ABSTRACT
Background and Aims
Guidelines recommend the 5As model of brief intervention for providing smoking cessation support in clinical settings. This study assessed patient and hospital characteristics associated with self‐reported receipt of the 5As (Ask, Advise, Assess, Assist, and Arrange).
Design
Multicenter cross‐sectional study.
Setting and participants
Adult inpatients (N = 1,047) were randomly selected from 13 hospitals in the Barcelona province of Spain in 2014‐2015.
Measurements
We explored participants’ receipt of the 5As through a questionnaire. Given the progressiveness of the 5As, we recoded the fulfillment of the intervention as: A0: no intervention; A1: Ask; A2: Ask and Advise; A3: A2 and Assess; A4: A3 and Assist; and A5: A4 and Arrange a follow‐up. We explored patient (e.g., age, sex, comorbidities) and hospital (e.g., type of hospital, unit) characteristics. We adjusted multilevel robust Poisson regression models to estimate the prevalence ratios (aPR) of the association between the recoded 5As intervention received.
Findings
A total of 60.4% (n=624) of patients had been asked (A1) about their smoking status. Among smokers, 46.5% (n=90) were advised (A2), 26.6% (n=48) assessed (A3) and 4.6% (n=10) received all the components of the 5As (A5). Middle‐aged smokers (aPR=3.63; 95%CI:1.69 to 7.79) with a respiratory disease (aPR=2.19; 95%CI:1.11 to 4.34) were most likely to have been asked, advised and assessed (A3). The cessation intervention was most frequently performed by physicians.
Conclusions
In the Barcelona province of Spain, it appears that less than half of hospitalized patients who smoke were advised to quit and few received the full ‘five As’ brief intervention for smoking cessation.