‍This information is a short overview of Quit’s brief advice model.
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‍People who smoke generally use the health system more than people who do not smoke. Most people who smoke regret starting and want to quit. Stopping smoking reducesdisease risk, improves recovery, can boost treatment outcomes, and enhances overall health.

For many people who smoke, experiencing an episode of ill-health provides great motivation to make a quit attempt. Advice and support from a healthcare professional greatly increases the chances of initiating a quit attempt and maintaining long-term success.

However,many health practitioners find it difficult to prioritise smoking cessationamongst other competing health needs.

The Ask, Advise, Help model is a simple, quick, cost-effective, evidence-based approach endorsed by both the Royal Australian College of General Practitioners (RACGP) and theWorld Health Organization (WHO) as best practice for all healthcare professionals.

Brief Advice

Smoking cessation support is best provided by health professionals in the form of brief advice. In this model, health professionals encouragepatients/clients to use a combination of twobest-practice treatments:

1. Multi-session behavioural intervention (Quitline telephone support)

2. Stop smoking medications (including nicotine replacement therapy).

The brief advice model is used to motivate people to quit smoking and direct them to the right treatment over the course of a short conversation; it does not expect health professionals to deliver time-intensive multi-session interventions.

Ask, Advise and Help

The brief advice model has been designed to be delivered by all health professionals in as little as 3 minutes in just 3 short steps:

1. Ask all patients/clients about their smoking status and document answers in their medical records.

The questions include: “Do you currently smoke?”, “How do you feel about your smoking at the moment?”

2. Advise all patients/clients in a clear, non-confrontational tailored and relevant way that quitting smoking is one of the most effective steps they can take to improve their health. Tailor your advice to their current condition or reasons for visit for example:

“Stopping smoking will help with your recovery time and minimise complications after your surgery.”

“Stopping smoking will help improve your immune system and your recover time from illness.”

“It seems that you’re out of breath a lot recently. Smoking is known to affect people’s breathing. The best thing you can do today for your breathing is to quit smoking.”

Also advise on the most effective way to quit: “Did you know that combining counselling with stop smoking medication gives you the bestchance of quitting successfully?

3. Help patients/clients by referring them for a multi-session behavioural intervention (Quitline) and prescribing stop smoking medications (or facilitating access to stop smoking medications) such as nicotine replacement therapy.

“That’s fantastic that you’ve made a decision to quit smoking. I’m going to prescribe you some nicotine replacement therapy to help you manage the cravings you might get. After that, let’s make you a referral for the Quitline, they will support you to make a plan to give up smoking.”

This model of care is appropriate in all areas of the health system and can be used by any health professional.

This short video demonstrates the power that conversations, led by health professionals, can have to influence a patient’s decision to quit smoking.

Brief advice is appropriate in all areas of the health system and can be used by any health professional.

Further reading

1. Kotz D, Brown J, West R. ‘Real-world’ effectiveness of smoking cessation treatments: a population study. Addiction. 2014;109(3):491-499. https://doi.org/10.1111/add.12429
2. Stead L., Bergson G., Lancaster T. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews. 2008; (2). doi: 10.1002/14651858.CD000165.pub4
3. Alfred Health. Start the Conversation. http://starttheconversation.org.au/

The stories on this site are about real patients and clinicians. They share their experiences about the life-changing conversations that resulted in people quitting smoking.

While pharmacotherapy is integral to treating nicotine dependence, it does not deal with the behavioural and habitual challenges of stopping smoking. For busy health professionals, the Brief Advice model recommends referring onwards.

The Quitline telephone support service provides patients/clients with specialist behavioural interventions over multiple sessions for no charge.

Studies have found that patients referred to the Quitline, in comparison with in-practice management by a GP, were almost twice as likely to be abstinent at three months.

Opt-out referral

Referrals to Quitline can be made reactively where a patient/client initiates the call to the Quitline themselves, or they can be made proactively where the Quitline initiates contact with a patient/client after a referral from a health practitioner.

Evidence shows that patients who are proactively referred to the Quitline by a health practitioner are 13 times more likely to continue through with the cessation treatment than when a patient calls the Quitline themselves.

Given the efficacy of referral to the Quitline, Cancer Council WA recommends that all patients who smoke and consent to assistance be referred automatically to the Quitline. Under this method, it is up to the patient to refuse the assistance of the Quitline, rather than the patient’s responsibility to initiate the call. This opt-out method is likely to result in far greater uptake of the Quitline.

Making a referral to Quitline

Cancer Council South Australia runs and coordinates the Quitline for WA users.

Making a referral to the Quitline for your patient/client is fairly simple. There are three options:

1. Use the online referral form to refer your patient/client to the Quitline.
2. Call the Quitline with your patient/client to initiate support with a Quitline counsellor directly. The Quitline can be reached on 13 7848.
3. Webchat is also available.

Further reading

1. Vidrane JI, Shete S, Cao Y, Greisinger A, Harmonson P, Sharp B, et al. Ask-Advise-Connect: a new approach to smoking cessation treatment delivery in health care settings. JAMA Internal Medicine. 2013; 173(6);458-64. doi:10.1001/jamainternmed.2013.3751
2. Borland R, Balmford J, Bishop N, Segan C, Piterman L, McKay-Brown L, et al. In-practice management versus quitline referral for enhancing smoking cessation in general practice: a cluster randomised trial. Family practice. 2008;25(5):382-9. https://doi.org/10.1093/fampra/cmn046

While pharmacotherapy is integral to treating nicotine dependence, it does not deal with the behavioural and habitual challenges of stopping smoking. For busy health professionals, the Brief Advice model recommends referring onwards.

The Quitline telephone support service provides patients/clients with specialist behavioural interventions over multiple sessions for no charge.

Studies have found that patients referred to the Quitline, in comparison with in-practice management by a GP, were almost twice as likely to be abstinent at three months.

Opt-out referral

Referrals to Quitline can be made reactively where a patient/client initiates the call to the Quitline themselves, or they can be made proactively where the Quitline initiates contact with a patient/client after a referral from a health practitioner.

Evidence shows that patients who are proactively referred to the Quitline by a health practitioner are 13 times more likely to continue through with the cessation treatment than when a patient calls the Quitline themselves.

Given the efficacy of referral to the Quitline, Cancer Council WA recommends that all patients who smoke and consent to assistance be referred automatically to the Quitline. Under this method, it is up to the patient to refuse the assistance of the Quitline, rather than the patient’s responsibility to initiate the call. This opt-out method is likely to result in far greater uptake of the Quitline.

Making a referral to Quitline

Cancer Council South Australia runs and coordinates the Quitline for WA users.

Making a referral to the Quitline for your patient/client is fairly simple. There are three options:

1. Use the online referral form to refer your patient/client to the Quitline.
2. Call the Quitline with your patient/client to initiate support with a Quitline counsellor directly. The Quitline can be reached on 13 7848.
3. Webchat is also available.

Further reading

1. Vidrane JI, Shete S, Cao Y, Greisinger A, Harmonson P, Sharp B, et al. Ask-Advise-Connect: a new approach to smoking cessation treatment delivery in health care settings. JAMA Internal Medicine. 2013; 173(6);458-64. doi:10.1001/jamainternmed.2013.3751
2. Borland R, Balmford J, Bishop N, Segan C, Piterman L, McKay-Brown L, et al. In-practice management versus quitline referral for enhancing smoking cessation in general practice: a cluster randomised trial. Family practice. 2008;25(5):382-9. https://doi.org/10.1093/fampra/cmn046