Improving Tobacco Cessation Program Utilization

Ask-Advise-Connect (AAC) increases tobacco cessation treatment enrollment 29-fold compared to a control Ask-Advise-Refer (AAR) protocol.

Tobacco cessation substantially reduces the risk of cancer and other diseases, but evidence-based tobacco cessation treatments are currently underutilized. To address this problem, Wetter and colleagues developed and tested a proactive strategy called Ask-Advise-Connect, in which the electronic health record includes supports to assess the tobacco use status of every patient at every visit, provide advice to quit, and directly and electronically link interested tobacco users with the Quitline, which then proactively calls them within 48 hours. This system yielded markedly higher rates of treatment enrollment than other approaches and is now a CDC recommended “best practice.”


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Ask-Advise-Connect: a new approach to smoking treatment delivery in health care settings. Vidrine JI, Shete S, Cao Y, Greisinger A, Harmonson P, Sharp B, Miles L, Zbikowski SM, Wetter DW. JAMA Intern Med. 2013 Mar;173(6):458.

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The Ask-Advise-Connect approach for smokers in a safety net healthcare system: A group-randomized trial. Vidrine JI, Shete S, Li Y, Cao Y, Alford MH, Galindo-Talton M, Rabius V, Sharp B, Harmonson P, Zbikowski SM, Miles L, Wetter DW. Am J Prev Med. 2013 Dec;45(6):737.

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Quitline treatment dose predicts cessation outcomes among safety net patients linked with treatment via Ask-Advise-Connect. Piñeiro B, Wetter DW, Vidrine DJ, Hoover DS, Frank-Pearce SG, Nguyen N, Zbikowski SM, Williams MB, Vidrine JI. Prev Med Rep. 2019 Jan;13:262.