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Medically reviewed by, Russell Braun RPH
The statistics are staggering, tobacco is the leading cause of death worldwide. Approximately 1 person dies every six seconds from a tobacco related disease. According to the Centers for Disease Control (CDC) tobacco causes more than 7 million deaths every year. Can the 5 A’s of smoking cessation really help to stop the tidal wave of preventable deaths?
Nearly 50% of people who smoke for their lifetime will die due to tobacco related disease. Many in middle age, the prime of their adult life between 35-69 years of age. Another concern is the other diseases that tobacco use leads to. It is a risk factor for six out of the eight leading causes of death worldwide.
In addition to the damaging effects smoking has on the smoker, others are impacted as well. It is estimated that 7 million middle school and high school aged kids breath in second hand smoke at home or in a car. Getting smokers to quit is essential to prevent the damaging effects of second hand smoke on others.
“Tobacco is the single greatest preventable cause of disease and premature death in America today.”David Satcher, MD former U.S. Surgeon General
What is The 5 A Model?
The 5 A’s of smoking cessation is a model that uses different techniques to try and encourage people to stop smoking. It was developed by the U.S. Public Health Service to help drive smoking cessation. The model has been used internationally and has clinical trials supporting is effectiveness.
The A’s consist of:
The model was designed for healthcare workers to use on patients. However, it can easily be modified to use as a tool for personal use.
Taking a few minutes to run through these steps can help you establish goals and a plan of action for quitting smoking. In addition to smoking cessation the 5 A’s might also be applied for other behaviors and health problems. Obesity is another great example in which the 5 A’s are utilized.
What is The 5 A Framework?
The 5 A framework is about learning the impact of smoking on your health. It is also about learning the tips, tricks and techniques you can use to change your habit. Smoking is very habitual and many times you don’t even realize what triggers the habit. The 5 A’s helps open your eyes to these powerful habits so you can change them.
|Ask||Ask yourself how much are you REALLY using tobacco. Knowing how much you smoke you can help you identify the most appropriate tools needed to quit.|
|Advise||This is where a healthcare practitioner would advise you to quit smoking. However, if you’re reading this some part of you already knows you need to quit. Listen to that voice!|
|Assess||Ask yourself how determined you are to quit. Trying and failing can be demoralizing. However, everyone fails at something. If your willing to try and get the proper tools you can significantly increase your chances of success.|
|Assist||Help is on the way! Keep reading below to find information on tools and resources you can use to quit smoking. This may include counseling, pharmacotherapy and alternative treatments.|
|Arrange||If you are attempting to quit you’re going to need to arrange touchpoints with people you can talk to who will help you with quitting. Making sure these follow ups are arranged before you attempt to quit can be a game changer.|
What is The Most Successful Smoking Cessation Program?
Those who are most likely to drop the habit are those who are ready to quit. That is why ask is the first step in the 5A’s model. If your really not ready or willing to quit then the chances of success are low. However, many people can be persuaded when they think about the impacts smoking can have.
Ask Yourself About The Advantages to Quitting
|Packs smoked daily||Daily cost||Packs per year||Cost per year|
|1 1/2 Packs||$9.42||548||$3,441|
|2 1/2 Packs||$15.70||913||$5,733|
According to the National Cancer Institute the average cost of a pack of cigarettes is $6.28. As you can see these costs really add up over a year. However, what about your lifetime? Do you have a 10, 15 or even 20 year history of being a smoker? Curious of the lifetime cost at 1 pack a day?
$2,292 cost per year X 20 years = $45,840
Risk of Smoking Reward of Quitting
- Average life expectancy decreased by 10 years.
- Damages nearly ever organ in the body.
- Is a direct cause of cancer, heart disease, stroke, diabetes, chronic obstructive pulmonary disease (COPD) and emphysema
- Insurance premiums are higher for smokers.
- Improved health for you, kids, family and friends.
- Within 20 minutes heart rate and blood pressure drops.
- At 12 hours carbon monoxide levels drop.
- By 2 weeks your lung function starts to improve.
- At 1 to 9 months coughing and shortness of breath decrease.
- At 1 year risk of heart disease is half that of a smoker
Have Others Been Advising You To Quit?
If you smoke, your more likely to be in healthcare settings. Are the doctors, nurses and maybe your pharmacist telling you to quit? What about friends and family?
Because most people know how bad smoking is for you they are likely to say something. The voice in your head tells you to listen but you think about how powerful the addiction is. Ultimately, you have not stopped smoking yet due to one reason… fear
That’s right fear of:
- A period of misery due to cravings that may go on for an unknown duration.
- Social events will not be as enjoyable without cigarettes.
