A 52-Year-Old Man Walks into the Office for a Routine

A 52-year-old man walks into the office for a routine check-up. In the past, the patient had well-controlled hypertension and hyperlipidemia. He has a 35-pack-year smoking history and claims to consume 10-15 cigarettes daily. Lung cancer runs deep in his mother's family history. His father died of a stroke at the age of 65. When asked if he has considered quitting, the patient states that he is not ready to do so. He asserts, "I know I should, but I'm just too stressed out at work to give up smoking right now. To be honest, I probably smoke more than a pack of cigarettes every day." Which of the following is the most appropriate method to handle the patient?

A) "I suggest that you consider how your health may improve if you were to stop smoking."
B) "I understand that you're under a lot of stress, but you are capable of more than you think."
C) "What do you worry will happen if you quit smoking?  What about if you don't quit?"
D) "What is your understanding of how smoking relates to lung cancer and stroke?"
E) "With all the smoking cessation treatment options available, quitting is a lot more manageable."