T:	we'll there's some things that have come up in in what I've seen so far I I just want to talk to you about your blood pressure it looks higher than I'd like and and obviously that concerns because there are some things that can happen with high blood pressure and I got to point out that the smoking in combination with the blood pressure concerns me and there may very well be cause and effect I'm sure the last thing you need is is somebody to to nag you but could we talk a bit about your smoking
C:	yeah sure I'm comfortable
T:	okay okay so you smoked how long
C:	well 35 my first time I smoked was a I was 12 years old it progressed as I got through high school and I've been a regular smoker since about the age of 17
T:	okay so about half your life you've been a regular smoker
C:	yep
T:	okay about how much you did
C:	well oh it's kind of buried over that span of time but I'd say right now I'm about about half a pack a day
T:	okay okay the most important thing I mean I've got slides will and statistics and all kinds of scary things I can say but the most important thing from my perspective is what your thoughts are about your smoking where you at with being a cigarette smoker
C:	well I am aware that it's it does have adverse health effects and down the road I perceive me at making a change in my behavior and and knowing that the health consequences associated with with smoking but that day is not today I don't feel like I really use you know when it started off as I mentioned as a teen it was more of a social thing
T:	sure
C:	and acceptance my friends were doing it I got to college I was open and open to more people who were were smokers as well and it seemed to be more accepted and I've just been you know continued that uses of as an adult
T:	yeah
C:	you know it's it's for me it's now become much more of a habit and just a routine as much it is is the I feel like the the nicotine in the effects of the the cigarette itself it's very much part of my daily routine this is part of your life this is what you do
T:	yeah and you know I know it's it's you know the cost and have gotten increase in over the last few years with with the cigarettes but uh but like I said at this point in time in my life I have a trouble seeing myself quit I'm a little bit concerned about you know I've had friends who tried to quit as well some successful some haven't been as successful ones that you know have quit they've noticed they've gained a lot of weight and and that's kind of concerns me in my age ranges what kind okay so you're doing a lot of good thinking well what what I heard you say and clearly you're a guy who sought through some things about your health what I heard you say smoking has some negative consequences and I don't want those things to happen but today's not the day I'm not gonna sign up and say today all all quit cold-turkey right you know appreciate that I would like to know will more about what you know about potential negative consequences when you think about what happens to smokers even half a pack a day what consequences are we concerned about
C:	well my grandfather had had emphysema
T:	chirp
C:	which is you know a direct cause of his smoking non-filter cigarettes for 35 plus years
T:	yeah
C:	that concerns me
T:	yeah
C:	you know shortness of breath I noticed you know I still try to do some limited and exercise and and sometimes it's very labor intensive for me when I'm exercising that's a concern you know the health of my family my wife you know being exposed to secondhand smoke is mostly concern you know we're looking at starting a family soon and and I know that behavior will need to change when when that when that time comes but I guess you know in terms of other health concerns you know you know the more unpleasant ones the the complaints from the family members about the smell of me
T:	yeah yeah it's our that the the social pressure is a rough
C:	you know and now you know I with with different places and businesses outlawing you know smoking in side restaurants and bars around our area it's become much more of a challenge maybe publicly
T:	so these real big health problems some of which your grandpa has emphysema certainly lung cancer another risk that people take and then you look at what's going on in your own health already a little short of breath sometimes not having the lung capacity that you'd like to have social pressure exposing your wife you know I I wish I could say that's not a word but I think you're doing some good thinking I do think part of why all this hassle about smoking publicly has happened is because if your wife's exposed certainly it's the two of you had children if your children were exposed there are some real health consequences to people who are around you when you're smoking and already some some sense of some symptoms you've had with so it's you're breathing all right are there any other you mentioned breathing and people's negative reactions your fear for your wife's health are there any other things that I should understand that you don't like about being a smoker other concerns
C:	you know uh I mean I guess it's in terms of my health you know the my teeth the yellowness of that the whitening of teeth and the appearance that I have you know the I guess there's one thing on the surface that's of concern you know really I think that the respiratory issues that we talked about you know
T:	sure
C:	the lung cancer those were pretty much my primary big ones you're not concerned with but you know the the routine that I have with the smoking is it's so ingrained in my lifestyle that it's just really hard for me to fathom being of stopping
T:	yeah
C:	you know I've not really made a strong effort in the past to to quit you know if I've sampled some of the nicotine gum from friends who've tried it
T:	right
C:	and didn't care for that it was found it you know not an equal replacement for the real thing
T:	yeah yeah
C:	and I think that's kind of worrying
T:	okay so so when you weigh things you just say man I'm concerned about weight gain this trick I know the gum didn't seem so great what else do you know we'll about sort of small steps people could take who don't want to get emphysema or lung cancer or have this thing progressed are there any small step you're telling me you're not really quit cold-turkey
C:	well I think I mentioned in the beginning when we were talking at you know the the volume of cigarettes that smoke is kind of varied over the years there was a time in my early 20s where I was pushing close to a pack a day including trying to reduce the amount great is is one I guess more tangible a realistic option and in terms to losing it
T:	absolutely
C:	rather than cold turkey although I've kind of heard mixed messages that maybe cold turkey is the best way to go or not so I'm not really clear on what would be the best strategy to apply
T:	well you've taken an important step will one of the first things I say to people who say I can't stop cold turkey is could you consider cutting back that's a huge step that is significant it's not perfect but I'm not in the business of perfect patience will I'm in the business of people taking small steps and this is this is a big one and I want to congratulate you I do know some things about other steps will and and even it sounds like quit cold-turkey isn't a step today but I do know some other options some other options to lay out potentially would it be ok if you and I talked about those other options that you could just file away for when you're ready
C:	sure I'm always open to some suggestions and advice when it comes to this absolutely
T:	great