by Thomas P. Houston

About the author: Thomas P. Houston is director of the American Medical Association’s Department of Preventive Medicine and Environmental Health.

Iunderstand that educating my patients about tobacco is important, but how do I incorporate this into my practice in a cost-effective way"

Counseling is crucial. As many as 70% of smoking patients report that firm, supportive messages from physicians can be an important motivating factor. Minimal-contact doctor counseling strategies are effective, time-efficient and personally rewarding. The four “A’s” for smoking-cessation intervention are:
• Ask about smoking at every opportunity.
• Advise all smokers to stop.
• Assist patients in that effort.
• Arrange follow-up.

With children, a fifth "A" can be listed—anticipatory guidance to help keep kids from ever starting to smoke. But there's much that you and...