- Fear of failing and feeling shame about that.
- Inability to handle stress without a cigarette to calm you down.
- Fear that you will always have a desire to smoke.
These fears override the advise you get from others. If that sounds familiar to you then you should read the book Easy Way to Stop Smoking by Allen Carr.
Are you really ready to quit?
Probably not until you get the knowledge on what it takes to be successful in quitting. Then you need to devise a plan for quitting and get the resources you will need.
Have you recently had a scare with your health, or some other motivator? That is great that you have had a wakeup call, but it is important to understand this will take more than just willpower.
Assessing yourself and your readiness to quit requires some deep reflection. Do you know the most important steps to ensure success? On average about 3% of people who attempt to quit are successful. That is because most don’t devise a plan consisting of the 5 A’s of smoking cessation.
Assess your social situation
If you proclaim to friends and family that you’re quitting are the going to be on your side? It has been said that “you are the average of the five people you spend the most time with.” Ask yourself do those people also smoke?
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Ask For Others To Assist
This is the meat and potatoes of being able to successfully quit. Quite possibly the most important of the 5A’s of smoking cessation. Ask for some help!
Take these key steps below to make sure you kick the habit for good.
- Set a quit date far enough out that you have time to do steps 2-10 first. Typically 1-2 weeks out.
- Get and read the book Easy way to quit smoking.
- Find an accountability partner.
- Tell your doctor & pharmacist your quitting. They can prescriber medications or show you the nicotine replacement products (NRT) you need and how to use them.
- Find a group you can go to for support. This could be online or in person, think of it as a mastermind for quitters.
- Review information at www.smokefree.gov, the section on triggers is very useful.
- Sign up for text messages at the National Cancer Institutes text message service, text QUIT to 47848.
- Start exercising before the quit date.
- Schedule follow ups after the quit date
- Stop cold turkey on your quit date.
What is Included in Smoking Cessation?
Smoking cessation involves several components as you can see from the list above. However, there are many over the counter medications that can be used to ease nicotine cravings. These products are referred to as nicotine replacement therapy (NRT).
You should choose these products based on how much you currently smoke. That means keeping track of how many cigarettes you actually smoke per day.
The easy way to do this is to keep a smoking diary for the week leading up to your quit date. Keep a smoking journal and write down the exact time you smoke and the reason your smoking. This can be a huge advantage when you go to quit as you will have triggers throughout the day identified. Knowing what the triggers are will allow you to avoid them.
NRT is available in the following forms:
- Nasal spray
Normally the patches are used as a baseline to help replace the daily overall nicotine dose. Then you can use the other forms as support during times of cravings. Many people ask if they can use more than one product at a time. The answer is yes!
Click below for much more information on NRT and how to properly use it.
Arrange Follow ups
Getting follow ups from the right people is a must. Meet with your accountability partner, doctor, pharmacist, family and friends all within a week after the quit date . Tell them how it is going, what your struggling with. They can all add different perspectives on how to deal with quitting.
Talking it out and following up helps you to:
- Cope with triggers
- Talk about upcoming events that may be a trigger.
- Tweak things with NRT treatment
- Provide positive feedback
There is no better motivator than a reward for a job well done. The same is true of smoking cessation. Celebrate a smoke free day each night before bedtime. Reward yourself once a week with a special surprise to bring to light the fact you have quit.
Post your success on social media to help motivate others. Also, you will get a reward from the positive feedback you get from all your friends.
Do The 5 A’s of Smoking Cessation Work?
Studies have looked at the 5 A’s of smoking cessation model. They found the more parts of the process that were utilized the higher the success rates.
Almost 80% of patients in the study said they had been asked about smoking cessation. Of those who were asked, advised, assessed and assisted in receiving medication, 8.9% had not smoked at 30 days. Those who combined medication with counseling and support were nearly twice as like to quit at 30 days.
Completing all the steps and including the follow up with an accountability partner would increase these numbers significantly more.
At this point it is not a question of what to do, but rather ensuring the 5 A’s of smoking cessation process is followed. Unfortunately, healthcare workers do not always complete the 5 A’s. However, the good news is you now have the knowledge to complete this effective process yourself.
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Share Your Story
Have you tried to stop smoking using the 5A’s of smoking cessation? Chime in below with your comments and thoughts.
Quinn, Virginia et. al. Effectiveness of the 5-As tobacco cessation treatments in nine HMOs. J Gen Intern Med. 2009 Feb;24(2): 149-154.
Martinez, C, Factors associated with implementation of the 5A’s smoking cessation model. Too Induc Dis. 2017 Nov;(15): 41-43.