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Another area in which hypnotic strategies are utilized, but the concepts of hypnosis are not mentioned, is in the 3-minute smoking cessation interaction. At the conclusion of the oral examination and cancer screening, if there is an indication by the patient that there is a desire to 'quit', the following sample script is useful.

doctor: When did you have your last cigarette?

patient : On the way to the office, about half an hour ago.

doctor: So you had your last cigarette at three o'clock, on 6, May 1997. Do you really want to start smoking again?

patient: (Pause). I get it. Each time I burn the tobacco and inhale the smoke, I start smoking. It was not pleasant when I started at 18. Knowing what I know now, I have no desire to start today.

doctor: The choice to start is totally your own. Should you have a craving, consider taking a deep breath, hold it and gently release the tension. Drinking eight cups of water a day is a good habit to acquire. To keep your mouth feeling healthy and clean, gently brush the teeth and clean the tongue several times throughout the day.

Rarely do people feel comfortable in labeling themselves as quitters. The focus is changed from quitting to starting. This strategy eliminates the fear of failure at 'quitting', and does not strain the doctor-patient relationship. If more intense interaction is indicated, an appropriate referral is made to a mental health practitioner or smoking cessation program.

According to the National Cancer Institute, the realization that a dentist cares enough about a patient's health to encourage smoking cessation or continued abstinence from smoking can be a major factor in a patient continuing as a non-smoker. About 95% of non-practicing smokers decided not to start again without the help of formal cessation programs. In addition to having high motivation and good self-management skills, successful former smokers usually receive help and encouragement from family, friends, physicians and dentists. In fact, clinical studies show that patients whose doctors deliver a brief stop-smoking message are 2-10 times more likely to create a positive change than are patients who receive no such advice.

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