5-A MODEL

• The 5-A Model is an algorithm, or "shorthand" structured intervention designed to facilitate an evidence-based, effective intervention in a short period of time with patients. Please view the 5-A "Flow Chart" (pdf file) HERE. Click each link on the left, or below, to learn more about each of the 5 A's.
  • Ask. Ask about smoking. Assessing the patient's smoking and related habits is the first step towards intervention. There are many tools available to the clinician.
  • Advise. Advise to make permanent lifestyle changes by complete smoking cessation. The clinician's advice to change a patient's behavior, shown to be effective in clinical trials, must be CLEAR, STRONG, and PERSONALIZED.
  • Assess. Assess the patients READINESS TO CHANGE, using the "STAGES OF CHANGE" model presented in this course. By "Staging" a patient in this way, the clinician can better "tailor" the plan of action with the patient.
  • Assist. Assist the patient in a plan of action. Smoking Cessation guidelines and plans are available, and should be tailored for the patient's particular needs. It is at this stage that the physician can give the patient specific materials and specific referral information for a smoking cessation program or self-help services (such as telephone quit-lines or websites). It is also at this stage that the physician can assist the patient set a Quit Date, and prescribe Nicotine Replacement Therapies and/or Zyban if appropriate.
  • Arrange. Arrange for some kind of clinical follow-up with the patient. This is important for the patient to know that the clinical health care system, as well as their clinician, will be following their progress. Minimally, the clinician should document with chart reminders to follow-up at a future visit, but there are more intensive strategies including phone contact and follow-up visits.
  • Palm Users. If you have a hand-held computer, and would like a convenient version of this model on your device, please read the "PDA Support" document under "Course Materials" for a description of how this might be used.