Acute Caremiddle twist
A 58-year-old man is treated in the emergency department for a Colles fracture sustained tripping over a gutter. He smokes 25 cigarettes a day and lights the first one within a few minutes of waking, before breakfast. When the intern raises it he says he has smoked since he was 15, feels perfectly well, and has no intention of giving up. He has no history of seizures and no eating disorder, and he will be in the department for several more hours awaiting plaster. Which one of the following is the most appropriate response to his smoking at this visit?