M. Congratulate And Encourage Continued Abstinence

OBJECTIVE

Congratulate non-users for changing a difficult behavior and encourage continued abstinence.

BACKGROUND

Nicotine dependence is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal, because tobacco use causes coronary artery disease, chronic lung disease, and cancer. It is characterized by impaired control over tobacco use, preoccupation with the drug nicotine, use of tobacco despite adverse consequences, and distortion in thinking, including denial of addiction.

Therefore, congratulating those who do not use tobacco for maintaining their health is an important element in primary prevention.

RECOMMENDATIONS

1. All tobacco non-users should be congratulated for not using tobacco (“Good for you”) and advised to avoid initiation of tobacco. (“The single best thing you can do for your health is to avoid all tobacco products.”) [B]

DISCUSSION

Primary care reinforcement of not using tobacco among young non-smokers has been shown to prevent the onset of smoking, especially in boys (Fidler & Lambert, 2001). Brief motivational interventions promote positive behavior changes in tobacco users. Positive reinforcement of a behavior (not using tobacco) generally encourages its continuation. A simple, brief, congratulatory statement may serve this purpose.