Table 1.

Operationalized definitions of 5A’s tasks

5A’s task	U.S. Public Health Service definition	5A-DOC operationalized definition
Ask	Identify and document tobacco use status for every patient at every visit.	Is tobacco use identified in any way during the encounter?
Advise	In a clear, strong, and personalized manner, urge every tobacco user to quit.	Are specific reasons to quit given that are intended to be relevant to the patient? Is there a clear message to quit smoking?
Assess	Ask every tobacco user if he or she is willing to make a quit attempt at this time (e.g., within the next 30 days).	Is the patient’s readiness to make a quit attempt in the near future determined?
Assist	For the patient willing to make a quit attempt, use counseling, pharmacotherapy, and supplementary materials to help him or her quit.	Are attempts made to construct a plan of action for tobacco cessation? Are specific strategies suggested or explained? Is the patient referred to an outside source for assistance in cessation?
Arrange	Schedule follow-up contact, preferably within the first week after the quit date.	Is there a follow-up appointment scheduled with the stated purpose of monitoring tobacco-cessation efforts?