II. Technique: Five Rs Counseling (using Tobacco as an example)

  1. Relevance
    1. Encourage the patient to identify Tobacco Cessation reasons that are relevant to them
    2. Examples: Erectile Dysfunction, COPD or Asthma, Coronary Artery Disease
  2. Risks
    1. Discuss with the patient the harmful effects of continued Tobacco use on their families and themselves
    2. Examples: Spirometry to estimate "lung age", attributing a typical age for their actual lung function
      1. Parkes (2008) BMJ 336(7644): 598-600 [PubMed]
  3. Rewards
    1. Ask the patient what benefits they would foresee from Tobacco Cessation
    2. Examples: Financial savings, eliminating the Tobacco odor
  4. Roadblocks
    1. What are the barriers to Tobacco Cessation
    2. Examples: Stress, Weight gain, other smokers in same household
  5. Repeat
    1. Readdress at each visit with an unmotivated Tobacco user

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