Ask and Act Practice Toolkit

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

Tobacco Cessation Resources

Treating Tobacco Dependence Practice Manual -- Follow the recommendations to build a better office system and help patients quit tobacco use.
(24-page PDF file; About PDFs)

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

Medicare Benefits - Tobacco Cessation Counseling -- A chart explaining the new Medicare benefits on tobacco cessation counseling.
(1-page PDF file; About PDFs)

Integrating Tobacco Cessation Into Electronic Health Records -- Recommendations for creating a template to ensure tobacco use is addressed with patients and treatment is adequately documented.
(2-page PDF file; About PDFs)

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

Ask and Act Lapel Pins -- Prompt your patients to ask for assistance with their quit attempts by wearing a lapel pin that lets them know you can help.

Pharmacologic Product Guide -- Handy, detailed guide for quick access to information on dosing, precautions, and side effects of FDA-approved tobacco cessation medications.
(2-page PDF file; About PDFs)

Prescription Pad - English -- 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.
(1-page PDF file; About PDFs)

Prescription Pad - English (order pads of fifty) -- 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.

Prescription Pad - Spanish -- Prescribe healthy habits. Give these "prescriptions" to your Spanish speaking patients who are ready to quit so they'll know what to do before, during, and after their quit dates.
(1-page PDF file; About PDFs)

Prescription Pad - Spanish (order pads of fifty) -- Prescribe healthy habits. Help your Spanish speaking patients in their quest to stop smoking with these helpful "prescription" pads.

Quitline Referral Cards - English -- Refer patients to the National Network of Tobacco Cessation Quitlines, which will route your patients to your state quitline for counseling and resources.
(2-page PDF file; About PDFs)

Quitline Referral Cards - English (order packages of 100) -- Refer patients to the National Network of Tobacco Cessation Quitlines, which will route your patients to your state quitline for counseling and resources.

Quitline Referral Cards - Spanish -- Help your Spanish speaking patients by referring them to the National Network of Tobacco Cessation Quitlines, which will route them to your state quitline for counseling and resources.
(2-page PDF file; About PDFs)

Quitline Referral Cards - Spanish (order packages of 200) -- Refer your Spanish speaking patients to the National Network of Tobacco Cessation Quitlines, which will route them to your state quitline for counseling and resources.

Secondhand Smoke Brochures (order packages of 15) -- Use these brochures to educate patients about the effects secondhand smoke can have on children.

Steps to Help You Quit Smoking Patient Education Brochures - English (order packages of 50) -- Easy-to-understand patient brochure outlines how and why to quit smoking.

Steps to Help You Quit Smoking Patient Education Brochures - Spanish (order packages of 25) -- Easy-to-understand patient brochure in Spanish outlines how and why to quit smoking.

Stop Smoking Guide -- This booklet walks patients through the steps for getting ready to quit, quitting, and staying quit.
(20-page PDF file; About PDFs)

Stop Smoking Guide - Spanish Version -- Translated into Spanish, the Stop Smoking Guide booklets walk patients through the steps for getting ready to quit, quitting, and staying quit.
(20-page PDF file; About PDFs)

Stop Smoking Guide (order packages of 10) -- 20-page booklets walk patients through the steps of getting ready to quit tobacco use, quitting, and remaining tobacco-free.

Ask and Act Wall Poster - English (order) -- Encourage your patients to ask for help with their smoking cesation efforts by displaying this full-color 16" x 20" wall poster.

Ask and Act Wall Poster -Spanish (order) -- Encourage your Spanish speaking patients to ask for help with their smoking cessation efforts by displaying this full-color 16" x 20" wall poster.

PowerPoint Presentation for Patients

Use this "Quitting Smoking" presentation for sessions with patients or at educational community events.

English Presentation -- English language "Quitting Smoking" presentation for sessions with patients or at educational community events.
(26-page PowerPoint file; About Downloading)

Spanish Presentation -- Spanish language "Quitting Smoking" presentation for sessions with patients or at educational community events.
(29-page PowerPoint file; About Downloading)