Tobacco Use Cases

Presented by:
Dr. Mahmoud Elhabiby
Prepared by:
Dr . Husein ElKholy
Assistant Professors of Psychiatry
Ain Shams University
 Case 1
• Mrs. Sherien Medhat is a 29 years old lady,
married for 1.5 years and currently pregnant in
the first trimester. She has no history of any
medical or psychiatric problems. She has been a
smoker for 6 years with an average of 15-20
cigarettes per day. She has tried to quit smoking
several times in the past but in vain. She asked
her obstetrician to help her quit and thus he
referred her to the smoking cessation clinic.
Discuss the management of this case.
 Case 2
• Ayman Selim is a 15 years old boy brought by his
parents who were shocked that their son smokes
cigarettes. Ayman said that he smokes for 2 years
now, started for fun under peer influence and
now smokes around 5 cigarettes per day. Ayman
does not think smoking is a problem or even
hazardous to health especially that his
grandfather has been a smoker for most of his life
and yet is in good shape. He is only here under
his parents’ pressure. Discuss the management of
this case.
 Case 3
• Mr. Sayed Abo Raya is a 55 years old gentleman
referred to the smoking cessation clinic from the
neurology department. He was admitted to the
neurology department with a recent CVS for the 5th
time. He has mild weakness in his right arm and leg. He
has no history of hypertension or diabetes yet his
laboratory investigations showed elevated Cholesterol
and TGs. He has been a smoker for 38 years now,
smoking around 70 – 80 cigarettes per day. He is willing
to quit but all his previous trials were in vain. He never
received any professional help and now seeking your
advice. How will you proceed with the management?
 Cases 4
• Mr. Adel El Seginy is a 50 years old gentleman
who has been admitted several times in the chest
department. He has been smoking for 22 years
around 40 cigarettes per day. He was eventually
diagnosed by COPD and was advised many times
to quit smoking. Initially, he was welcoming the
idea of quitting but failed in several trials so he
gave up. Again, brief intervention technique was
conducted and the patient is still unwilling to
quit. You were requested to come see the patient
and advise about his management.
 Cases 5
• Mr. Ahmed Shokry is a 36 years old gentleman.
He is unemployed and single. He has been
suffering from Schizophrenia for 15 years and he
is now controlled and compliant on medications.
• Ahmed has been smoking since the beginning of
his psychiatric illness. he smokes 40 cigarettes per
day. He came to the Tobacco Dependence Clinic
as he wants to quit.
• How to manage this case?