T:	hi I'm Amy the pharmacist so I understand you have some questions
C:	hi I'm Mario and my doctor suggested I talked to a pharmacist about quitting smoking do you have the time for this
T:	sure why don't you tell me a little bit about what you're thinking how soon you'd like to quit and why you want to quit
C:	my cholesterol and my blood pressure are high my father and my uncle both had heart attacks when they were pretty young so my doctor's been telling me that if I quit I'll cut down on my chances of having a heart attack
T:	that's correct quitting would be important for you and it will reduce your chances of having heart problems
C:	so that's the situation I've tried to quit a couple of times before but it didn't work so what I was hoping is that you could go over the different options and help me pick the best one
T:	hmm I'd be happy to do that first tell me exactly which products you used and more importantly how you use them
C:	first I tried the gum I like to chew gum so I thought this would be good so I chewed about three to four pieces of gum a day but I was miserable and I started smoking after four days then I tried the patch a couple of months later I felt pretty good for about a week so I quit using it didn't think I needed it anymore started smoking two days later
T:	based on what you've told me it sounds like you didn't get the full benefit of the product a few pieces of gum won't get enough nicotine into your body to make you comfortable you need at least nine pieces a day for it to be effective and it has to be used in a very specific way not chewed like regular chewing gum
C:	I admit I didn't read the directions last time
T:	as for the patch sounds like it worked for you you just didn't stay on it long enough we recommend 10 to 12 weeks and this gets enough nicotine into your body to help reduce most of the withdrawal symptoms while you work on learning to live your life without cigarettes you were able to quit for a week with it so it seems like it might be a good choice now but there are others as well
C:	yeah my doctor said something about a pill I didn't like the taste of the gum much
T:	well that's understandable but you should know there are new flavors that my patients say tastes better to be honest all the medications are effective it's just a matter of what you prefer you've already tried the patch there's also a nicotine lozenge a nasal spray an oral inhaler in tablet form we have bupropion which you've probably heard called zyban and there's a newer medication varenicline or chantix
C:	yeah I've heard of those but I think I'd rather stick with the patch and this time I'm gonna make sure I keep it on long enough it
T:	sounds like a good choice for you and given that you have some experience with it and you know that it works for you um how many cigarettes do you smoke a day
C:	about a pack a day
T:	okay so you'll want to start with the 21 milligram patch for six weeks and then the 14 milligram patch for two weeks and then the seven milligram patch for the last two weeks it's pretty easy to use in the morning of your quit day I want you to put one patch on a hairless part of your upper body and leave it on for 24 hours and the next morning you take that off you put another patch on in a different location you want to switch site so you don't get any skin irritation if you have trouble sleeping you can take it off before you go to bed you read the directions on the box and if you have any questions let me know
C:	okay I'm gonna try it again and read the directions and stick with it this time
T:	one more thing there are two parts to smoking so there are two parts to quitting it's an addiction to nicotine and a habit the patch will take care of the physical addiction and help with the withdrawal symptoms but you'll have to make changes in your behavior if you want to stay quit for good
C:	yeah dr. Ward mentioned that to me and he gave me the card for this quitting line
T:	that's perfect our stay quit line is excellent and convenient so let's talk about picking a quit date and we'll get you set up with a box of patches