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Ask and Act Practice Toolkit

Ask your patients if they use tobacco. Act to help them quit. Use these free resources (shipping charges may apply), created by the AAFP, to help your patients. Check back regularly as we add new products.

Coding Reference -- A list of HCPCS, CPT and ICD-9 codes related to tobacco cessation counseling. (3-page PDF; About PDFs)

Guide To Tobacco Cessation Group Visits -- A step-by-step guide to conducting and billing for group visits to help your patients quit smoking. (12-page PDF; About PDFs)

Lapel Pins -- Prompt your patients to ask for assistance with their quit attempts by wearing this lapel pin and letting them know you can help.
PowerPoint Presentation for Patients -- Use this "Quitting Smoking" presentation for sessions with patients or at educational community events.
PowerPoint Presentation for Physicians -- Use this tobacco cessation presentation for Grand Rounds, conferences and other physician-to-physician presentations. (50-page PowerPoint; About Downloading)

Prescription Pad -- Prescribe healthy habits. Give these "prescriptions" to patients who are ready to quit so they’ll know what to do before, during and after their quit dates. Order pads of fifty or print your own from PDFs.
Prescribing Guidelines -- Keep this detailed pharmacologic product guide in your office for quick access to information on dosing, precautions and side effects of FDA-approved tobacco-cessation medications.
(2-page PDF; About PDFs)

Quitline Referral Cards – Refer patients to the National Network of Tobacco Cessation Quitlines: (800) QUIT-NOW, which will route patients to your state quitline for counseling and resources. Order plastic cards or print your own from pdfs.
"Steps to Help You Quit Smoking" Patient Education Brochures -- These easy-to-read patient education brochures provide an overview of how and why to quit smoking. Display in your reception area and exam lanes.
Tabletop Poster -- Print out this 8.5 x 11" poster to encourage your patients to ask for help with their smoking cessation efforts. Display it on a wall, a door or in a plastic sign holder.
Wall Posters -- Encourage your patients to ask for help with their smoking cessation efforts by displaying this full-color 16"x20" wall poster.
Secondhand Smoke Brochures -- Use these brochures to educate patients about the effects secondhand smoke can have on children.
Stop Smoking Guide -- These 20-page booklets walk patients through the steps for getting ready to quit, quitting and staying quit.