Effectiveness of 5-As for smoking cessation

As per a report published on US National Library of Medicine National Institutes of Health, in the list of leading causes of preventable morbidity and even mortality, smoking is on the top.

Despite that fact, it is a major contributor, 45 million (approx) adults in the US continue to smoke and 1200 die prematurely every day from nicotine related disease. The direct medical cost in annual smoking-attributable expenditures is approximately $96 billion and it is $97 billion in lost productivity. It is also a concerning sign that among U.S. adults, the 7-year decline in smoking prevalence has also ended.

So it is evident that there is a dire need for an effective clinical guideline just like 5-As. What are 5-As?

Ø Ask

Ø Advice

Ø Assess

Ø Assist

Ø Arrange

Demonstration of the 5As

There is an easy way to understand 5-As from the story of Kelly, who visited her doctor and he applied the same to her.

The doctor prescribed her some antibiotics for a lung infection. Now he said that he is hoping that they can talk about smoking today. That's something she’d be comfortable talking about. Kelly accepted the offer.


The doctor asked about smoking per day. Kelly replied with 15 to 20 cigarettes and added that she has been smoking for 20 years. According to the doctor, it’s a long time and she must understand that right now quitting smoking will be the most effective thing that she could do to improve her health especially in the context of her lung infections.

Kelly replied that she had tired in the past and she got so cranky, angry and frustrated. It was very hard for her. The doctor said though she found it tough in past but what if she is going to quit smoking in the next 30 days? Kelly was surprised and said that she hadn’t thought about it but she supposes she could give it a try.