Integration of the 5As Nicotine Cessation Framework in a Primary Care Clinic

J Nurs Care Qual. 2022 Jul-Sep;37(3):257-262. doi: 10.1097/NCQ.0000000000000622. Epub 2022 Feb 28.


Background: Nicotine causes significant morbidity and mortality. Many adults who want to quit using nicotine may not be receiving adequate support from their primary care providers. If used properly, the 5As nicotine cessation guidelines may help patients address their nicotine use.

Local problem: Smokers screened for tobacco use at a primary care clinic were not consistently offered evidence-based interventions using the 5As at each primary care encounter.

Methods: The 5As framework was presented to providers via PowerPoint presentation and printed materials. Provider and patient behaviors were measured using data from pre- and postintervention chart reviews.

Results: There was a statistically significant postintervention increase in the proportion of smokers who received the 5As components (P < .001). Patients' nicotine use decreased post-intervention.

Conclusion: Results suggest that the intervention increased providers' knowledge and use of the 5As, which helped patients reduce their nicotine use.

MeSH terms

  • Adult
  • Delivery of Health Care
  • Humans
  • Nicotine
  • Primary Health Care
  • Smokers
  • Smoking Cessation* / methods


  • Nicotine