Problem/Objective: In November 2003, the American Dental Hygienists' Association (ADHA) was awarded a grant by the Robert Wood Johnson Foundation's Smoking Cessation Leadership Center, University of California San Francisco, to launch a nationwide effort to promote cessation efforts by registered dental hygienists.

Methods: Ask. Advise. Refer. is ADHA's national Smoking Cessation Initiative (SCI) designed to incorporate cessation intervention into clinical practice and dental hygiene curricula. The Ask. Advise. Refer. approach integrates the “5 A's” (Ask, Advise, Assess, Assist, Arrange) into an abbreviated intervention that remains consistent with recommended guidelines. Dental hygienists systematically refer their clients to quitlines, web-based and cessation programs. A national network of state SCI Liaisons has been established to disseminate pertinent information to hygienists at the local and constituent levels on how to incorporate Ask. Advise. Refer. into clinical practice and dental hygiene core curricula. Smoking Cessation Practice Guidelines programs have been presented to hygienists across the country during the three years of the grant and continue into the fourth year. A website with professional and consumer resources is an important element of the SCI.

Results: By incorporating the Ask. Advise. Refer program into practice, as one of the largest cadre of health care professionals and a profession with multiple clinical opportunities, dental hygienists are having a tremendous impact on the number of tobacco users making quit attempts. A national survey completed in December 2006, documents the significant and beneficial consequence of the SCI.

Conclusions: This accessible model has demonstrable potential to influence cessation practice among all the health care professions.