Ask-Advise-Refer Increases Referrals to a Smoking Cessation Group Clinic

People 2010 objective for smoking cessation is to decrease smoking prevalence to less than 12 % of all Americans by 2010.1 However, the Centers for Disease Control and Pre-vention (CDC) estimated the prevalence of cigarette smoking among adult Americans as 19.8 % in 2007,2 which has decreased minimally from 22.5 % in 2002.3 To achieve the Healthy People 2010 objective, health-care professionals must address smoking cessation at ev-ery patient visit. The “5 As ” remains a traditional method for tobacco cessation counseling4: (A1) ask about tobacco use, (A2) advise the patient to quit, (A3) assess willing-ness to quit, (A4) assist with the quit attempt, and (A5) arrange follow-up assistance.5 The Public Health Service Clinical Practice Guideline on treating tobacco use and dependence recommends that, at a minimum, clinician