Tobacco dependence is a chronic relapsing condition that requires repeated intervention & a very systematic approach to stop it.

When councelling patients about smoking cessation, do mention briefly about smoking cessation intervention 5 A’s .

5 A’s are as follows:

1. ASK : Ask patient’s tobacco history & how many times he/she uses in a day. Also ask them about any quit attempts they made & failed. Help them identify what didn’t work in previous quit attempts.

2. ADVICE : They should be advised to quit by being supportive. Advice them in strong, clear & personalised manner. Personalised manner here refers to the strong reason that made his/her mind to quit but is unable to do so. Help them know that you are committed to help them quit when they are ready.

3. ASSESS : Here we assess that whether the patient is really ready to make a quit attempt. We ask the patients to rate their efforts on a scale of 1-10. 1 number meaning not being ready to quit . 10 meaning, ready to stop using tobacco right now.

In this way, we can assess what all barriers are coming in their way while making a quit attempt. In this we can also access nicotine dependence that the person is going through.

4. ASSIST : Assist individual interested in quitting. Make a plan for them. Every individual will have different quit plans & goals. Some may have plan of quickly cutting down the habit, others may take time to gradually cut down. Tell them to discuss about this from their families & friends and gain support.

Offer them behavioural support. Help them access resources that will be helpful in quit attempts by sharing about Nicotine Replacement Therapy.

5. ARRANGE : Always arrange up a follow up meeting/ phone calls to check their progress. Patient with follow up treatment are more likely to sustain their quit attempt.

Congratulate about small successful changes you see in them like reduction in daily tobacco consumption or avoiding smoking in difficult situations.