Patients Unwilling to Quit


Although every clinician must warn patients about the risks of nicotine addiction and facilitate their recovery, there might be cases when people are not ready to quit smoking. Fiore et al. (2008) noted that clinical interventions in the form of persuasion, lectures, and debates about the downsides of smoking have negative effects on the likelihood of withdrawal. As opposed to clinicians’ appeals, one has to focus on the patients’ interpretations of the situation. Doctors have to utilize four steps of “expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy” to achieve the best patient outcomes in terms of accepting the fact that quitting smoking is mandatory (Fiore et al., 2008, p. 57). During an intervention, a medical professional has to use “change talk,” which urges patients to process reasons for quitting, and “commitment language,” which leads to voicing more concrete action plans and cessation strategies (Fiore et al., 2008, p. 57). Such an approach of uncovering one’s beliefs and ideas about smoking is more likely to lead a person to naturally and independently created conclusions, which works better than active persuasion.

Intensive Smoking Intervention Strategy

There are specific strategies and steps a clinician has to take to facilitate smoking cessation. According to Bhattacharya et al. (2017), a specialist has to “individualize and contextualize coping strategies, emphasize the need to support nicotine withdrawal, mitigate social triggers, mediate social support, and navigate dependencies with other healthcare providers” (p. 1). Consequently, every tobacco dependence intervention should be highly personalized and continuous.

Firstly, a professional has to assess whether a patient is willing to quit smoking by providing counseling and linking stress levels, addiction, and other variables with nicotine dependence. Furthermore, both healthcare clinicians and nonmedical staff have to be involved in the process by providing the necessary information, recommendations, and prescriptions (Fiore et al., 2008). The success of the treatment greatly relies on the intensity, has to occur at least four times, and each session has to last for 10 minutes or more (Fiore et al., 2008, p. 65). Developing problem-solving skills should be a core of behavioral therapy and can be provided in an individual or a group setting (Fiore et al., 2008). Patients can be prescribed “first-line medication like bupropion SR, nicotine gum, nicotine inhaler, etc.” (Fiore et al., 2008, p. 66). These steps compound the intensive intervention strategy that is recognized as the most effective in smoking cessation.

Age-Specific Recommendations

People become smokers at different points in their lives, and when facilitating the recovery of patients of varying age groups, it is necessary to account for their needs and specifics. As per the elderly, the guidelines for intensive interventions still apply since age does not diminish one’s potential to quit tobacco addiction. Age is a primary determinant for a better understanding of the potential risks of smoking since nicotine dependence significantly contributes to the development of respiratory and heart conditions that might be lethal for elders (Fiore et al., 2008). Although the strategy of intensive smoking intervention is equally successful for the older population, necessary precautions and alterations should be made in regards to the limitations specific to the age group. For instance, decreased mobility and the possibility of medication not being suitable for an elderly patient are risks that have to be accounted for during behavioral therapy (Fiore et al., 2008). Active phone counseling sessions are recommended as a substitute for more conventional approaches that might not be available to older patients.

As it concerns adolescents, preventive strategies are as important as the treatment itself. According to Chun (2019), “Most smokers start smoking in adolescence, and more than 80% of smokers become addicted to nicotine as adolescents” (p. 4). Thus, preventive strategy and developing early coping mechanisms to fight addiction are essential on this step. Consultations and behavioral therapy for smoking cessation are primary drivers of change in this age group (Chun, 2019). While complex cases that require medication for coping with withdrawal symptoms are rare, adolescent patients need to be thoroughly assessed and helped to stop further development of dependence.


Bhattacharya, A., Vilardaga, R., Kientz, J., & Munson, S. (Eds.). (2017). Lessons from practice: Proceedings of the 2017 CHI conference on human factors in computing systems. Association for Computing Machinery.

Chun, E. (2019). Smoking cessation strategies targeting specific populations. Tuberculosis and Respiratory Diseases, 82(1), 1-5.

Fiore, M., Jaén, C., Baker, T., Bailey, W., Benowitz, N., Curry, S., Heyman, R. B., Koh, H. K., Kottke, T. E., Lando, H. A., Mecklenburg, R. E., & Mermelstein, R. J. (2008). A clinical practice guideline for treating tobacco use and dependence: 2008 update. American Journal of Preventive Medicine, 35(2), 1-276. Web.

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NursingBird. "Patients Unwilling to Quit." November 13, 2023.