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.
  • 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. Click HERE to see a list of them.
  • 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. For examples of conversational scripts demonstrating this advice, click HERE.
  • 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. If the patient is NOT ready or willing to change their behavior, evidence shows that this may HARM their chances of making behavioral change in the near future(2).
  • 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. 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. For more detail on this step, click HERE.
  • 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 chart reminders to follow-up at a future visit, but there are more intensive strategies. Click HERE for a list of strategies.
  • Palm Users. If you have a hand-held computer, and would like a convenient version of this model on your device, click HERE [Coming Soon!] for more information.