Fax to Assist - Module 2

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The A3C Clinical Model

Overview of Module 2

In this module you will learn:

The A3C for Brief Intervention

  • The A3C clinical model is a simple, brief way to address tobacco use with your clients.
  • The A3C clinical model consists of the following tasks: Ask, Advise, Assess, Connect
  • Adapted from the Agency for Healthcare Research and Quality (AHRQ) Guidelines for Treating Tobacco Use
  • Only takes 1 – 5 minutes to implement

1. ASK: Ask about Tobacco Use Every Time

  • Asking about tobacco use is just as important as taking a client’s blood pressure, asking about current symptoms, or any other standard procedure used in your office or clinic.
  • Because a person’s smoking status and readiness to make a quit attempt can change, it is important to discuss smoking with clients at each visit.
  • Ask clients:
    • Are you a current/former smoker?
    • How much do you smoke?
    • How long have you smoked?

2. ADVISE: Urge ALL tobacco users to quit

  • Utilize clear, concise, strong and personalized advice
  • Examples:
    • "It is important for your health to stop using tobacco right away."
    • "Quitting tobacco use is necessary for both your health and your family’s health."
    • "There are a number of different options to help you quit and we can talk about which are best for you."

3. ASSESS: Determine readiness to make a quit attempt

  • Talk to each tobacco user about his or her readiness to make a quit attempt at the time of their visit and mention Fax to Assist.
  • To assess readiness to quit: Determine where the smoker is in the process of change.
  • A ‘Readiness Ruler’ is a helpful tool to assess readiness to quit.
Measure Readiness with a Readiness Ruler

4. Connect: Connect tobacco users who are ready to quit directly to tobacco cessation treatment

  • Provide an array of possible treatment options
  • Fax to Assist through the Maryland Quitline
  • Smoking cessation groups
  • Local health department resources
  • Pharmacotherapy* *when medically advisable (consider pregnancy, other medications, allergies, etc.)
  • Help the client set a personal quit date

Additional information for providers who can spend more time with clients:

  • Teach Abstinence: Advise the client to avoid smoking even one puff after the quit date.
  • Consider past quit attempts: Discuss the negative and positive aspects of previous attempts
  • Identify triggers or barriers for this quit attempt and how to overcome them
  • Talk about alcohol use: For many quitters, alcohol can lead to relapse; talk to the client about reducing use or abstaining from alcohol during their quit attempt.
  • Living with other smokers: Clients may want to ask others in the home to make a quit attempt with them or not to smoke in their presence.

8. Summary of the A3C Clinical Model

A3C Clinical Model


Ask every patient about their smoking at every visit


Provide brief advice to quit


Assess patient’s readiness to change smoking behavior


Connect patients directly to tobacco cessation treatment. Utilize our fax referral program to connect your patients directly to the MD Quitline!

YOU HAVE COMPLETED MODULE 2. Please CLICK HERE to proceed to MODULE 3, which covers: Stages of Change, Motivational Strategies and The 5 R’s.