Pilnick2003a

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Pilnick2003a
BibType ARTICLE
Key Pilnick2003a
Author(s) Alison Pilnick, Tim Coleman
Title “I'll give up smoking when you get me better”: patients' resistance to attempts to topicalise smoking in GP consultations
Editor(s)
Tag(s) EMCA, Medical consultations, Medical EMCA, Conversation Analysis, Smoking
Publisher
Year 2003
Language English
City
Month
Journal Social Science & Medicine
Volume 57
Number 1
Pages 135–145
URL Link
DOI 10.1016/S0277-9536(02)00336-2
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
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Abstract

This paper focuses on general practice consultations where the issue of patients’ smoking is raised and problematised by general practitioners (GPs) by linking it to their presenting or ongoing medical conditions. The data are taken from a larger study in one country of the UK, of the factors influencing discussion of smoking between GPs and patients who smoke. Consultations have been examined informed by the conversation analysis literature, with a focus on patients’ resistance to doctors’ problematisation of smoking. It is argued that, despite evidence from other areas of health care that advice is most effective when it is personalised, and despite GPs’ expressed views that a preferred way of topicalising smoking is to make links to a patient's current medical problems, this is not generally the case in these consultations. Linking smoking to current problems commonly results in explicit resistance from patients of a kind that is rarely seen in other medical consultations. It is postulated that this results from the moral implications of linking a person's health status with their own behaviour, thereby undermining their claim to legitimate illness and to medical help.

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