Training general practitioners in the ABC versus 5As method of delivering stop-smoking advice: a pragmatic, two-arm cluster randomised controlled trial

Sabrina Kastaun*, Verena Leve, Jaqueline Hildebrandt, Christian Funke, Stephanie Klosterhalfen, Diana Lubisch, Olaf Reddemann, Hayden McRobbie, Tobias Raupach, Robert West, Stefan Wilm, Wolfgang Viechtbauer, Daniel Kotz

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


This study assessed the effectiveness of a 3.5-h training session for general practitioners (GPs) in providing brief stop-smoking advice and compared two methods of giving advice - ABC versus 5As - on the rates of delivery of such advice and of recommendations of evidence-based smoking cessation treatment during routine consultations.

A pragmatic, two-arm cluster randomised controlled trial was carried out including a pre-/post-design for the analyses of the primary outcome in 52 GP practices in Germany. Practices were randomised (1:1) to receive a 3.5-h training session (ABC or 5As). In total, 1937 tobacco-smoking patients, who consulted trained GPs in these practices in the 6 weeks prior to or following the training, were included. The primary outcome was patient-reported rates of GP-delivered stop-smoking advice prior to and following the training, irrespective of the training method. Secondary outcomes were patient-reported receipt of recommendation/prescription of behavioural therapy, pharmacotherapy or combination therapy for smoking cessation, and the effectiveness of ABC versus 5As regarding all outcomes.

GP-delivered stop-smoking advice increased from 13.1% (n=136 out of 1039) to 33.1% (n=297 out of 898) following the training (adjusted odds ratio (aOR) 3.25, 95% CI 2.34-4.51). Recommendation/prescription rates of evidence-based treatments were low (

Original languageEnglish
Article numberARTN 00621-2020
Number of pages11
JournalERJ Open Research
Issue number3
Publication statusPublished - 1 Jul 2021



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