Tobacco Cessation Clinical Toolkit for Primary Care Teams
For the heart healthy quality improvement project, we promote the use of the 5As (Ask, Advise, Assess, Assist, and Arrange) as a basic model of identifying and addressing tobacco cessation with primary care patients. This works best when tobacco status is assessed as a vital sign during rooming. All of these steps could be done by the person who rooms the patient. We note that for patients who do smoke and are interested in quitting, incorporating the 5As adds a minute to the work of the medical assistant.
Resource 1 highlights a flowchart for practices to review and adapt. The flowchart promotes screening at every visit, medication to assist interested patients in quitting, and referral to the quit line using a direct e-referral, fax, or web referral. Direct referral to the quit line enhances uptake of telephonic counseling by patients as this approach allows the quit line to reach out directly to the referred patient.
We have also developed a tobacco cessation support toolkit with many additional resources and tools for medical practices when helping patients quit tobacco. Using the toolkit, practices can assess the best opportunity to improve tobacco cessation support for their patients.