Background: Nicotine a psychoactive part of tobacco belongs to the substances with the strongest potential to initiate dependency. Not only treatment itself, but also a motivation to start it is one of the most difficult therapeutic problems. Substance causes changes in mood, reduces stress, increases activity, excitement, attention and concentration and many others. Contrary to these short-time effects, serious negative health consequences of tobacco smoking such as pulmonary emphysema, cancer, cardiovascular diseases, which are closely associated with regular tobacco smoking, are usually delayed by many years. The goal of the study was to find out why patients treated from alcohol dependence do not enter also treatment for tobacco dependence. We wanted to find out how better motivate patients to stop smoking. Our study was divided into quantitative and qualitative part. Patients and methods: Sample consisted of 72 patients of CT DD Bratislava treated from alcohol dependence, who were at the time of study regular smokers (72 % males, 28 % females; average age 44.7 (SD ± 11.5). Seven-item questionnaire was administered to them, SPSS database was used for data processing. Qualitative part was a case history of 77-years old colleague, doctor – psychiatrist. Results: 100 % (72) of the patients had knowledge that smoking causes health damages and from them 4 % (3) thought, that smoking do not damage their health. 93 % (67) of patients knew about the possibility of the treatment, but in treatment were only 6 % (4) of them. Only 3 % did not know about possibility of treatment from the patients who were not in the treatment. 19 % did not want to stop smoking, 19 % had fear to stop it (they thought that they would fail), 21 % did not consider such option at all and 38 % did not see any reason to stop smoking. Case history has illustrated how financial reward could increase motivation to enter treatment. Conclusions: Results of our survey support the hypothesis that heavy smokers even after the offer of free of charge treatment, who are aware of serious health consequences, have only small motivation to stop smoking. Financial reward can be one of the factors, which can support their decision to enter the treatment and to comply with it.

Key words: tobacco dependency – motivation – financial reward