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Patient and doctor sitting in consultation discussing tobacco use

Meet Philip – relapsed smoker

Meet Philip, a 32-year-old office worker. Philip has smoked ‘on and off’ for a number of years but now ‘only’ smokes socially when he goes for drinks with his friends. In general, he is very healthy and doesn’t see his smoking as cause for concern.

Philip is seeing his GP about a knee injury. Find out how his doctor uses Very Brief Advice to help Philip with advice on how to tackle cravings in situations where there may be strong temptation to smoke in this three-minute video.

In this example of Very Brief Advice, Philip’s doctor uncovers that Philip has been smoking more recently due to socialising more in his spare time as his knee injury means he cannot play football. His doctor mentions that he has been successful at quitting smoking before, which will give him confidence, and highlights that a combination of support and treatment is the best way to prevent relapse after quitting.

It is also likely that in Philip’s situation his smoking may be delaying his recovery following his knee surgery. It has been shown that smoking is associated with significantly worse clinical outcome scores, an increase in anterior translation, and increased complication rates after anterior cruciate ligament (ACL) reconstruction3.

For people who feel they might be missing out by not smoking (being the only person left in the office or the bar, for example, when colleagues and friends are discussing things outside), e-cigarette use (vaping) has become popular. While there is still a lack of evidence around the long-term safety of e-cigarettes, there is nothing more harmful than tobacco smoke and patients should be supported to continue their quit attempt using their preferred strategy4.

References

3. Novikov DA, Swensen SJ, Buza JA, Gidumal RH, Strauss EJ. The effect of smoking on ACL reconstruction: a systematic review. Physician and Sportsmedicine. 2016;44(4):335–341. 

4. PCRS. E-cigarettes. PCRS position statement. Available at: https://www.pcrs-uk.org/resource/e-cigarettes-pcrs-position. Accessed 11 March 2020.