Version May 2024
| Intervention | Technique |
| Ask | Implement an officewide system that ensures that, for every patient at every clinic visit, tobacco-use status is queried and documented. Repeated assessment is not necessary in the case of the adult who has never used tobacco, or has not used tobacco for many years, and for whom this information is clearly documented in the medical record. |
| Advise | Strongly urge all tobacco users to quit in a clear, strong, personalized manner. |
| Advice should be: | |
| Clear - "I think it is important for you to quit smoking now and I can help you." "Cutting down while you are ill is not enough." | |
| Strong - "As your clinician, I need you to know that quitting smoking is the most important thing you can do to protect your health now and in the future. The clinic staff and I will help you." | |
| Personalized - Tie tobacco use to current health/illness and/or its social and economic costs, motivation level/readiness to quit, and/or the impact of tobacco use on children and others in the household. | |
| Assess | Determine the patient's willingness to quit smoking within the next 30 days: |
| If the patient is willing to make a quit attempt at this time, provide assistance. | |
| If the patient will participate in an intensive treatment, deliver such a treatment or refer to an intensive intervention. | |
| If the patient clearly states that they are unwilling to make a quit attempt at this time, provide a motivational intervention and/or offer the option of initiating pharmacotherapy rather than waiting until they are ready to quit. | |
| If the patient is a member of a special population (eg, adolescent, pregnant smoker), provide additional information specific to that population. | |
| Assist | Provide aid for the patient to quit. These actions are summarized in the accompanying table. |
| Arrange | Schedule follow-up contact, either in person or by telephone. Follow-up contact should occur soon after the quit date, preferably during the first week. A second follow-up contact is recommended within the first month. Schedule further follow-up contacts as indicated. |
| Congratulate success during each follow-up. If tobacco use has occurred, review circumstances and elicit recommitment to total abstinence. Remind the patient that a lapse can be used as a learning experience. Identify problems already encountered and anticipate challenges in the immediate future. Assess pharmacotherapy use and problems. Consider use or referral to more intensive treatment. |
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