Engagement of the Nicotine-Dependent Person in Treatment

Abstract

If smoking tobacco is the greatest preventable cause of death in the United States today,¹ then health caregivers must be trained to engage smokers in an abstinence treatment program. Millions of nicotine-dependent people (called “smokers” in this chapter) have already quit, many of them without professional assistance. In fact, the number of smokers per capita has been cut in half over the past 30 years. However, the remaining smokers may be the ones most dependent on nicotine and, therefore, most in need of professional help. Engaging these smokers in a treatment program (i.e. ensuring that they become involved with a plan or even make a pledge to participate²), is the key to their—and the nation’s—greater health. Yet, this engagement is often difficult to effect. Like other uses of this term, engagement here brings with it an aura of commitment (“engaged to be married”) as well as an aura of struggle (“engaged in battle”). Both senses of the word fit this situation: addicted smokers battling the urge to smoke will emerge victorious only if they are possessed of a firm commitment to do so. With so much at stake, it is important for health caregivers to understand the analysis of the engagement phase—its structure, content, and process—so that they can maximize their own talents as well as the success of their patients.

The development of this manuscript was supported in part by Grants 89-35 and 90-50 from the Ohio Minority Health Commission.