Friday, Sep 29, 2023

What are the 5 A’s of smoking cessation

Smoking cessation is extremely important in individuals who are addicted to smoking as smoking is a major risk factor for multiple medical comorbidities such as cardiovascular diseases and stroke. It is estimated that 70% and more of cardiovascular and stroke patients are active smokers.

Smoking cessation can be the very first thought in many individuals. However, most of them will have many hurdles and obstacles to overcome to completely stop smoking. Generally, there are 5 basic stages of smoking cessation, starting from precontemplation, contemplation, preparation, action and relapses stages. Thus, it is very vital to get help from a doctor or a specialist to help you throughout the journey of smoking cessation as it requires very careful monitoring and progress charts.

In this article, we are going to learn more on the 5A’s which is included in the brief clinical intervention of smoking cessation conducted by doctors in the quit smoking clinic. Continue reading for more information.

The 5A’s of smoking cessation

Generally there are two types of intervention practiced by doctors in quit smoking clinics which are the brief intervention and the intensive intervention. The brief intervention is targeted to all smokers regardless of whatever stage of change you are in. Here are the 5A’s of smoking cessation with brief explanation.

  1. Ask about tobacco smoking – This question is targeted to all smokers which is usually done opportunistically during a routine consultation. The doctors will usually ask these questions to know more about your tobacco smoking status on your addiction level and severity of withdrawal symptoms. It is crucial to know these statues as it may help the doctors to classify your category and help you further in smoking cessation.

Bear in mind to be always honest with your doctors as this is really helpful to assist your doctors to guide you throughout the smoking cessation process.

  1. Advice to quit – this is done to all patients who are currently smokers or labeled as active smokers, It is important to make sure that the doctors advice to be strong, clear and personalized. Here are some common examples of advice given to smoking patients.
  • Clear—”I think it is important for you to quit smoking now and I can help you.” “Cutting down while you are ill is not enough.”
  • Strong—”As your clinician, I need you to know that quitting smoking is the most important thing you can do to protect your health now and in the future. The clinic staff and I will help you.”
  • Personalised —Tie tobacco use to current health/illness, and/or its social and economic costs, motivation level/readiness to quit, and/or the impact of tobacco use on children and others in the household.
  1. Assess willingness to make a quit attempt – If the patient is willing to make a quit attempt, the role of a doctor is to provide further assistance on options of smoking cessation. On the other hand, for patients who clearly made an unwilling statement to quit smoking, the doctor will not try to assist but will provide motivational intervention which is built around the 5 R concept as below;

Relevance: why need to quit?

Risks: what are the potential negative consequences of tobacco use?

Rewards: what are the potential benefits of stopping?

Roadblocks: what barriers that patients fear/don’t want to stop?

Repetition: repeat motivational intervention in clinic setting

  1. Assist in quit attempt – Here are some of the preparation of quitting methods used by come doctors in clinical practice.
  • Set a quit date: should be ideally within 2 weeks on assessment to quit
  • Tell family, friends, co-workers and request understanding and support
  • Anticipate challenges to planned quit attempts (especially during critical few weeks)
  • Remove tobacco products from his/her environment
  1. Arrange follow ups – Do take note that the highest risk of relapse occurs during the first days of quitting, thus it is important to arrange adequate follow ups to monitor all the patients. These are the frequency of sessions recommended by some specialists around the world on the follow ups. There will be changes according to hospital or clinic settings.

Session 1: Pre-quit Assessment (1 or 2 weeks prior to Quit Date)

Session 2: Quit Date

Session 3: 1 week post Quit Date

Session 4: 2 weeks post Quit Date

Session 5: 3 weeks post Quit Date

Session 6: 4 weeks post Quit Date