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TOBACCO TRIGGER TAPE SYNOPSES – CANCER CARE PROVIDERS Tape Dialogue Scenario Problem 5 “I’ve quit at least a hundre...

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TOBACCO TRIGGER TAPE SYNOPSES – CANCER CARE PROVIDERS Tape

Dialogue

Scenario

Problem

5

“I’ve quit at least a hundred times. I just don’t know that I can stay off cigarettes once I get home.”

Man is in a hospital bed, receiving bedside counseling.

Many individuals who have had multiple relapses convince themselves that they can never quit.

20

“I just have too much stress in my life to even think about quitting.”

Patient examination room

The pervasive belief that smoking either gets rid of stress or helps the smoker deal with stress prevents many smokers from attempting to quit or prompts them to relapse back to smoking once they have quit.

23

“I already have cancer. What’s the point in quitting?”

Hospital room

Many cancer patients think that they are near the end of their lives so “why not enjoy myself.” They see no point in quitting smoking.

Page 1 of 2

Solution  Instruct the patient to think of quitting smoking as a learning process similar to learning to ride a bicycle. Consider saying, “When you learned to ride a bike, you fell off, figured out what worked and what didn't, and then got back on. You did this until you were able to ride without falling. Some people even used training wheels.”  Educate the patient about the quitting process and how he can learn from his past quit attempts. Consider saying, “Those past experiences were your ‘training wheels.’ What did you learn about yourself during those attempts? Apply those lessons now to make this quit successful. Don’t let those past ‘falls’ be the excuse to never try again.”  Help the patient understand that smoking does not get rid of stress, it causes it.  Because there is no drug in cigarettes that magically gets rid of stress, remind the patient that they have actually been the one to deal with their stress for their entire life. Advise the patient to give themselves credit, not the cigarette, for successful stress management.  Refer patients to local stress management programs, advise them to begin to exercise, or suggest that they take a meditation class, all ways to effectively learn to deal with stress.  Inform the patient that smoking negatively impacts the success of surgery, chemotherapy, and radiation treatment. Likewise, continuing to expose the body to the cancer causing chemicals in tobacco significantly increases the chances of secondary tumors occurring.  Many patients who make this statement are focusing on dying. Refocus these patients on quality of life and how continued smoking can negatively impact their ability to engage in everyday activities. Remind these patients that a cancer diagnosis is not necessarily a death sentence.

Copyright © 1999-2011 The Regents of the University of California. All rights reserved.

TOBACCO TRIGGER TAPE SYNOPSES – CANCER CARE PROVIDERS (CONT’D) Tape

24

Dialogue “So, I’m going to be miserable enough recovering from this surgery. Why would I want to make it worse by quitting now?”

Page 2 of 2

Scenario N/A

Problem

Solution

These patients feel that they will inevitably go through significant physical withdrawal when quitting.

 Advise the patient, “There are seven effective medications for quitting that will significantly reduce your withdrawal symptoms from nicotine, making you more comfortable during the quitting process. Most of these medications can be used even if you are hospitalized so if it’s alright with you I’ll speak with your physician to determine what will work best for you.”  Reframe surgery as the ideal time to quit. Hospitalized patients cannot smoke as inpatients, and surgical outcomes can be significantly improved in smokers who quit.  Remind the patient that this is a good time to quit precisely because they will not be feeling well. The discomfort experienced as a result of the surgery will mask many of the negative feelings they might experience from quitting.

Copyright © 1999-2011 The Regents of the University of California. All rights reserved.