Ask: systems should be established in each clinic that identify the smoking status of each patient and that communicate this status to physicians.
Advise: a personalized, open, and reflective patient-centered discussion should be provided on how smoking cessation can help patients achieve their goals.
Assess: it should be determined whether patients are ready to consider attempting to quit and, if ready, how confident they are about success.
Assist: for those not yet ready to attempt quitting, communication lines should be kept open for motivational messages, to let them know help is available when they are ready. For those who are ready, a menu of available pharmacotherapy and counseling options should be provided. First-line pharmacotherapy doubles the success rate of a quit attempt.
Arrange follow-up: patients should be connected with a counseling follow-up within a week of their quit date. This can be with a telephone counseling quit line, with face-to-face group or individual counseling, or with return clinic visits or telephone calls from the clinic.