Working with a heavy smoker

[eeor1006]

I recently started working with a patient who is a heavy smoker, minimum 2 packs a day. I am fairly sensitive to smells and my office is tiny. Every time after she leaves, my throat burns for a day or two. I also can smell cigarettes smoke lingering on my sweater the night I see her. I tried having a fan on ("It is so warm today") and sitting as far as I can from her. I don't know what else to do.

I am not seeing her for smoking cessation. I did very enthusiastically provided smoking cessation resources.

If this was a colleague, I feel pretty comfortable having a candid discussion about this. But she is a patient and I don't know what to do. Tips?

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[The Cinnabon]

Get one of those oil based air fresheners that's constantly going if you can. In my role I do work with individuals that are currently homeless and the smells can also be super strong. I would just make a habit of washing whatever clothes you wear that day as soon as you get home if you're extremely averse to the smell.

 

[R. Matey]

Not entirely the same, but I've had the 'smell talk' with a number of adolescents way back in my LPC days. Most of the time, the honest feedback was appreciated. My guess is this person doesn't even realize that they do. You might start by asking them to refrain from smoking an hour before the session.

 

[PsyDr]

Tell them.

Maybe you’re not the right therapist for them. No shame in that.

 

[Cam_Chai19]

I used to work with unhoused individuals and heavy cigarette smokers. One trick that really helped was using a strongly scented hand lotion or scented hand sanitizer before session and leaning my head on my hand for large parts of the session. I would also keep a can of febreeze on hand to spray my office, clothes, or hair after if needed (the one with gain mostly smells like fresh laundry). Depending on the therapy and your location, having outdoor walking sessions could also be an option.

Also if you want to avoid putting extra wear on your clothes by washing them after work, running them through the dryer with a dryer sheet will often neutralize the smell.