Power of reason reaching smokers

Bruce Arroll says his motivation is to get through to smokers before, not after, their health fails. Photo / Sarah Ivey

The trump card in Bruce Arroll's quit-smoking pack is helping a smoking patient visualise their life blighted by a heart attack or diseased lungs.

But he holds this in reserve in the brief talk he has with almost every patient about whether they smoke and why smokers should quit.

Some doctors now make smoking status the first question of every consultation.

Professor Arroll, a GP in Manurewa and head of general practice and primary healthcare at Auckland University, likes to weave it in where he judges the fit is best.

"If there's some obvious entree, like a patient with respiratory disease, I would go into it early. If not, I would deal with your issues and then I would say, 'Are you still smoking? Are you interested in quitting? You're 45, a good age to quit', because that personalises it. I seem to get traction by saying that.

"And if they are not interested, I say, 'What would it take to make you quit?'. I see people who have had a heart attack or a stroke, then they gave up. They've got bad health and they are smoke free. I would like people to be smoke free with good health.

That's my trump card. If people don't show any interest earlier on, that's my final thing."

This is Professor Arroll's version of the ABC method of smoking cessation advice - A: Ask every patient if they smoke; B: give Brief quit-smoking advice to smokers; C: provide Cessation treatment such as nicotine replacement therapy, or a quit-smoking drug such as Zyban, or refer the person to a quit-smoking service.

Professor Arroll says his practice, Greenstone Family Clinic, has been asking almost every patient for a year.

"Some people we thought would never give up are showing an interest."

A new addition to the scheme is a container of nicotine replacement therapy lozenges at the front counter.

"[The aim is], here is something for you while you're waiting if you feel like ... having a smoke. And there's a notice saying if you want to talk about smoking cessation, feel free to discuss it with our doctors and nurses."