• Patient education materials
• Special Populations

Ask your patients at every visit if they use tobacco and help them quit

• Use the Starting the Conversation tools. Assess patient readiness to change behavior, briefly counsel each patient, and set behavior change goals. These tools can help you increase efficiency.
• Use the full Five A’s protocol to effectively counsel patients
• Find quitting resources in the community with the NC Good Health Directory
• Use the fax referral form (English / Spanish) and NC Quitline services.
• Set up a system where every tobacco user is identified and spoken to about quitting.
  • Ask NC Prevention Partners about Prevention Rx
  • See powerpoint on how to set up a system similar to Providence Healthcare's System's

Mental Health Patients

The US Preventive Services Task Force "strongly recommends that clinicians screen all adults for tobacco use and provide tobacco cessation interventions for those who use tobacco products." This should not only be done at annual healthcare visits but at all clinic visits.  Given the time constraints in a busy practice, meeting these recommendations is often a challenge.

Intensive interventions that combine both behavioral counseling and pharmacological treatment can produce cessation rates of 20% to 25% per year.¹ The gold standard for intervention is the Public Health Service’s Clinical Practice Guideline: the Ask-Advise-Assess-Assist-Arrange (5 A’s) protocol. Every clinician, if possible, should master these steps and lead their patients who use tobacco through them.
 
For the busy clinician who feels unable to intervene effectively with tobacco users using the 5 A’s protocol, there is an excellent alternative: you can identify tobacco users, advise them to quit (thus doubling the chances they will try), and then refer them to the NC Quitline.  This is easy to do with the Fax Referral form (English / Spanish) developed for this purpose.  The completed form may be sent to the Quitline by anyone in your office, provided it has been signed by the patient.  Faxing the form to the Quitline assures that your patient will be called by Quitline personnel, thereby ensuring that contact will be made. This can be valuable for patients who want to quit using tobacco, but have difficulty following through with planning for tobacco cessation.  The Quitline counselor in essence will complete the remainder of the 5 A’s, offering the benefit of a tailored plan for counseling.  The Fax Referral form should be used only for patients planning to quit using tobacco within the next 30 days.  If patients decline referral via the Fax Referral system, or are not planning to quit within the next 30 days, then they may be given the phone number for the Quitline so that they may call when they are ready to proceed.