Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, USA.
N Engl J Med. 2011 Sep 29;365(13):1222-31. doi: 10.1056/NEJMcp1101512.
A 45 year-old overweight woman with a history of asthma and depression presents to her primary care physician with her third episode of acute bronchitis in the last 24 months. She began smoking at age 15 and now smokes 10 to 15 cigarettes per day, but every day she starts smoking immediately upon awakening, an indication of severe nicotine dependence. She has made multiple unsuccessful attempts to quit, once briefly using the nicotine patch, but relapsed due to strong urges to smoke and weight gain. She has not used cessation counseling or other medications. She is bothered by the cost of cigarettes, and is worried about smoking’s health effects on her two children and on herself. Importantly, she is reluctant to make a quit attempt now, in part, because she fears she won’t succeed. What would you advise?
一位 45 岁超重的女性，有哮喘和抑郁症病史，在过去 24 个月中出现了第三次急性支气管炎。她从 15 岁开始吸烟，现在每天吸烟 10 到 15 支，但每天她一醒来就立即开始吸烟，这表明她有严重的尼古丁依赖。她曾多次试图戒烟，但都没有成功，曾经短暂使用过尼古丁贴片，但由于强烈的吸烟欲望和体重增加而复吸。她没有使用戒烟咨询或其他药物。她对香烟的成本感到困扰，并担心吸烟对她的两个孩子和她自己的健康影响。重要的是，她现在不愿意尝试戒烟，部分原因是她担心自己不会成功。你会怎么建议？
