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Guideline Syntheses: Treatment of Tobacco Dependence

All three guidelines recommend a variation of the “Five A’s” of treating tobacco dependence (Ask, Advise, Assess, Assist, and Arrange follow-up). According to this framework, all patients should be asked about tobacco use and should have their tobacco use status documented in the medical record on a regular basis. Tobacco users identified during screening should then be advised to seriously consider making a quit attempt using a clear and personalized message. Once a tobacco user is identified and advised to quit, the clinician should assess the patient’s willingness to quit. Patients not willing to quit should be offered a motivational intervention such as the “5 R’s”: Relevance (encourage the patient to indicate why quitting is personally relevant), Risks (ask the patient to identify potential negative consequences of tobacco use), Rewards (ask the patient to identify potential benefits of stopping tobacco use), Roadblocks (ask the patient to identify barriers or impediments to quitting), and Repetition (repeat the motivational intervention every time an unmotivated patient has an interaction with a clinician).

Posted in: Guidelines Plus on 10/29/2013 | Link to this post on IFP |
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