Smoking Cessation and Alcohol Brief Interventions
NMC CBT practice on brief interventions: very brief advice for smoking, UK alcohol unit guidance, safe advice, and worked scenario answers.
Some of the most useful things a nurse does take under a minute. Brief interventions for smoking and alcohol are structured, evidence-based conversations that fit into ordinary care, and the CBT tests whether you know the structure and the safety limits.
Very brief advice on smoking
The model to know is Ask, Advise, Act. You ask whether the person smokes, advise that the most effective way to stop is with support and medication rather than willpower alone, and act by offering a referral to a stop smoking service. The whole thing takes seconds.
The point candidates miss is that you do not need to assess motivation first. You offer the referral to everyone who smokes, ready or not. The service can explore readiness; your job is to open the door and make the offer. Options that make you wait until the patient declares themselves ready, or that turn the moment into a lecture, are wrong.
Alcohol: know the numbers
The current UK guideline, from the Chief Medical Officers, is no more than 14 units a week for everyone, spread over three or more days, with some drink-free days. The old higher limits, and the idea that men could safely drink more than women, are out of date. Saving up units for a single heavy session is specifically advised against.
You should be able to estimate units. The rule is strength in percent times volume in millilitres, divided by 1,000. A pint of 5% beer is about 5 times 568 divided by 1,000, close to 3 units. A rough figure is enough to give realistic advice.
The safety trap: dependence
The one clinical danger in this chapter is telling a dependent drinker to stop suddenly. Abrupt withdrawal in alcohol dependence can cause seizures and delirium tremens, which can be fatal. So a patient who is dependent needs medically supported withdrawal, not a cheerful “just stop today.” Recognising when advice to quit becomes unsafe, and referring instead, is exactly what the exam is checking. Next: nutrition, obesity and lifestyle advice. Five brief-intervention scenarios first.
Sources & further reading
Frequently asked questions
What is the UK alcohol guideline?
Do I need to assess if a smoker is motivated before advising them to quit?
Why should a heavily dependent drinker not stop suddenly?
Check your understanding
Quick quiz: Smoking Cessation and Alcohol Brief Interventions
5questions. Click an answer to see the explanation. Your score is saved on this device only.
- 1
A patient mentions they smoke 15 a day. Using very brief advice, what should the nurse do?
- 2
The UK Chief Medical Officers advise drinking no more than how many units a week?
- 3
A patient who is alcohol dependent says they will stop drinking completely today with no help. What is the safest advice?
- 4
A pint of beer at 5% strength is about 568 mL. Roughly how many units is it?
- 5
What best describes a brief intervention for alcohol?
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