Tobacco Use and Dependence Treatment

Commercial tobacco use is the leading preventable cause of death and disease in the US, and tobacco dependence is a substance use disorder that can be treated with counseling and medication. All health care providers – from behavioral health to primary care – can play a critical role in curbing nicotine addiction and tobacco dependence among Washingtonians. Learn how you can treat tobacco use and dependence:

Brief intervention

At a minimum, providers should follow the Ask-Advise-Refer brief intervention model:

  1. Ask every client if they use tobacco. Most providers already do this as part of intake process, but this question should be asked at every visit (particularly for teens and young adults).
  2. Advise clients who use tobacco to quit. According to the U.S. Surgeon General, over 40% of adults who smoke do not receive this simple, straightforward advice that is proven to increase their likelihood of quitting.
  3. Refer clients ready to quit to evidence-based treatment. If you or a colleague can bill for tobacco cessation counseling and offer nicotine replacement therapy or prescribe medications, include these in treatment plans. Otherwise, refer your client to the Washington State Quitline.

Alternatively, providers can follow the 5 A's model (Ask-Advise-Assess-Assist-Arrange). The CDC offers a practical guide (PDF) that describes these steps, with suggested language you can use to help your patients quit.

To learn more about treating tobacco use and dependence, start with this 45-minute online training. If you are interested in becoming a Tobacco Treatment Specialist, visit the Tobacco-Free Behavioral Health Initiative to learn about upcoming trainings.

Additional resources




See the ADAI Clearinghouse and search for ‘tobacco' to order posters, rack cards, fact sheets, guides, and other printed materials to inform and promote tobacco dependence treatment.