Chronic obstructive pulmonary disease (COPD) is a type of irreversible condition characterized by narrowed airways affecting breathing and oxygenation, such as emphysema and chronic bronchitis. The Five A’s Approach includes Ask about tobacco use, advise quitting, assess readiness to quit, assist smokers who are ready to quit, and arrange follow-up. Since 2008, most professional societies advocate the AAR approach: Ask about tobacco use, assist the patient in taking steps to quit, and refer to the appropriate professional.