Practice Integration

Practice Assessment Resources & Knowledge Checklist

• Assign clear roles and responsibilities for conducting interventions with tobacco using patients.

  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 treatments (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.^1,3

  Practice Performance Evaluation: Consider conducting an audit and/or developing a system for determining how well your practice addresses tobacco use dependence with patients.¹

• Use the 5As to counsel patients to quit.

  The 5 A’s of Tobacco Cessation Support: 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 A’s 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.

• Set time aside to call patients to follow up on quit dates / attempts.

  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.¹

• Use screening tools and reminder systems to identify tobacco users.

  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.¹

  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.¹

• Use the QuitlineNC Fax Referral Program.

  QuitlineNC Fax Referral Program: The Fax Referral Program allows QuitlineNC to proactively make the first call to your patient who would like to quit within the next 30 days. After explaining QuitlineNC to the patient, if he/she agrees, fill out the fax referral form with the patient and ask him/her to sign and date it. Then, fax the form to 1-800-483-3114. QuitlineNC will call your patients to get them started.If the referral is being made by phone, the health care professional may signify the patient's consent by writing their name, position and date under the patient signature line.

  Fax Referral form (English)
  Fax Referral form (Español)
  

• Understand appropriate codes and/or reimbursement policies and requirements used for bill of patient visits.

  Here is a list of appropriate codes.

• Take continuing medical education courses to learn the risks of tobacco use, the benefits of quitting and the physiological and emotional processes that a patient experiences when quitting.¹

  There are several Tobacco Treatment Training CME/CEUs credit courses available for physicians, nurses and pharmacists to learn more about treating tobacco use dependence.

• Understand prescribing guidelines for pharmacotherapy.

  
  

  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. They are:

  Over the Counter:
  Gum
  Lozenge
  Patch

  By Prescription:
  Nasal Spray
  Oral Inhaler
  Bupropion SR
  Varenicline

  Download the Pharmacotherapy Reference Guide

  Nicotine Replacement Therapy and Adolescent Patients: Information for Pediatricians