Five Major Steps to Intervention (The "5 A's")

Successful intervention begins with identifying users and appropriate interventions based upon the patient's willingness to quit. The five major steps to intervention are the "5 A's": Ask, Advise, Assess, Assist, and Arrange.
  1. Ask - Identify and document tobacco use status for every patient at every visit. (You may wish to develop your own vital signs sticker, based on the sample below).
  2. Advise - In a clear, strong, and personalized manner, urge every tobacco user to quit.
  3. Assess - Is the tobacco user willing to make a quit attempt at this time?
  4. Assist - For the patient willing to make a quit attempt, use counseling and pharmacotherapy to help him or her quit. (See Counseling Patients To Quit and pharmacotherapy information in this packet).
  5. Arrange - Schedule followup contact, in person or by telephone, preferably within the first week after the quit date.

Vital Signs

Blood Pressure:__________________________________________

Pulse:__________________ Weight:__________________


Respiratory Rate:________________________________________

Tobacco Use:        Current        Former        Never        (circle one)

* Alternatives to expanding the vital signs are to place tobacco-use status stickers on all patient charts or to indicate tobacco use status using electronic medical records or computer reminder systems.

Page last reviewed December 2012
Page originally created December 2012
Internet Citation: Five Major Steps to Intervention (The "5 A's"). Content last reviewed December 2012. Agency for Healthcare Research and Quality, Rockville, MD.
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