School of Nursing


Doctor of Nursing Practice (DNP)


Kenneth Thompson


Smoking Cessation Education, Smoking Cessation Program, 5As, 5A’s, Smoking Cessation Counseling, Tobacco, Cigarette Smoking


Nursing | Social and Behavioral Sciences


Tobacco use represents a significant cause of morbidity and mortality in the U.S. and is a contributing risk factor for multiple pulmonary, cardiovascular, and oncologic diseases. Despite documented evidence of these health hazards, use of tobacco products remains high, particularly in rural America. While providers may frequently question patients regarding tobacco use and inform patients of associated health hazards, a standardized, structured process for delivering smoking cessation counseling (SCC) is rarely established in practice settings. One such method for standardization of SCC is the 5A’s (Ask, Advise, Assess, Assist, Arrange) model which has a robust body of evidence to support its efficacy. An evidence-based practice project to incorporate evidence-based SCC into practice at a clinic in rural Virginia was performed. Provider education concerning the 5A’s of SCC was delivered to all clinic providers along with educational handouts. Data collection involved baseline and postintervention retrospective chart review of provider rate of SCC performance and the percentage of patients who smoke cigarettes at the clinic. An increase in provider performance of SCC and a decrease in current smokers was identified on evaluation of 90-day postintervention data. Results suggest that the evidence-based intervention was successful at this clinic in producing desired outcomes, and other clinics may find this example of incorporating evidence-based SCC into practice helpful.