CASE STUDY 1

Patient J is a 28-year-old single mother of two children who has been considering quitting smoking cigarettes. Her 2-year-old daughter was recently diagnosed with asthma, and the patient is concerned about the effects of secondhand smoke impacting her child's breathing. Even though she keeps her smoking away from her kids, she is worried that the scent on her clothes or irritants remaining in the air may be contributing to worsening her asthma. She wants to be a good role model to her children and support her daughter's journey in optimizing her asthma treatment. Patient J started smoking when she was 16 years old and is concerned that quitting will be difficult, especially while she is going to school part time, working, and taking care of her young children.

After a thorough discussion with Patient J, she decides she is ready to start treatment for smoking cessation. She is concerned that it will be incredibly difficult; she shares that she tried quitting several times during her pregnancies, but she always struggled with abstaining after stressful arguments with the father of her children. She does not know how she is going to manage all of the responsibilities of her life without being able to take breaks to smoke cigarettes and do something selfish for herself. She is worried that she is going to put a lot of effort into a quit attempt, just to fail at it.

Patient J is ready to start treatment for smoking cessation. She has never utilized nicotine replacement therapy but notes that this may be helpful for her to reduce her cravings that were difficult to deal with during past quit attempts. Patient J smokes about a pack of 20 cigarettes per day and typically smokes her first cigarette within the first 10 minutes of waking up in the morning.