Medicaid provider delivery of the 5A's for smoking cessation counseling
Abstract
This paper assesses rates of the 5A's (ask, advise, assess, assist, and arrange) of brief provider counseling received by Medicaid-enrolled smokers and recent quitters and the differences in receipt of counseling as a function of age, gender, race, ethnicity, and health status. A random sample telephone survey was conducted among Medicaid-enrolled smokers and recent quitters in four geographic areas in the United States. Multivariate logistic regression models estimated the relationships between demographic characteristics and delivery of the 5A's. Less than 10% of Medicaid smokers and recent quitters reported receiving all 5A's. Medicaid providers delivered the ask, assess, and advise components of smoking cessation counseling to the majority of their patients who were smokers or recent quitters. However, they were much less likely to provide comprehensive counseling, with fewer than 25% of patients reporting receiving any assistance with quitting (i.e., a prescription for pharmacotherapy or referral to counseling) or arrangement of a follow-up visit or phone call. Receipt of the 5A's varied as a function of health status, race, and ethnicity. Medicaid needs to (a) increase provider delivery of the full spectrum of counseling interventions recommended for smoking cessation and (b) extend provider outreach to the demographic groups that receive the lowest rates of counseling.
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Limited visit time, competing medical priorities, and insufficient financial incentives for health promotion all create barriers to behavioral counseling.
“Limited visit time, competing medical priorities, and insufficient financial incentives for health promotion all create barriers.45”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [45]
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Better Population Health Through Behavior Change in Adults: A Call to Action
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- Authors
- Chase, E., McMenamin, S., & Halpin, H. A.
- Affiliations
- University of California, Berkeley (US)
- Corresponding author
- McMenamin, Sara
- ORCID
- McMenamin, Sara
- Venue
- Nicotine & Tobacco Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-11
- Volume
- 9
- Issue
- 11
- Pages
- 1095-1101
- ISSN
- 1462-2203 (ISSN-L)
- OpenAlex
- W1980309902
- Cited by
- 67
- References
- 15
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 4 · 2022: 3 · 2021: 7 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 4 · 2016: 3 · 2015: 4 · 2014: 5 · 2013: 3 · 2012: 5
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nicotine & Tobacco Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- Medicaid, smoking cessation, brief counseling, health disparities, racial and ethnic disparities, health status, tobacco use
- MeSH terms
- Smoking Prevention, Adult, Counseling, Female, Humans, Male, Medicaid, Middle Aged, Office Visits, Patient Education as Topic, Primary Health Care, Surveys and Questionnaires, Smoking, Tobacco Use Disorder, United States, Logistic Models, Smoking Cessation
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