Encourage patients to indicate why quitting is personally important to them. Motivational information has the greatest impact if it is relevant to a patient's disease status or risk, family or social situation (e.g., having children in the home), health concerns, age, gender, and other important patient characteristics (e.g., prior quitting experience, personal barriers to cessation). Use open ended questions to explore patient perceptions about quitting:
"How important do you think it is for you to quit smoking?"
"What might happen if you quit?" Use reflective listening to seek shared understanding:
"So you think smoking helps you to maintain your weight."
"What I have heard so far is that you enjoy smoking. On the other hand, your boyfriend hates your smoking and you're worried you might develop a serious disease." Normalize feelings and concerns:
"Many people worry about managing without cigarettes." Support the patient's autonomy and right to choose or reject change:
"I hear you saying you're not ready to quit right now. I'm here to help when you are ready."