Tobacco Resources

Ask. Advise. Refer. (AAR) – Three Minutes or Less Can Save Lives

The advice of a health care professional can more than double smoking cessation success rates. Since we know that tobacco and nicotine use has significant imact on the health of the smoker, it is recommended that physicians use 2 A’s and an R Program (ask, advise, and refer) to promote smoking cessation.

Step 1: Ask.

While collecting vital signs, a nurse or medical assistant can ask the patient whether he or she smokes or uses other forms of tobacco, and document the patient’s tobacco use status in the chart or electronic health record.

Step 2: Advise.

You can briefly advise the patient to quit by saying something like, “I see that you smoke. Quitting smoking is one of the most important things you can do for your health right now. Have you thought about quitting?” This advice works best when delivered in a nonjudgmental tone.

You can make the advice more compelling by personalizing it: for example, by linking it to the reason for the patient’s visit.

Step 3: Refer.

For patients who are interested in trying to quit, you, a nurse, or other members of your team can refer patients to Quitline Iowa or other community counseling resources. Quitline Iowa Learning Portal provides access to multiple educational modules that will help care for patients with tobacco dependence by providing important tools and resources.