Alcohol and smoking counselling

It is important to counselling patient within 3 minutes for USMLE step 2 CS encounter
in health risk behaviors that detected by SODA question ( Smoke,Sex,Safety - alcOhOl -Drug-Appetite&diet) I prefer using " Ask, Address,Advise,Assist method in bief intervention.

Alcohol
Ask: Do you drink alcohol?
How much do you drink per week?
Address: As a concerned physician,Because ( eg.you have abdominal pain)
I worried about your drinking,Have you ever though cutting down alcohol?
then CAGE ( practice to finish it within 20 second!!)
Advise if patient say yes -> That is very good for your help....
if patient say no -> I understand your reason, however, cutting down alcohol will
improve your health in long run... when ever you ready please contact us...
Assist: We have a professional team to help you get through it.

amount of alcohol drinking that should start CAGE
if more than 4 units in man / 2 units in woman per day
or more than 14 units in man / 7 units in woman per week


2. CAGE Alcohol Screen
Cut down on drinking: Have tried repeatedly without success :
Have you ever tried to cut down?
Annoyed by criticism about drinking habits
Have you ever felt annoyed by criticism about your drinking?
Guilty feelings about drinking
Have you ever felt guilty about your drinking?
Eye-opener drink needed in the morning
Have you ever had a drink first thing in the morning to help you through the day?
If yes in 2 or more start Brief counselling

This is a good approach to alcohol example which take time only about 3 minutes. Adapted from http://www.hepatitis.va.gov/vahep?page=prtop03-alc-video

Smoking
Ask: Do you smoke
How many cigarettes do you smoke per day
How long have you been smoked
Address: As a concen physician.Because ( eg.you have coughing) I worries about your smoking habit.Have you ever though stopping cigarette?
Advise:
if patient say no: Mr XX, I understand your reasons, However stop smoking will improve your
health in the long run..when ever you are ready please contact us
Assist: we have a professional team to help get through it

Note: Recreation druge Slang: Pot = Malijuana, Joint = cigarette with Malijuana