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Screening for smoking

Screening for smoking: Tips

The most important element of a tobacco use screening program is a reliable system to remind you to ask all patients if they smoke. Reminders to screen can come from a computer system or from your staff, or they can appear on the patient's chart.

In addition to having a reliable screening reminder system, follow these specific practices in your screening program:

  • Identify the smoking status of all patients over age 10 on every visit.
  • Congratulate patients who don't smoke or who have quit.
  • Tell patients who smoke that quitting would be the single most important change they could make in their health.
  • Ask all patients who smoke if they are considering quitting.
  • If patients are not considering quitting, ask what might be the reasons.
  • If patients are considering quitting, congratulate them and ask when they might be willing to try quitting.
  • If patients are willing to try quitting within the next month, suggest a follow-up visit to discuss it.
  • If patients are willing to try to quit in the next year, tell them that you can help when they need it.

Screening steps

The "five As" are an easy way to remember the key steps of screening for smoking cessation:

Ask: Identify in their chart all patients who smoke.

Advise: Find a kind but clear, forceful and personalized way of recommending that the patient quit.

Assess: Check out the patient's readiness to quit.

Assist: Offer assistance whether the patient is ready or not.

Arrange: Arrange for the patient to follow up with you or at a smoking cessation clinic.

Provincial regulations may allow doctors to bill for screening for smoking. For example, in Ontario, the Ministry of Health and Long-Term Care has provided extra fee codes that physicians can use in addition to codes for regular visits if they complete the five As with patients.

More information about provincial billing codes.