| T: I can great to see you today nice to see you too so I understand your smoker and I wonder if you would talk with me about your smoking? | |
| C: sure I'll be | |
| T: all right and so can you describe for me your pattern of tobacco use? | |
| C: uh it's sort of sporadic I mean it mostly revolves around either i'm drinking with friends or or when I have you know emotions that I don't know how to deal with whether it's anger frustration or sadness or loneliness or pretty much any emotion that couldn't feel good yeah and | |
| T: so how many cigarettes would you say that you have you smoked each day? | |
| C: uh like I said I'm sporadic I don't smoke the same every day but on average maybe a half a pack a day I mean it could be none one day and then the full pack another day and so but maybe on average a half a pack | |
| T: okay and how soon after you wake up in the mornings do you have your first cigarette? | |
| C: uh you know it's not right away from me normally I in most days it will probably when I'm in in the car and the way to work you know and just it's one of those places where I'm in a car and start the car and light a cigarette and you know follows right afterwards | |
| T: well it seems like you have a lot of awareness of your triggers for smoking | |
| C: uh yeah you know I don't I don't I think crave it in a way that I think maybe most people do all the time I just have situations for sure that that I by smoking you know | |
| T: okay and how long have you been smoking? | |
| C: I had my first cigarette when I was years old | |
| T: and has your pattern been the same since then? | |
| C: uh you know what varies a little bit but but it's mostly been like that you know I never smoked a lot more than I do right now or really even a lot less it's mostly been mostly about same on average | |
| T: and so are you interested in stopping smoking? | |
| C: uh yeah I mean I I I quit all the time frankly I I've thrown away you know half full packs and and and swear I'm done and then I think I'm done but it only lasts for for a few days and then you know either I'm out with friends drinking all right I I get upset and then and then without even thinking about it I go and buy a pack on I'm a smoker again yeah | |
| T: and so those times when you decide to quit what are your reasons for quitting? | |
| C: uh well i think i'm stupid for smoking you know i mean i think everybody knows that it's horrible for you and do awful things to you and your lung cancer and kill you you know and then i have asthma too and so put it on top of that and I you know more recently I've seen family members die lung cancer and it's awful a horrible way to go you know and so it seems more real and I I don't want to do that to myself I wouldn't want anybody I care about to smoke and yet somehow I keep doing it to myself you know I I sort of can't believe that I choose to do it and yet i choose to do it without thinking all the time | |
| T: but it seems like it really fits in with your lifestyle with the friends that you spend time with and | |
| C: yeah we we all work nights we all go out afterwards we all drink and smoke and you know I I don't think i could really imagine being out of them and watching them smoking me not doing it to you know I just it would do all it takes is being around it you know and I'm smoke with them | |
| T: yeah well it sounds like it's really it helps you to connect with them and part of socializing | |
| C: well yeah I mean yeah I don't they don't pressure me to do or anything it's just being having it all around me you know and having a drink in one hand you know like it's it's like it couldn't be any other way you know just being being around it and and and and people spoken and I'm I'm gonna smoke with them too | |
| T: it also sounds like when you're really feeling bad or feeling negative emotions that it's the one thing that you know you can go to and for a little while anyways it helps you to feel better | |
| C: uh yeah I with any kind of emotion that I don't know how to deal with it just feels like a ton of pressure inside of me and and and smoking two cigarettes like pushing the pressure release valve you know like I just but I feel relief and I don't feel nearly as angry or sad or frustrated or whatever and and so it does what I mean it to do I guess | |
| T: let's stop here so we can discuss what you have seen so far consider the following questions how do you think this conversation is going so far? how effective is the assessment? are there other questions you want to ask? what have we learned so far about Kens smoking pattern and history? what are your initial thoughts about potential tobacco cessation medications and counseling strategies? let's see what happens next and so right now in this moment can you talk with me about you know how ready are you to quit? so on a scale from one to ten one being not ready to quit it all and ten being you know you would set a quit date right now where are you? c at huh you know I would say maybe six or seven i would say I'd be I'd be happy to be done you know I'd be happy if I didn't ever smoke again I just I just don't really believe it's going to happen I guess you know I like I said I quit all the time and now it's even sort of a joke that that me Quinton's like not quitting at all it just means I'm out t um okay well did you know though that um people who quit without any sort of assistance using any tobacco cessation medications or counseling have a four percent chance of success of quitting in the long term | |
