Rethink five A's of smoking cessation

LETTER — Posted Sept. 5, 2005

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Regarding "Time to enhance '5 A's' of smoking cessation?" (Article, July 25): I remember learning this in residency seven years ago and thinking that Ask and Assess were too similar to list separately. I also produced an interactive handout to be used by both physician and patient with a sixth A: Anticipate, that is, anticipate risks for relapses. If you want a seventh A, Address them proactively. Also, to push an eighth one, we must make ourselves Available to the struggling patient who now needs more of our support than usual.

I suggest a revision of the 5 A's. Assess, which includes ask and assess; Advise; Assist, which includes arrangements for referrals, etc.; Anticipate relapses; and, finally, Available, as above.

The bottom line is for physicians to do the first A. The interested physician will know how to follow up with the rest of the discussion from there.

Carlos Vargas, MD, Franklin, N.C.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/09/05/edlt0905.htm.

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