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30 Seconds To Save A Life

A Word to Clinicians

Because 44 million Americans still smoke, clinicians will inevitably encounter patients who smoke in their practices.

When a health professional has a smoking patient, four responses are possible:

  1. Do nothing
  2. Use the full Five A’s protocol
  3. Develop systems within your institution to which you can refer smokers
  4. Use the Five A's in a new way, such as Ask, Advise, Refer

The first choice is unacceptable. Given that intervening with a patient who smokes can produce bigger health returns than any other intervention, every clinician must view himself or herself as a tobacco interventionist. More is now known about what works to help patients quit using tobacco, more tools are available to aid the process, and despite time and other constraints, no health professional is off the hook.

The gold standard for intervention is the Clinical Practice Guideline, the Ask-Advise-Assess-Assist-Arrange protocol. Every clinician, if possible, should master these steps and lead patients who smoke through them.
For those who can’t become full fledged smoking cessation experts, there are two alternatives. You can develop systems within your institution that can identify smokers and offer them treatment options. Alternatively, you or your staff can identify smoking patients, advise them to quit (thus doubling the chances they will try), and refer them to a quitline. You can tell them to call 1-800 QUIT NOW, a national routing number that will take them to the nearest free, efficacious quitline and double the chances of successfully quitting. In essence, the quitline counselor will be completing the rest of the 5 A's, offering the benefit of a tailored plan with pharmacotherapy and counseling to help the patient quit. For more information and resources on quitlines, visit the links below.

Links