Positive changes in lipid profile and body fat distribution also occur. The patient can be encouraged to avoid weight gain with an exercise programme and have low kilojoule prepared snacks at hand. A good start is to document each patient's smoking history as part of general history-taking on initial presentation. Gentle encouragement of the patient to think about their habit and making it clear that you are available for further support is the most effective approach. Unsure The advantages of continuing to smoke are still as important as the advantages of quitting.
Discussion can focus on weighing up the pros and cons and any other specific concerns.
Ready They will respond positively to advice to stop and can be given more specific help on how to deal with withdrawal symptoms. It is therefore useful to identify how ready the patient is to change in order to provide the most appropriate individual assistance. An approach that helps the patient to take control and responsibility for the problem is more likely to be successful than systematically giving advice to stop or telling the patient what to do. Relapses Many ex-smokers relapse, especially in the setting of social events, peer pressure and alcohol. Patients should be encouraged to view these as learning experiences, and to learn from there how to avoid future relapses when they try again.