Smoking cessation behavioral change models Flashcards
1
Q
What are the 5 A’s?
A
- Ask–> about tobacco use/smoking status
- Assess–>Extent of current use and readiness to make a quit attempt
- Advise–>Tobacco users to quit and discuss benefits of qutting
- Assist–> With the quit attempt via non-pharm and pharm interventions
- Arrange–>Follow-up care
2
Q
ASK about tobacco
A
- Identify and document tobacco use status for every patient at every visit
3
Q
ASSESS nicotine dependence
A
- Number of cigarettes per day
- Time to first (TTF) ciagrette
- Has the patient ever quit in the past?
- PMH/comorbidities
- Current medications
- Triggers?
- Challenges/barriers?
4
Q
ADVISE to quit
A
- In a clear, strong and personalized manner, urge every tobacco user to quit
- Focus on the benefits
5
Q
ASSIST with treatment options
A
- For the patient willing to make a quit attempt, offer medication and counseling or additional treatment to help patient quit(set a quit date,discuss support system)
- For patients unwilling to quit at the time, move to using the 5 R’s
6
Q
ARRANGE follow up
A
- For the patient willing to make a quit attempt, arrange for follow up contacts, beginning w/in the first 2-4 weeks after the quit date
- Discuss past quit attempts
- For the patients unwilling to make a quit attempt at the time, address tobacco dependence and willingness to quit at next clinic visit; use 5 R’s
7
Q
Stages of change
A
- Pre-contemplation
- Contemplation
- Preparation
- Action
- Maintenance
8
Q
Pre-contemplation
A
- Patient does not even consider changing
- Patient is “in denial”
- Patient may not see the advice applies to them personally
9
Q
Contemplation
A
- Patient is undecided about change
- Giving up the behavior causes them to feel a sense of loss despite percieved gain
10
Q
Preparation
A
- Patient is preparing to make a specific change
- Patient may experiment with small changes as their determination to change increases
11
Q
Action
A
- Patient is fully implementing change
- Proper preparation in previous stages can lead to better results
12
Q
Maintenance
A
- Relapse prevention
- Encourage patients not to give up over ocassional slips
13
Q
The 5 R’s model
A
- Relevance
- Risks
- Rewards
- Roadblocks
- Repetition
14
Q
Relevance
A
- Encourage the patient to indicate why quitting personally relevant
- Motivational interviewing has greater impact if it is relevant to the patient’s situation
15
Q
Risks
A
- Ask the patient to identify potential negative consequences of tobacco use
- Suggest or highlight those that are most relevant to the patient
