I have a number of clients who continue to smoke. Over the years, I have seen patients give up smoking over and over again. I certainly believe the research that says nicotine is an extremely addictive drug in the category with such drugs as cocaine. A number of my clients have given up smoking in response to developing medical conditions related to their “habit.” One client, however, that I have worked with for many years who has a chronic mental illness has, in the last few years, developed chronic obstructive pulmonary disease and has had a number of hospitalizations. He has been told by me and by his physicians that the next time he develops pneumonia and enters the hospital, he may not leave.
But does such a “scare ‘em” approach really raise their awareness of the need for change since, if you believe in the stages of change, consciousness raising is one of the processes that you need to use to move people from precontemplation, not thinking about making a change into contemplation, actually thinking about and weighing the pros and the cons of changing.
This effort on my part and the part of other medical providers seems to have made my client more fearful regarding the possibility of dying and more willing to “cut down” and to at least consider stopping.