Naturally the doctor-nurse-patient relationship is best applied when physicians are familiar with the evidence justifying smoking intervention and cessation. Doctors can give advice with authority and conviction, and they are frequently responsible for discussions and counseling regarding diagnosis and treatment. Burt, et al. (1974) showed their control group at 27.5% quit smoking in comparison to 63.2% in the study group. The doctor's effectiveness with the patient is compounded when the same knowledge and enthusiasm is applied by the nurse, (Burt, et.al., 1974). In many current medical settings physicians are responsible for prescribing medications for smoking cessation, and as such, they continue to play a key role in interventions and care. This is always a part of a multifocal approach to secondary prevention of myocardial infarction, a health issue that often motivates coronary patients to change their smoking habits. Physicians and nurses alike play a key role, during interviewing and counseling, in overcoming resistance a critical care patient's resistance to change. The importance of these intertwining relationships is also critical throughout the separate stages of smoking cessation. The first stage involves contemplation, when smokers are actually considering quitting smoking and changing their habit (Percival and Milner, 2002). The combined effort of doctor and nurse are important at any stage in the process, but the physician plays a key role in this first stage as he communicates directly with the patient regarding diagnosis and treatment (Percival and Milner, 2002). Physicians, as such, should be encouraged to effectively promote smoking cessation during discussions about diagnosis and prognosis. Ultimately, patients need assistance with smoking cessation, and treatment starts with healthy relationships between the patient, doctor, and nurse. The synergistic effect of involving more of the health care team has undoubtedly more influence in contributing to smoking cessation.
The doctor-nurse dynamic of introducing the concept of