At the addiction psychiatrist's

In this fourth english corner, you will find a contribution dealing with psychiatry, and more precisely tobacco addiction. Again, our aim is not to teach medicine but to familiarize readers with medical english as used by professionals and patients.

Dr Lighter : Come in Mr. Fag, please sit down. Now, how can I help you ?

Mr. Fag : Well, doctor, my G.P. said that you may be able to help me; you see, I want to stop smoking.

Dr. Lighter : I see, and what made you decide to stop smoking ?

Mr. Fag : Several things actually. First, my brother was diagnosed with lung cancer last month, and he didn’t smoke as much as me. And then, I’m trying to get fit again, and I get out of puff just walking to the shops, and on top of that my wife has been pestering me for years; you see, she managed to stop, and if she can do it, I can too.

Dr. Lighter : So, you’re really motivated ? Tell me, how long have you been smoking?

Mr. Fag : About 35 years; I started when I was 15. 

Dr. Lighter : And how many do you smoke every day ?

Mr. Fag : I’m down to about a packet a day now, but it used to be two a day.

Dr. Lighter : And have you ever tried to stop ?

Mr. Fag : Yes, I’ve tried all sorts, patches, chewing gum, electronic cigarettes, acupuncture; you name it, I’ve tried it. It works for a bit and then the craving comes back; someone offers me a cigarette and it’s back to square one.

Dr. Lighter : Did you take any medication when you were trying to stop, antidepressants, for example? There is some evidence that they relieve the withdrawal symptoms. Or a smoking cessation aid, such as Champix?

Mr. Fag : No, you’re the first person I’ve consulted. I always tried to do it on my own.

Dr. Lighter : I see. Tell me, have you ever tried hypnotherapy or group therapy?

Mr. Fag : No, but I know some people who did. It worked for a couple of them, but most started again pretty quickly.

Dr. Lighter : Well, at the end of the day, it’s all a question of willpower. All of these NRTs to break the smoking habit work better if the person is highly motivated.

Mr. Fag : Sorry, what are NRTs ? ?

Dr. Lighter : It stands for nicotine replacement therapy. 

Mr. Fag : So, Doctor, what do you recommend ?

Dr. Lighter : Well, as NRTs didn’t have much effect, perhaps we could try hypnotherapy. I’ve had some success with this, even in chain smokers. It doesn’t work for everyone, but it’s worth a try in your case, especially as you seem to be motivated. I’d rather not try antidepressants as they have some rather unpleasant side-effects and you’d need to be weaned off them eventually. There is a new treatment called repetitive transcranial magnetic stimulation, which seems to have some effect in people with substance use disorder, but it’s still in its early days and it’s not yet been shown that it’s better than placebo. What do you think ?

Mr. Fag : Hypnotherapy sounds fine for me doctor. When can I begin?

Dr. Lighter : In fact, you should only need one session. Could you see my secretary on your way out to make an appointment ?

Mr. Fag : Yes, of course. Just one more thing, Doctor. I was just wondering. If I manage to stop, will it lessen the risk of lung cancer ?

Dr. Lighter : Not that much, I’m afraid. Of course you’ll feel the benefits immediately. Smoking causes an almost permanent state of inflammation and this diminishes quickly. Your food will taste better, your sense of smell will return. You won’t suffer from bad breath. You’ll find that you’ll enjoy walking again and your wife will be happy.

Mr. Fag : You’re right, Doctor – I’m going to do it. 


1. Asking myself = wondering

2. Attenuate = relieve 

3. Back to the beginning = back to square one

4. Besides that = on top of that

5. Discontinue the medication gradually = be weaned off them

6. Family doctor = GP

7. Finally = eventually, at the end of the day

8. Give me any example = you name it?

9. Halitosis = bad breath?

10. I’d prefer not to = I’d rather not

11. In good shape = fit

12. In the end = eventually, at the end of the day 

13. In the past, it was = it used to be

14. It has a good chance of success = it’s worth it

15. Proof = evidence?

16. Putting pressure on = pestering

17. Reduce = lessen?

18. Short of breath = out of puff

19. Strength of character, motivation = willpower

20. Strong desire = craving

21. Symptoms that appear when you try to quit an addiction = withdrawal symptoms

22. Very heavy smokers = chain smokers

23. Without help = on my own



*Professeurs d’anglais médical `a l’université de Dijon

Portrait de Didier Carnet
article du WUD 25

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