Practice Integration for Tobacco Dependence Treatment
Implementing a system that includes tobacco dependence treatment does not need to be time-consuming. There are a few simple strategies you may wish to apply in your office to support patients who use tobacco in successful quit attempts.
Use the following checklist to determine practice readiness to deliver tobacco dependence use treatment.
Practice Assessment Resources & Knowledge Checklist
Roles and Responsibilities: Communicate the importance of intervening with tobacco users. Designate a staff person (e.g., nurse, medical assistant or other provider) to serve as an office champion to coordinate tobacco dependence treatments. Delineate and communicate responsibilities including instructing patients on the effective use of treatment (e.g., counseling, pharmacotherapy, and scheduling follow-up visits, especially in the immediate post-quit period). Incorporate a discussion of these responsibilities into training of new and temporary staff.
Practice Performance Evaluation: Consider conducting an audit and/or developing a system for determining how well your practice addresses tobacco use dependence with patients.
Studies show that brief counseling when delivered by a trained health care provider can double or, in some cases, triple quit rates. Patients expect and appreciate when health care providers help them with their quit attempts. The 5 As of Tobacco Cessation Support is the evidence-based method of helping patients to quit.
Ask about tobacco use.
Advise patient to quit.
Assess readiness to quit (within 30 days).
Assist in quit attempt (Refer them to QuitlineNC at 1-800-QUIT-NOW).
Arrange Follow-up with tobacco users.
For patients making a quit attempt, consider implementing a protocol for scheduling follow-up appointments within the month following the quit attempt. QuitlineNC does follow-up with patients over the phone and will provide you with progress reports that details your patients quit status.
Waiting room screening tools: Develop a protocol to systematically identify tobacco users as they check in for their appointments. Waiting-room screening tools such as Tobacco Use Conversation Starters offer a quick and simple method for ensuring that every patient is asked about their tobacco use status.
Real-time reminder system and protocols: Use a real-time reminder system to identify tobacco users and deliver tailored cessation messages. This may include electronic health record reminders to serve as a prompt.
There are several Tobacco Treatment Training CME/CEUs credit courses available for physicians, nurses and pharmacists to learn more about treating tobacco use dependence. These courses share risks of tobacco use, benefits of quitting and the physiological and emotional processes that a patient experiences when quitting.
Pharmacotherapy Reference Guide: Appropriate use of tobacco dependence medications reduces withdrawal symptoms and nearly doubles the chances of success for a given quit attempt.
There are seven medications approved by the FDA to aid in cessation:
- Over the Counter:
- Gum
- Lozenge
- Patch
- By Prescription:
- Nasal Spray
- Oral Inhaler
- Bupropion SR
- Varenicline
Download the Pharmacotherapy Reference Guide (PDF)
Nicotine Replacement Therapy and Adolescent Patients: Information for Pediatricians