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The widely recommended 5As strategy for brief smoking cessation includes five tasks: Ask, Advise, Assess, Assist, and Arrange. Assessments of the 5As have been limited to medical-record review and self-report. Using observational data, an instrument to assess the rate at which the 5As are accomplished was developed.
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Worksheet Instructions: Several common triggers are listed below. Check your key triggers and add any that are missing. Then, circle your top 5 triggers.
Please rate your feelings about the possibility of quitting smoking. For each scale, circle the number that shows how you feel about quitting smoking today.
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