Table 1 Approach to patient smoker profile types in intervention and enhanced usual care groups

25-year-old male smoker seen for flu-like symptoms, smokes ≥ 5 cigarettes per day, more evenings and weekends, uninterested in discussing his tobacco use (pre-contemplative)

“What do you know about the risks of smoking?”

“What are potential benefits of quitting?”

“Why don’t you return for an appointment next week so we can follow up your flu symptoms and specifically discuss quitting smoking?”

“I understand if you’re not sure about quitting, but I can help. You should give treatment, like with varenicline, a try.”

60-year-old female smoker consulting for a urinary tract infection, 20 cigarettes per day, stressful home and work environment, wants to quit but not now (contemplative)

“What is it that you like and don’t like about cigarettes?”

“You say that smoking is bad for your health. What barriers do you see to quitting?”

“What do you see as the next step?”

“Now is the time to quit smoking. There effective treatments that can help”

“I council my patients to try quitting sooner rather than later”

“Let’s make an appointment next week to make a detailed plan”

65-year-old male smoker with mild asthma consulting with seasonal allergies, has already tried quitting and is open to trying again (action)

“Congratulations! I propose setting a quit date.”

“Have you hear about medications that can help with quitting? I would recommend that you try one.”

“If you’d like, we can schedule regular appointments to help you with your symptoms”

“Congratulations! Let’s set a quit date.”

“Nearly all of my patients use a medication to help quit. Some use e-cigs. This tool can help us choose the approach that’s right for you.”

“My assistant will call you next week to see if you are tolerating the medication and make a follow-up appointment”