Seventy percent of smokers visit a physician at least once a year. Tobacco users who receive advice and resources to quit from their provider have higher satisfaction rates. Yet, only half of tobacco users report being advised to quit by a doctor during the past 12 months.1
According to the Treating Tobacco Use and Dependence: Clinical Practice Guideline, 2008 Update, “busy clinical teams should make the treatment of tobacco use a priority based on the compelling evidence:
Asking and advising patients to quit are not just good patient care, but can actually double the chance a smoker will make a quit attempt.2 According to the Clinical Practice Guideline, the gold standard for tobacco use intervention by health care providers is the “5 A’s” intervention: Ask, Advise, Assess, Assist, and Arrange.
Providers have not broadly implemented the 5 A’s due to a pervasive belief that they take too much time. Many clinician groups now promote a streamlined version of the intervention, such as “Ask-Advise-Refer”. The goal of the alternate approaches is to increase the likelihood of clinicians intervening by simplifying their task: they Ask and Advise, then hand the patient off to a quitline or other cessation service provider to Assess, Assist, and Arrange. Such efforts have been successful both in changing health care provider behavior and in generating referrals for cessation treatment providers.
1 Danesh D, Paskett ED, Ferketich AK. Disparities in Receipt of Advice to Quit Smoking From Health Care Providers: 2010 National Health Interview Survey. Prev Chronic Dis 2014;11:140053.
2 Kruger, J, Shaw L, Kahende J, Health Care Providers’ Advice to Quit Smoking, National Health Interview Survey, 2000, 2005, and 2010. Preventing Chronic Disease 2012; 11_0340