How to provide effective smoking cessation advice in less than a minute without offending the patient

BACKGROUND: General practitioners have the opportunity, credibility and authority to provide smoking cessation advice and are effective in assisting smokers to quit. Despite their potential, GPs identify just over half the smokers in their practice and counsel approximately one-third to quit. Implementation of smoking cessation advice has not improved in the past 10 years despite the availability of evidence based guidelines. Effective smoking cessation advice should include both the 5As (Ask, Assess, Advise, Assist, Arrange) and the development of a supportive infrastructure within the practice setting. OBJECTIVE: This article outlines the rationale for GP involvement in assisting smokers to quit, advises how GPs can provide smoking cessation advice in less than a minute, the main barriers to quitting smoking, and the core activities in the 5As. DISCUSSION: General practitioner effectiveness in smoking cessation can be improved by adopting a systematic approach to identifying smoking status, more effective engagement of smokers by separating information from the 'moral imperative', use of brief motivational interviewing techniques and appropriate pharmacotherapy, and use of the QUIT line and other smoking cessation resources.