4 Years in Patient Safety, Preventive & Ethics — Case | Ethics | SMLE Q#16974
SMLE Question #16974
Patient Safety, Preventive & Ethics
Ethics
Objective: OBJ-243
Last updated: February 2026
A 20-year-old primigravida at 10 weeks’ gestation smokes 20 cigarettes/day for 4 years. You counsel her on pregnancy risks and available smoking-cessation supports and assess readiness to quit. She demonstrates understanding but declines to stop now and refuses referral for further help. She has decision-making capacity, is not intoxicated, and there is no evidence of coercion or psychiatric incapacity. She asks that her family not be informed. What is the most appropriate next step in managing this patient?
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