Screening and assessing tobacco use is an important component for building rapport and treatment plans with clients. Click on the boxes below to learn more about the key components of a comprehensive assessment.
Most people who use tobacco will have thought about quitting, however, they may not feel ready to quit. To assess readiness to quit, you can use a tool called the Readiness Ruler to see how important it is for your client to quit and how confident they feel making this change.
To use the Readiness Ruler with your clients ask the following questions:
On a scale of 0 to 10, where 10 is the most confident, how confident are you in your ability to quit or cut down your tobacco?
On a scale of 0 to 10, where 10 is the most important, how important is it for you quit or cut down your tobacco?
High importance + high confidence = Ready to change
Low importance + low confidence = Not ready to change
High importance + low confidence OR low importance + high confidence = Ambivalent
It is important to gather a detailed history of your client’s tobacco use so that you can develop a quit plan that will work for them. You will want to ask about:
Assessing your client’s level of dependence and if they are experiencing withdrawal symptoms are important factors in determining whether your client may require cessation medications to support quitting.
You can assess your client’s level of dependence by using one of the following tools:
Common withdrawal symptoms may include:
A tool that may be helpful to assess withdrawal symptoms is the Minnesota Withdrawal Scale.
For more information on the tools listed above as well as others you may consider using, click on the following link.
People may use tobacco in response to specific triggers or stimuli. Identifying challenging situations or feelings is an important first step towards being able to develop a way to cope with triggers to use tobacco. Triggers may include:
Before you help your clients develop coping strategies, you will need to identify any barriers they may face to quitting or reducing. Barriers may include:
It is important to identify your client’s strengths which can help with quit or reduce tobacco. Strengths may include:
You will also want to discuss with clients the supports within their network to support quitting or reducing. Support systems may include:
There is a high likelihood that your clients who use tobacco will also be experiencing health challenges which could impact their ability to quit or reduce. Assess whether your client will require additional support. Remember to assess the following:
Ask your client about some of the external and/or internal reasons motivating quitting or reducing. Any reason is a good reason however; you may spend some time eliciting more internal reasons underlying their decision to quit by helping them understand their tobacco use and how it impacts their lives. It’s also helpful for your client to share ideas for quitting. This will help them to avoid strategies that may not have worked for them and instead focus on strategies that are meaningful to them.
Now that you have learned how to complete an assessment with your client, how will this impact your practice? What will you continue to do and what will you start doing?