Five Tips for Creating a Successful Tobacco Cessation Initiative

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Cigarette smoking is the leading cause of preventable disease and death in the United States, accounting for more than 480,000 — or one out of every five — deaths each year, according to the Centers for Disease Control and Prevention (CDC).

Health Services Advisory Group (HSAG) — the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Arizona, California, Florida, Ohio and the U.S. Virgin Islands — partnered with the American Cancer Society (ACS) to offer a webinar to highlight best practices for creating a successful tobacco cessation program. Here are five takeaways from the webinar:

1Initiate Brief Interventions

Communication between a care provider and patient that lasts less than three minutes has been shown to increase overall tobacco abstinence rates. Even when patients are not ready to make a quit attempt, clinician-delivered brief interventions enhance motivation and increase the likelihood of future attempts.

2Apply the Five A’s Intervention Model

The Agency for Healthcare Research and Quality (AHRQ) compiled a list of Five Major Steps to Intervention (The 5 A’s”) for providers to reference:

  • Ask about tobacco use: Identify and document tobacco use status for every patient at every visit.
  • Advise to quit: In a clear, strong and personalized manner, urge every tobacco user to quit.
  • Assess willingness to make a quit attempt: Is the tobacco user willing to make a quit attempt at this time?
  • Assist in quit attempt: For the patient willing to make a quit attempt, use counseling and pharmacotherapy to help him or her quit.
  • Arrange follow-up: Schedule continued contact, in person or by telephone, preferably within the first week after the quit date.

3Refer Patients to Quitlines

Quitlines can be used to support cessation that begins in clinics and offices. Each year, state quitlines receive 1.3 million calls, enroll 400,000 smokers in treatment (with 30 percent quit rates) and receive approximately 180,000 referrals. The North American Quitline Consortium (NAQC) produced a Quitline Map for patients across the nation to find resources available in their state.

4Facilitate Behavioral Support and Coaching

Focusing on practical counseling and providing support and encouragement can be helpful to patients’ tobacco cessation journeys. In addition, motivational interviewing elicits behavioral change by exploring and resolving ambivalence to tobacco use. It can also help with realistic goal setting and accountability.

5Utilize a Systems Approach

Providers can implement a tobacco user identification system in every clinic to provide education, resources, feedback and monthly metrics to promote provider intervention. Providers can also dedicate staff members to deliver tobacco dependence treatment and assess its delivery in staff member performance reviews. By promoting policies that support tobacco dependence services, QIN-QIOs can help enable a more comprehensive support system for tobacco users.