| C: you know I that sort of discouraging I guess that no one can get away from it you know but I guess I'm not the only one | |
| T: um but there are some cessation medications and aids that can really help you to successfully quit | |
| C: what a kind of things you're talking about | |
| T: well there are things like um the patch or the gum so nicotine replacement therapy there's also other medications as well as counseling where it could really help you learn and practice some strategies to help you stop smoking especially at those times when you're really triggered or you have some real cravings they'd have to be really good techniques | |
| C: i think you know I but like i said i don't i'm so convinced that i'm done each time that I quit and then and then I start again and I don't even think about it you know there's whatever technique would have to uh has a lot to overcome I think in my case | |
| T: so so then that leaves me to asking you about your confidence level so if you could rate yourself your confidence level about your ability to quit on a scale from one to ten one being not having any confidence at all and ten being yeah I know I can do it this time where are you at with that | |
| C: uh you know i would say maybe you two maybe a three out you know I I don't know you know I can go like I said a day or two without smoking but I've never gone for good you know I all I need is you back in that situation again either upset or out with friends and I'm right back and so I just I have a hard time believing I have a hard time even imagining a world in which I really wouldn't wouldn't go to smoke when uh when times get tough I guess | |
| T: yeah well and so can you talk with me a bit more about the reasons why you would really want to be quit? | |
| C: so there's health reasons | |
| T: yeah um is there anything else that really you know is one of the reasons why you would want to quit? | |
| C: uh you know i just i don't i don't want to live this way where I do things that to myself and I wouldn't do to anybody i love you know I wouldn't want any any loved one to smoke you know and but somehow I I do it to myself you know and and and and I'm trying to start exercising you know doing some running in some hike in and and and then I get short of breath and I cough and I'm worn out if I smoked a lot the day before and and I'm not sure you can choose both smoke and ends being in good shape you know I just I just I don't I don't believe in me making that choice I guess to be healthy and | |
| T: so it really does sound like for you quitting smoking would be an expression a self love | |
| C: i would i would have to love me more i guess to get there like I said I would I would I would want anybody I loved and not smoke and so if I I chose to not smoke if I was actually be able to do it I think it would have to be because because I cared enough about me to do it | |
| T: yeah and so your confidence you said is that a two or three why not a one | |
| C: you know because I do go days a time sometimes without smoking I mean as long as I'm not in a situation that sort of forces me to do it you know as long as i'm not out with friends drinking or as long as I don't have some situation gets me upset than I don't I don't feel it has control over me you know just in those situations where there's nothing else I can do you know but smooth | |
| T: well it sounds like quitting smoking is really important to you but that you know you don't really feel confident and you're not sure about what strategies are out there to help you and I'm wondering if you'd be willing to meet and talk with one of our tobacco treatment specialist who can we tell you what your options are get you connected to resources to help you quit would you be willing to do that? | |
| C: you know like I said they gotta have something pretty special I mean I outside of them coming to the bar with me and not going to figure it out of my hands I'm not sure what they can do but but I I don't want to keep Quentin I want to quit one more time and it'd be it'd be it you know so we'll give them a try | |
| T: yeah well in like you said you know you've quit many times before and for multiple days and that is a real success and I know that because you ended up going back to smoking that it doesn't feel like a real success but certainly being able to stop for hours or days at a time is really an accomplishment and I hope you can feel that | |
| C: well it feels like something maybe I mean I'm better off having a few days often then smoking a pack every day but but i don't i don't think you'd really quit until you really quit you know like i don't i don't think my quit and I know you really want to quit I don't I don't know that there's anything better I could do for myself if I could actually do it | |
| T: okay so if I connect you with them with the tts you'll um follow up with them and talk with them about it? | |
| C: I'll give them a try | |
| T: in our next meeting we can check in and see how things went for you | |
| C: all right | |
| T: okay well wonderful great talking with you it's good talking you |