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Involving More Health Professionals in Tobacco Cessation: What Works

Involving More Health Professionals in Tobacco Cessation: What Works. Connie Revell Deputy Director, Smoking Cessation Leadership Center May 18, 2006 National Network of Tobacco Cessation Quitlines. Cessation Partnerships. Helping Clinicians Become Tobacco Interventionists.

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Involving More Health Professionals in Tobacco Cessation: What Works

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  1. Involving More Health Professionals in Tobacco Cessation: What Works Connie Revell Deputy Director, Smoking Cessation Leadership Center May 18, 2006 National Network of Tobacco Cessation Quitlines

  2. Cessation Partnerships Helping Clinicians Become Tobacco Interventionists

  3. The Smoking Cessation Leadership Center • Robert Wood Johnson Foundation National Program Office • Housed at UCSF • About three years old • Director is Steven A. Schroeder, M.D., former RWJF president

  4. The Mission • Increase the number of smokers who quit • Increase the number of clinicians who help them do it • Promote quitlines and 1-800 QUIT NOW as key strategy

  5. Eight Key Partnerships • Nurses • Dental Hygienists • Pharmacists • Family Physicians • Emergency Physicians • Physician Assistants • Respiratory Therapists • Anesthesiologists

  6. Seven Key Projects • JCAHO Smoking Cessation Project • Kaiser Permanente of Northern California • VA in the Vanguard • Make It Your Business Campaign • Wellpoint/Blue Cross California • Dana Farber Organized Labor Project • National Association of State Mental Health Program Directors

  7. Why the Focus on Quitlines? • They work--calling a quitline can more than double the chance of successfully quitting • They are simple and easy to use • They save time • They are the missing part of a complete management plan for cessation • They are available everywhere

  8. And… • They have made the difference in persuading clinician groups to become tobacco interventionists

  9. From National to State and Local Levels • Most national groups have state constituent organizations • Work gets carried out through them in most cases • State groups, in turn, use district or component structure to carry out work plans

  10. How Our Message Has Evolved • Expected more willingness to do the Five A’s • Barriers were ignorance and resistance • No one knew about quitlines • Almost universal readiness to try Ask-Advise-Refer approach • Availability of the single number and the card greatly increased chances of success

  11. Honing the Message • Dr. Schroeder’s July 2005 JAMA article further refined the message • Of four responses to smoking patients, three are acceptable….

  12. The Three Choices • Do the full Five A’s • Do a brief intervention (A-A-R including pharmaceuticals) • Work on change within your system • (Or some combination)

  13. The National Card

  14. And Order Cards… • Check the SCLC web site at smokingcessationleadership.ucsf.edu • More than two million cards have now been ordered • The VA project is generating great demand

  15. Partnerships--A Way to Stretch Scarce Resources • Partnerships can be greater than the sum of the parts • Population-based approaches are feasible with partnerships • Less visible clinician groups have shown more enthusiasm • We can make a big dent in the 46 million smokers

  16. The Four Questions Model • Where are we now? (baseline) • Where do we want to be? (target) • How will we get there? (multiple strategies) • How will we know we are getting there? (measures)

  17. An Example: The Smoking Cessation Initiative of the ADHA • Thirteen dental hygienists formed a task force • Leadership from elected president of ADHA • Support from Smoking Cessation Leadership Center • Expert facilitator

  18. How ADHA Answered the Four Questions • Where are we now?– About a quarter of hygienists intervene with patients who use tobacco. • Where do we want to be? We can double that in three years. • How will we get there? Very broad work plan using state affiliates to deliver at the grass roots. • How will we know we are getting there? Develop an evaluation plan with baseline and one-year follow-up surveys.

  19. The ADHA’s SCI Communication Plan • Developed a web site • Created a liaison in each state affiliate organization • Created scripts and protocols to help clinicians broach the subject of quitting with patients • Publicized the initiative through local channels and nationally through newsletter and meetings

  20. Examples of State Initiatives • The New California Gold Rush • A version just was launched in New York • Minnesota, Hawaii, other states are interested • Pharmacy is establishing effort in each state

  21. And Now– The Place-Based Partnership • The LA Cessation Initiative • Interest in other places such as Chicago, Washington, D.C. • Looking for triggers • Looking for ways to weave the various partners together into a comprehensive initiative in a particular place • How might you take advantage of this opportunity?

  22. Thank you!http://smokingcessationleadership.ucsf.edu

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