As in all medical procedures it is a patient's right to refuse. However, it is often the case that refusals are based on misunderstandings. So, ask the patient why they do not want to participate. Based on their concerns some possible responses include:

• “Your doctor feels that your health habits are important to your overall health.“
• “We ask the questions of everyone and we don’t single anyone out.”
• “We have a set of standard questions that we ask everyone to make sure we provide the best care possible.”
• “We ask everyone to help improve our patients’ long-term health.”
• “We ask everyone, as substance misuse is a major factor in accidents, injuries and chronic health conditions.”