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Because 44 million Americans still smoke, clinicians
will inevitably encounter smoking patients in their practices.
When a health professional has a smoking patient,
three responses are possible:
1) Do nothing
2) Use the full Five A’s protocol
3) Use of the Five A's in a new way
The first choice is unacceptable. Given that intervening with
a smoking patient 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 smoking or 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 smoking patients through them.
For those who can’t there is an alternative. You 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.
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