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Table 3 Teachable moments categories

From: Teachable moments and missed opportunities for smoking cessation counseling in a hospital emergency department: a mixed-methods study of patient-provider communication

Category and definition

Example

Positive reinforcement Provider expresses support for patient’s previous or ongoing attempt to quit smoking.

D: Have you thought about quittin it altogether?

P: Oh yeah, yeah, I plan on stoppin. Cause she used to smoke but she stopped because of him and

D: That’s great.

P: I cut, I cut, I cut down a lot. Like I said, [today I didn’t smoke.

D: [(Well.) Yeah, well. Extra little bit now, you’re practically there.

Encouragement Provider encourages patients to quit smoking but does not provide any advice or tailored feedback.

P: There are times, there are times when I don’t smoke. When (name) and (name) was here I didn’t smoke for five days. ((laughs))

D: Um-

P: So it’s one of things-

D: [Ok well if you can do it for five days

P: [(I care about)

P: It’s not-

D: It’s not good for you. I’m not telling you anything you don’t know.

P: Well yeah.

D: If you can stop, I mean you probably should.

Assessing readiness Provider inquires about patient’s willingness to make a quit attempt.

D: Ok. Do you smoke at all?

P: Yes. Don’t plan on quitting […]

P: I’m drug and alcohol free except for the medications that I am prescribed.

D: And the cigarettes.

P: Well they’re not technically a drug.

D: Nicotine is.

P: I don’t believe it.

D: Ok.

P: That drug I’m not yet to let go of.

D: Ok. Alright, well I encourage you to consider it when you’re ready. Ok?

P: Yes sir.

Motivating reasons: medical Provider discusses the health consequences of smoking.

N: Um I encourage you to quit because it causes every known cancer out there in addition to bronchitis, pneumonia and lots of stuff.

P: Yes ma’am.

Motivating reasons: family Provider discusses the consequences of smoking for the patient’s family.

N: Ok. Um do you have kids at home?

P: No I don’t have my kids at home. My kids live with their mother but uh there’s kids there that I look at like my own so.

N: Ok.

P: Yeah.

N: So you don’t need to be exposing them to-

P: Yeah.

N: To tobacco and smoke.

P: Oh when I smoke I go outside the house.

N: But it’s still on your clothes.

Motivating reasons: economic Provider cites the financial burden of smoking to motivate the patient to quit.

D: Good. Do you smoke?

P: Yeah.

D: Well that's a big money saver.

P: I know.