Unheard and Unsaid

Patient: My chest really hurts because of all my coughing.
Jake: A good sign you should stop smoking.
Patient: I have been hospitalized multiple times this year because of my asthma.
Jake: Probably the smoking.
Patient: Oh my god I just feel so terrible, the respiratory therapist says my flow meter results are too low.
Jake: What? With all the smoking? Really?

...

Jake out loud : So, have you thought about quitting smoking?