Table 2

The OMSC in primary care—Ask, Advise, Act model

Clinical practiceResponsible primary care team member(s)Description
Ask
(30 s)
Triage nurse/Medical assistant Ask and document
Include tobacco use question as one of the patient’s vital signs: “Have you used any form of tobacco in the last 7 days?” “Have you used any form of tobacco in the past?”
Advise
(2 min)
General practitioner/Nurse practitioner Advise, offer support and refer
  • Provide strong, personalised, non-judgmental advice to quit with offer of support.

  • Arrange rapid referral to smoking cessation counsellor.

  • Provide brief, periodic, motivational intervention to persons not ready to quit.

Act
(20–30 min)
Smoking cessation counsellor (eg, nurse, nurse practitioner, pharmacist) For patient who is ready to quit
Quit plan visit:
  • Strategic counselling;

  • Pharmacotherapy;

  • Follow-up (2–6 months).


For patient who is not ready to quit
  • Strategic counselling (reduce to quit/smoking reduction) pharmacotherapy;

  • Follow-up;

  • Self-help material.

  • OMSC, Ottawa Model for Smoking Cessation.