Get Ready:

1. Organize the office team - plan together

• All team members should help plan and implement the program
• Agree on a plan coordinator
• Various duties may be distributed among team members
• A well-informed team is important for effective tobacco intervention

2. Organize a tobacco-free office environment

• Display tobacco prevention and cessation materials and eliminate magazine tobacco advertising in the reception area

3. Organize office records, codes, and procedures

• Tobacco use on medical history, 5 A's Chart Stickers and Follow-Up System, status chart stickers, central system for follow-up

4. Organize patient literature

• Tobacco Cessation Pamphlets

ASK - systematically identify all tobacco users at every visit

• Do you use tobacco? How do you feel about your tobacco use?
• Have you ever thought about quitting - or quit in the past?
• If we could help you quit, would you be interested?

ADVISE - urge all tobacco users to quit

• Show the oral effects of tobacco if present
• Advise clearly the risks of continued use and emphasize the benefits of stopping
• Personalize the cessation message using a non-judgmental, low-key, sensitive, and caring manner
• Commend nonusers

ASSESS - determine willingness to make a quit attempt

• Use an intervention appropriate to their stage of change

ASSIST - aid patients in quitting

• Discuss patients reasons for quitting, previous quit attempts, triggers and challenges
• Provide and discuss self-help materials
• Discuss possible withdrawal symptoms, weight gain, and coping tips
• Encourage patients to develop their individualized plans and seek social support
• Encourage a quit date if patient is ready
• Recommend tobacco cessation programs in the community and phone helplines
• Use pharmacotherapy except in the presence of contraindications

ARRANGE - schedule follow-up contact

• Arrange follow-up for those patients who want help (telephone calls, office visits, letters, or some combination)
• Have a system for continuing patient contact and record follow-up progress
• Follow Through With Your Community: Participate in organizations that educate, assist high-user populations, and help prevent children from starting to use tobacco