Standardizing Tobacco Cessation Counseling Using the 5 A's Intervention

Tobacco use is the leading cause of preventable death due to cardiovascular disease.

Tobacco cessation counseling (TCC) is varied among providers, leading to suboptimal willingness to make a quit attempt.

We used a quality improvement framework to pilot the 5 A's for TCC from April 2021 to August 2021 in our outpatient cardiology clinic.

Providers implemented TCC using the 5 A's intervention. Patient follow-up phone calls were conducted 30 days after receiving TCC.

Of 629 patient encounters, the mean TCC rate increased by 27.5%, and the mean reported cessation rates improved by 3.9%. Variation among providers decreased for TCC rates when they used the 5 A's intervention.

The 5 A's intervention standardized TCC efforts. Using the 5 A's led to an increase in patients who reported smoking cessation 30 days after TCC was received.