Abstract

Cigarette smoking remains the most important preventable cause of premature death in the western world How best to help adults to give up cigarettes and stop the young from starting is unknown. If all doctors gave up cigarette smoking the example might be their most useful contribution to preventive health care. Health Education campaigns and anti-smoking clinics have had little success. Yet about one out of every four patients can stop after firm unequivocal advice from the doctor to do so.¹ Where motivation was increased by a recent myocardial infarction, 62% of patients were persuaded by their doctor to stop for at least one year.² No method is known to be more effective than this personal advice from doctor to patient, yet many patients have never been told by their doctor to stop smoking, even for chronic bronchitis or ischaemic heart disease.