The 5As for the patient willing to quit and 5Rs for enhancing motivation to quit tobacco
| Component | Action & strategy |
|---|---|
| The 5As for the patient willing to quit tobacco | |
| Ask | Ask the patient if he or she uses tobacco • For every patient at every clinic visit, implement an officewide system that ensures that tobacco-use status is documented |
| Advise | Advise him or her to quit • In a clear, strong, and personalized manner, urge every tobacco user to quit |
| Assess | Assess every tobacco user's willingness to make a quit attempt at this time • “Are you willing to give quitting a try?” |
| Assist | Assist those who are willing to make a quit attempt • Help with a quit plan: to set a quit date, tell family, anticipate challenges to the upcoming quit attempt, and remove tobacco products from your environment • Recommend the use of approved medication, provide intra-treatment social support, provide supplementary materials |
| Arrange | Arrange for follow-up contact to prevent relapse, either in person or via telephone • Timing, actions during follow-up contact |
| The 5Rs for enhancing motivation to quit tobacco | |
| Relevance | Encourage the patient to indicate why quitting is personally relevant, being as specific as possible. Motivational information has the greatest impact if it is relevant to a patient's disease status or risk, family or social situation (e.g., having children in the home), health concerns, age, gender, and other important patient characteristics (e.g., prior quitting experience, personal barriers to cessation). |
| Risks | Ask the patient to identify potential negative consequences of tobacco use. |
| Rewards | Ask the patient to identify potential benefits of stopping tobacco use (e.g., improved health, better food taste, improved sense of smell, saving money). The clinician may suggest and highlight those that seem most relevant to the patient. |
| Roadblocks | Ask the patient to identify barriers or impediments to quitting and provide treatment (problem-solving counseling, medication) that could address barriers (e.g., withdrawal symptoms, fear of failure, weight gain). |
| Repetition | The motivational intervention should be repeated every time an unmotivated patient visits the clinic setting. |