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Introduction Brief Clinical Interventions Beginning the Brief Clinical Intervention Stages of Change Stages of Change Information 4 A’s, 5 R’s SOC & Main Interventions Quick Reference Active Living BCI Tool using Stages of Change Healthy Eating, Healthy Weights BCI Tool using Stages of Change Low Risk Drinking BCI Tool using Stages of Change Tobacco-free Living Smoking Cessation Intervention (4 A’s Program) BCI Tool using Stages of Change Resource Options Links Health Promotion Calendar Health Connection Flyer Call to Action Health Professionals –Take the Challenge Endnotes

Smoking Cessation Intervention - 4 A’s Program

Ask about tobacco use at every contact with clients
Advise all tobacco users to consider quitting
Assist according to client readiness/stages of change
Arrange offer to arrange for follow-up/referral

ASK

Have you used any tobacco products in the last 6 months?

ADVISE

As your health care provider, the most important advice I can give you is to stop smoking.

ASSIST
INTERVENTION

MINIMAL INTENSIVE
  • referral to community resources
  • self-help material
  • referral to other health care providers
  • Smokers’ Helpline 1-877-513-5333
  • pros and cons
  • past experiences
  • stages of change
  • feelings & meaning of smoking
  • challenges and triggers
  • pharmacotherapy options
  • encourage and support
  • set a quit date

ARRANGE

Offer to arrange for follow-up or referral to smoking cessation program

Smoking Cessation - Stages of Change  

Assess client’s readiness to change and utilize the appropriate intervention.

Offer to arrange for follow-up or referral for clients in each stage of change as appropriate.

Pre-contemplation – Not thinking of quitting in the next 6 months.

Goals: Help client think about quitting.
Ask about feelings, pros and cons. Offer information.
Assist: Offer resources

Contemplation – Thinking of quitting in the next 6 months.

Goal: Help client move towards quitting soon. Increase self-confidence.
Ask about barriers to change. Explore creating smoke free spaces.

Preparation – Planning to quit in the next month.

Goal: Help client develop quitting skills.
Advise by identifying barriers to stopping and finding solutions.
Assist by providing information, devising an action plan, setting a quit date in the next 2 weeks and discuss NRT and/or pharmacotherapy.

Action – Quit in the last 6 months.

Goal: Help client not to smoke and understand slips and relapses.
Ask re: relapse prevention plan, triggers, successes, NRT and/or pharmacotherapy use.
Assist with resources/referrals, developing social support network.

Maintenance – Quit for more than 6 months.

Ask about planning for the future.
Advise on issues raised by client, reinforcing health benefits.
Assist with preparation for difficult situations.

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