History – Smoking

Taking a smoking history is an important part of a patient’s health assessment. It helps in understanding the patient’s risk for smoking-related diseases and in guiding appropriate interventions. Key questions in a smoking history typically include:

  1. Smoking Status:
    1. Are you currently smoking? (This includes cigarettes, cigars, pipes, or any other forms of tobacco.)
    2. If not, have you ever smoked in the past?
  2. History of Use:
    1. If currently smoking: How many cigarettes (or other tobacco products) do you smoke per day?
    2. If a former smoker: When did you quit smoking?
    3. If never smoked: Have you ever tried smoking, even just one or two times?
  3. Duration of Smoking:
    1. How old were you when you started smoking regularly?
    2. This helps calculate the total duration of smoking, which is important for assessing risk.
  4. Type of Tobacco Product:
    1. What type of tobacco products do you use or have used in the past (e.g., cigarettes, cigars, pipe tobacco, electronic cigarettes, smokeless tobacco)?
  5. Dependence:
    1. How soon after you wake up do you smoke your first cigarette? (This question can help gauge nicotine dependence.)
    2. Where do you smoke?
    3. Other activities associated with smoking ie coffee, alchohol, after sex?
    4. Do you find it difficult to refrain from smoking in places where it is forbidden?
  6. Previous Quit Attempts:
    1. Have you ever tried to quit smoking? If so, what methods did you use (e.g., cold turkey, nicotine replacement therapy, medications, counseling)?
    2. How long were you able to quit?
  7. Motivation to Quit:
    1. Are you interested in quitting smoking?
    2. Have you thought about when you would like to quit?
  8. Environmental Tobacco Exposure:
    1. Are you regularly exposed to secondhand smoke? If so, where and how often?
  9. Smoking-Related Health Issues:
    1. Have you experienced any health problems that you think might be related to smoking (like coughing, shortness of breath, chest pain)?
  10. Family Smoking History:
    1. Does anyone in your household smoke?
    2. What about your family’s smoking history?

Understanding a patient’s smoking history is crucial for risk assessment and for planning interventions. This history can guide healthcare providers in offering appropriate smoking cessation advice, support, and treatments. It’s important to approach the topic in a nonjudgmental and supportive manner to encourage open and honest communication.