The 5 A’s of Tobacco Cessation Support

* Ask about tobacco use
* Advise patient to quit
* Assess readiness to quit (within 30 days)
* Refer them to QuitlineNC at 1-800-QUIT-NOW
* Assist in quit attempt (with the help of QuitlineNC)
* Arrange follow-up (QuitlineNC will follow-up over the phone)

ASK

* Ask every patient if they smoke
* Consider tobacco use one of the vital signs
* Employ a universal identification system (stickers, computer reminders, etc.)

ADVISE

* Give clear advice about quitting
* Offer strong warnings about health effects (ex. “Quitting smoking…is the single best thing you can do for your health.”)
* Provide personalized support (ex. “Quitting will reduce your risk of…”)

ASSESS

* Assess patient’s willingness to make quit attempt in next 30 days
* Listen for “I want to quit” NOT “I need to quit”
* Complete fax referral only for those wanting to make a quit attempt within 30 days

ASSIST

* Quitline coaches will help patients develop a quit plan
* Follow STAR

ARRANGE Follow-Up

* Quitline can follow-up with three phone calls to participant to check on the cessation progress
* Important for local provider to also provide follow-up at future clinic visits
* Congratulate success
* Identify problems/anticipate challenges
* Evaluate pharmacotherapy use/problems

Quitline Fax Referral Key Points
* Ask everyone about tobacco use
* Advise all tobacco users to quit
* Refer to Quitline only those who want to make quit attempt within 30 days
* Discuss pharmacotherapy (doubles quit rates)
* Discuss quit attempt at next clinic visit

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