5. The Five A's: #3 - Assess

To be able to assist a client with smoking cessation you need to be able to assess your client's willingness to commit to this change. Here is a flow chart to help you determine where your client stands.

Does the client currently use tobacco products? Yes or No	No: Has the client used tobacco products in the past? Yes or No	No: No intervention is required for this client. Please encourage continued abstinence.
		Yes: Assist with client's tobacco cessation maintenance in an attempt to prevent relapse.
	Yes: Is the client willing to quit at this time? Yes or No	No: Provide motivational materials to the client being sure to utilize the five R's model (see below).
		Yes: Provide appropriate tobacco cessation techniques using the five A's as a counseling tool.

Implementation: Ask every tobacco user if she is willing to make a cessation attempt at this time.

Some areas to address if the client is considering quitting.

As the Health Care Provider:

• Praise her for her readiness to quit smoking
• Help her set goals to maintain a smoke free lifestyle
• Discuss an action plan to assist her in smoking cessation
• Inquire about her support network
• Respond to her specific concerns about quitting smoking

Possible Goals:

To not have a cigarette before work
Not to smoke in the car
Not to smoke indoors
To make it through today without smoking
To go to the bar with friends and not smoke

Cessation Plans or Strategies:

Tapering (cutting) down (1 less cigarette today, 2 less tomorrow, etc.)
Cold turkey
Nicotine fading
Possibly a pharmacological method to assist with cessation

Possible Support Persons:

Close Friends
Family
Co-workers

Specific Concerns:

Stress - help her develop ways to manage stress (deep breathing exercises)
Weight gain - women need to gain weight during pregnancy so this may be a good time to quit
Withdrawal symptoms - not all smokers have withdrawal symptoms (signs of recovery) and, those who do, find that they will lessen over time.

< #2 - Advise

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