​SCREENING

“The USPSTF [U.S. Preventive Services Task Force] recommends that clinicians ask all adults about tobacco use and provide tobacco cessation interventions for those who use tobacco products.” Level A recommendation¹

Counseling

• Quit rates increase with the intensity of counseling (i.e. frequency and length) up to about 90 minutes of total counseling time.¹
• However, brief counseling (3 minutes or less) has been shown to be effective at increasing tobacco abstinence.^1-3

2 A’s + R Model

• Ask about tobacco use²
• Advise tobacco users to quit²
• Refer them to cessation services (e.g. 1-800-QUIT-NOW)²

 

5 A’s Model

•  

Ask about tobacco use^2,3

Advise tobacco users to quit^2,3

Assess willingness to attempt quitting^2,3

Assist in quit attempt^2,3

Arrange for follow-up^2,3

Motivational Interviewing

• A directive, patient-centered counseling technique that helps patients recognize thoughts and feelings that lead to their continuation of unhealthy behaviors and helps them alter thought patterns to assist behavior change.⁴
• The goal of motivational interviewing is to help patients move through the stages of readiness for change:he goal of motivational interviewing is to help patients move through the stages of readiness for change:
  • Precontemplation: The patient does not acknowledge a problem.⁴
  • Contemplation: The patient recognizes a problem and is thinking about treatment or behavior modification.⁴
  • Action: The patient starts treatment or behavior modification.⁴
  • Maintenance: The patient integrates new behavior into everyday life.⁴
  • Relapse: The patient falls back to the undesired behavior.⁴ 

1. Final Recommendation Statement: Tobacco Use in Adults and Pregnant Women: Counseling and Interventions. Retrieved October 7, 2014 from U.S. Preventive Services Task Force Website:  http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions.
2. Counseling About Smoking Cessation. Retrieved October 3, 2014 from American Academy of Pediatrics: Julius B. Richmond Center of Excellence Website: http://www2.aap.org/richmondcenter/CounselingAboutSmokingCessation.html.
3. American College of Obstetricians and Gynecologists. (2011). ACOG Committee Opinion 503: Tobacco Use and Women’s Health. Washington, DC:  American College of Obstetricians and Gynecologists.  Available Online: http://www.acog.org/-/media/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/co503.pdf?dmc=1&ts=20141016T2150223316. 
4. American College of Obstetricians and Gynecologist. (2009). ACOG Committee Opinion 423: Motivational Interviewing: A Tool for Behavior Change. Washington, DC: American College of Obstetricians and Gynecologist. Available Online: http://www.acog.org/-/media/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/co423.pdf?dmc=1&ts=20141016T2154558634.