Positive reinforcement key to help patients quit smoking

Doctors should say 'Thank you for not smoking' to patients and avoid the use of discouraging remarks

New Delhi, 30 June 2017: As part of its commitment to working closely with all National Health Programmes alongside the government, the IMA has urged individual doctors to counsel their patients who smoke about quitting smoking. It has, however, said that such counseling should be done in a manner that turns a negative situation into a more positive action. According to statistics, more than one-third (35%) of Indian adults use tobacco in some form or the other. Of these, 21% adults use only smokeless tobacco, 9% only smoke and 5% smoke as well as use smokeless tobacco. Additionally, about 52% of the adults are exposed to second-hand smoke at home.

The National Tobacco Control Programme aims at making the public aware of the harmful effects of tobacco use, controlling tobacco consumption, and minimizing related deaths. Tobacco use has many adverse health effects and is a major preventable cause of morbidity and mortality. Smoking not only increases the risk of various diseases but also reduces the quality of life, and increases health care utilization and cost.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "Campaigns on tobacco control convey the message 'smoking kills' with the intention of highlighting the potentially life-threatening health consequences of this habit based on the assumption that this would deter people from smoking or using tobacco products. However, many of these campaigns do not reinforce these messages in a positive manner. It is time to alter the tone of such public health campaigns from negative to positive. Quite often, we rebuke patients for failing in their efforts to quit smoking and tell them they may die if they do not quit. A statement worded in this manner can inadvertently sound discouraging to the patient."

People should know the dangers of smoking or using tobacco products. However, rather than adopting a critical approach, this message should be conveyed through positive communication for a more fruitful impact. Any violent communication should also be avoided.

Adding further, Dr Aggarwal, said, "It is best to avoid the 3Cs of violent communication - Condemn, Criticize, and Complaint. A nonviolent communication approach should be used instead to help and support patients in their efforts to quit smoking. It is important to say 'Thank you for not smoking' to the patients. Appreciate their hard work and perseverance in trying to quit this deadly habit. This way, they would know that they have your support and will in turn have trust and faith in you. Empathetic and supportive communication can increase the chances of patients adhering to lifestyle modifications."

There is a very strong relationship between a doctor's communication skills and the patient’s capacity to follow through with medical recommendations, self-manage their medical condition, and adopt preventive health behaviors. It is imperative for a doctor to adopt a positive approach to explain, listen, and empathize with the patient. This in turn can have a profound effect on the biological and functional health outcomes.