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The Terror of Yes was a phrase used by one of the course instructors during training at Mayo Clinic . It stuck with me. It was used to describe the reluctance of physicians to diagnose and treat a problem unless they’re specialists.

Physicians are not specialists in nicotine addiction. Nor are they expected to be. You will generally only hear a physician say, “You need to quit smoking,” and not “Would you like my help with quitting smoking?” Physicians are equipped to make some general recommendations about the approved pharmaceuticals and nicotine replacement therapies to help people quit smoking. But nicotine addiction is complicated!

Physicians are not trained to develop a customized approach to quitting smoking. A customized approach should evaluate a patient’s desire to quit smoking, readiness to quit smoking, confidence in their ability to quit smoking, perception of the importance of quitting smoking, previous quit attempts and previous quit methods, to name a few things.

Physicians can avoid the “terror” by not offering help with quitting smoking. Telling a patient to quit smoking and writing a prescription may be the path of least resistance.

Imagine a patient asking their physician a question about quitting smoking and hearing “I don’t know.” It probably won’t happen. Instead, he/she will make an effort to answer the question until the patient seems satisfied. This is not to suggest that the physician is trying to mislead the patient. It is to suggest that physicians may not know enough about nicotine addiction, including the latest research in the field, to provide the most appropriate advice to a smoker genuinely seeking help with quitting.

Physicians are no different than the rest of us in this regard. Who would ask a question (Would you like my help?), if they fear the answer (Yes!)?

It does, however, raise the question of whether or not your physician is the best person to deliver advice about quitting smoking.  But who, then, is? I don’t have that answer. It still seems like the most logical place to start.

I think a Certified Tobacco Training Specialist working in collaboration with a physician is a great start. But most independent physicians, or even large physician groups or hospitals, do not have one on staff.

Alpha Lifestyle Center of Birmingham has a Certified Tobacco Training Specialist. However, this business offers a very specific approach to nicotine addiction; laser therapy or laser acupuncture. We customize a customer’s appointment based on individual responses and experiences, but we do not customize the specific approach. When customers make their appointment at Alpha Lifestyle Center of Birmingham, they have already determined for themselves to use laser therapy to quit smoking. We did not evaluate the individual and recommend laser therapy.

If you are thinking about quitting smoking, consider asking your physician, “Who is the best person to talk to about quitting smoking?” That question might help a physician consider that a better answer may be elsewhere or that some new resources should be identified.