Background: Primary and secondary health care services in New Zealand are gearing up for a “whole service” approach to addressing the first and second hand smoke exposure of people in their communities. This is requiring standard screening questions between services. Screening options include using a label (Are you a smoker?), a behaviour (Do you smoke?) or health goal (Are you smokefree?) This presentation examines the rationale for deciding screening language in particular and intervention language in general.

Discussion: Modern linguists agree that language influences thinking and behaviour (Moderate Whorfianism). This places language at the heart of leading change. The language of health policy and systems has implications for how clinical teams think and intervene with patients and how patients experience the intervention. Changing the question changes the answer and the discussion that follows. Public health interventions are required to address inequalities as well as the health issue itself. The policy strategy promoted here is: lead with positive, inclusive, goal-focused language. Education for Change programmes take great care with language and achieve high levels of uptake, acceptability and effectiveness across all programmes. Evidence from our work in smoking cessation, midwife education and smokefree hospital coordination will be shared in this presentation.

Conclusion: Language matters. The language of our vision needs to be the language of our policy. A simple orientation from problem to solution language at policy level has the potential to align organisational culture, professional education, clinical practice and patient experience with that vision and make its reality more likely.