5As | Patients’ survey | Physicians’ survey |
---|---|---|
Ask | Have you been asked about your tobacco consumption habit during today’s visit? | Do you take the history of tobacco usage of the patients who come to you? |
Advise | Did your physician advise you to quit tobacco? | Do you tell people who come to you to quit tobacco use? |
Assess | Did your physician ask for your willingness to quit? | Do you ask whether patient is willing to quit tobacco? |
Assist | Did your physician inform you about different medicines for quitting? | During the past 12 months, did you suggest nicotine replacement therapy such as a patch or gum? |
Did your physician suggest ways to quit tobacco use? | During the past 12 months, did you perform one time counselling to your patients to help them quit? | |
Did your physician provide you any printed material (take away material)? | Have you ever given any printed material (take away material) to the patient? | |
Arrange | Did your physician inform you about the further follow up at higher centres? | During the past 12 months, did you arrange for counselling with follow-ups? |
Did your physician tell you when to return for follow-up counselling? |