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Promoting Tobacco Cessation

Promoting Tobacco Cessation. Sterling M. Fulton-Smith, MHA Grants Manager, TUPC. Advice from a provider will lead the patient along the path to quitting. Overview:. The Role of the Healthcare Provider Counseling Ask, Advise, Refer (1-800-QUIT-NOW) Consider Fax Referral

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Promoting Tobacco Cessation

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  1. Promoting Tobacco Cessation Sterling M. Fulton-Smith, MHA Grants Manager, TUPC

  2. Advice from a provider will lead the patient along the path to quitting

  3. Overview: • The Role of the Healthcare Provider • Counseling • Ask, Advise, Refer (1-800-QUIT-NOW) • Consider Fax Referral • Counseling Reimbursement • Cessation Counseling in Schools

  4. Scope of Problem in NC: Cost of Tobacco In North Carolina: • Total health care costs from smoking: $2.46 billion • Portion covered by state Medicaid program: $769 million • Total losses in productivity caused by smoking: $3.30 billion Campaign for Tobacco-Free Kids, “The Toll of Tobacco in North Carolina” Fact Sheet accessed May 19, 2008 at http://www.tobaccofreekids.org/reports/settlements/toll.php?StateID=NC

  5. Cessation Programs Breathe Easy Live Well You Quit Two Quit Old North State Medical Society The Tobacco Control Branch NCSTEP

  6. The Role of the Healthcare Provider Increasing Tobacco Use Cessation Clinicians play an important role in promoting tobacco cessation among patients

  7. Efficacy of Physician Advice to Quit Abstinence Rate % • No advice 7.9 • Physician Advice 10.2 • Patients expect healthcare providers to ask about tobacco use and advise them to quit Source: Treating Tobacco Use andDependence, USDHHS, Public Health Service, 2000

  8. The 5A’s of Tobacco Cessation • Askabout tobacco use • Advise patient to quit • Assessreadiness to quit Refer (1-800-QUIT-NOW) • Assistin quit attempt • Arrangefollow-up

  9. Vital Signs: Create a Reminder System Include tobacco use in other medical / dental advice • Use an identification system • Stamp, Sticker, EMR Reminder systems are key to helping busy providers incorporate the 5A’s into their busy schedules. It gets others in the office involved with process of asking all patients about tobacco use, at every visit.

  10. The 5A’s of Tobacco Cessation • Askabout tobacco use • Advise patient to quit • Assessreadiness to quit Refer (1-800-QUIT-NOW) • Assistin quit attempt • Arrangefollow-up

  11. 1-800-QUIT-NOW (1-800-784-8669) • 8 a.m. – 3 a.m. - 7 days a week • Toll-free • Confidential • All North Carolinians - youth and adult • Proactive calls by Quit Coach • Fax referral • Available in multiple languages

  12. QuitlineNC helps patient ready to: • STAR: - Set a quit date (within 2 weeks) - Tellfamily, friends, coworkers - Anticipatechallenges to quitting - Remove tobacco products from environment • Make up to three follow-up calls, • Discuss pharmacotherapy, refer back to HCP, • Encourage those not ready to set a quit date to call back • Four call program is evidence-based

  13. QuitlineNC Fax Referral

  14. ARRANGE Patients ready to quit within 30 days

  15. QuitlineNC Outcomes Report • Tool to follow patient progress with your advice to quit / utilize Quitline services • Most useful in clinic setting with dedicated fax machine/staff to retrieve reports • Outcomes Report information includes: • Accepted services • Declined services • Unreachable

  16. What is QuitlineNC?

  17. How does QuitlineNC work?

  18. www.quitlinenc.com

  19. Counseling Coverage in NC

  20. Counseling Coverage in NC Medicaid added two CPT codes Jan. 1, 2009 99406 – 3-10 minutes 99407 – > 10 minutes Private payer benefits are subject to specific plan policies. Before providing service, benefit eligibility and payer coding requirements should be verified. Medicare, BCBSNC, and State Health Plan also reimburse these codes

  21. Dental Providers • The American Dental Association’s position statement on tobacco “urges its members to become fully informed about tobacco cessation intervention techniques to effectively educate their patients to overcome their addiction to tobacco.” • Although tobacco interventions are not usually a covered benefit, the ADA insurance code D1320 (tobacco counseling for the control and prevention of oral disease) could be used, if appropriate.

  22. Coverage for Counseling For more information see Medicaid Bulletins: Jan 2009:http://www.dhhs.state.nc.us/dma/bulletin.htm Oct.2008:http://www.ncdhhs.gov/dma/bulletin/1008bulletin.htm www.endsmoking.org

  23. Counseling by the School Staff Coaches School Nurses Teachers and Administrators

  24. Coaches Can Influence Youth • Sports activities present great opportunities to reach young people. • Young athletes learn to make important health decisions related to tobacco use and physical activities.

  25. School Nurses • School based cessation counseling • ALA - N-O-T program • QuitlineNC • Or other cessation programs

  26. Teachers and Administrators: Cessation in the schools • State law now requires every school district in NC to adopt and implement a 100% tobacco-free schools policy (effective August 2008) • Work with staff in the schools to increase compliance of the 100% Tobacco Free Law.

  27. Take-Home Message • The Role of the Provider • Counseling • Ask, Advise, Refer (1-800-QUIT-NOW) • Consider Fax Referral • Counseling Coverage in NC • Counseling in Schools

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