MUS - Tobacco Cessation Contract - Wellness 2025

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Physicians and qualified nonphysician practitioners can bill Medicare for smoking and tobacco-use cessation counseling.
Smoking remains the leading cause of preventable mortality in the US. The national clinical guideline recommends an intervention for tobacco use known as the 5-As (Ask, Advise, Assess, Assist, and Arrange).
Traditionally, the process of taking up smoking has been conceptualised as a progression through stages, including precontemplation, smoking preparation, trying cigarettes, experimentation, regular smoking, and addiction.
43. The 5 As Model for Treating Tobacco Use and Dependence-2008 Ask about tobacco use. Advise to quit. Assess willingness to make a quit attempt. Assist in quit attempt. For patients unwilling to quit at the time, provide interventions designed to increase future quit attempts. Arrange followup.
The clinician can motivate patients to consider a quit attempt with the 5 Rs: Relevance, Risks, Rewards, Roadblocks, and Repetition.

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Recommendation Summary The USPSTF recommends that clinicians ask all adults about tobacco use, advise them to stop using tobacco, and provide behavioral interventions and US Food and Drug Administration (FDA)--approved pharmacotherapy for cessation to nonpregnant adults who use tobacco.
The widely recommended 5As strategy for brief smoking cessation includes five tasks: Ask, Advise, Assess, Assist, and Arrange.
The 5 Rs: Relevance, Risks, Rewards, Roadblocks, and Repetition. are designed to motivate smokers who are unwilling to quit at this time. Smokers may be unwilling to quit due to misinformation, concern about the effects of quitting or demoralization because of previous unsuccessful quit attempts.

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