For smokers, snubbing out their last-ever cigarette is a key element of "getting good care" in their pursuit of Healthy Survivorship. But smokers often feel miserable while quitting, enough that most relapse.
On page 7 Marsha Epstein, MD, MPH, a board-certified Preventive Medicine physician and the primary author of the paper offers clinicians "5 Rs for tobacco users unwilling to stop."
- Relevance - Make your advice personally relevant to the patient, being as specific as possible.
- Risk - Ask the patient to identify negative consequences of tobacco use.
- Rewards - Ask the patient to identify positive consequences of stopping tobacco use.
- Roadblock - Ask patient to identify their barriers and note elements of treatment (problem-solving, pharmacotherapy) that could address barriers.
- Repetition - Repeat the motivational intervention at every visit. Inform them that most people make repeated attempts to become free of tobacco before they are successful.
Dr. Epstein's "5 Rs" to Healthy Survivors can be generalized to almost any of the challenges of Healthy Survivorship. For example, "5 Rs to calming fear of cancer recurrence" or "5 Rs to eating a healthful diet, to grieving illness-related losses, to communicating effectively with physicians and nurses,..."
In my next post I'll explain how the 5 Rs echo many of the fundamental tenets of Healthy Survivorship and can help patients and support people get good care and live as fully as possible.