer if you suspect cancers or heart disease caused by tobacco. Changes in the colour of the tongue or mouth, a persistent cough for more than a month, chest pain and difficulty breathing in longterm smokers are all signs that the person needs a medical examination.

Tags: tobacco use