Tobacco Cessation InterventionsFor Utah health care providers

Tobacco Cessation for Healthcare Providers 2

Table of Contents

Tobacco Statistics 3 4United States Tobacco Statistics for 2011 4United States Tobacco Statistics 4Utah Tobacco Statistics 4

Health Care Providers Role 5The Health Care Providers Role 6

The Utah Quit Line 7Utah Tobacco Quit Line - A Free Tobacco Cessation Service 8The Utah Quit Line offers two levels of services: 8Fax Referral Form 10

Tobacco Cessation for Healthcare Providers 3

Tobacco Statistics

Tobacco Cessation for Healthcare Providers 4

United States Tobacco Statistics for 2011

Tobacco use is the leading the leading cause of death among both men and women in the United States. Tobacco use also causes numerous other disease and conditions, including emphasyma, bronchitis, and heart disease. Because of this, tobacco users may experience a significantly lower qualiy of life than non tobacco users.

United States Tobacco StatisticsDeaths per Year 443,000Secondhand smoke Deaths per year 49,000Percent of Tobacco use in the U.S. 19%Percent of High Schoolers who use Tobacco 16%

Utah Tobacco Statistics Deaths per Year 1,156Children exposed to secondhand smoke 11,400Percent of Tobacco use in the Utah 11.3%Percent of High Schoolers who use Tobacco 5.9%

Tobacco attributed medical and productivity costs

$663 million

Tobacco advertising expenditure $57.9 million

Tobacco Cessation for Healthcare Providers 5

Health Care Providers Role

Tobacco Cessation for Healthcare Providers 6

The Health Care Providers Role

1. Tobacco users expect their health care provider to advise them to quit2. When speaking to patients, it is important to advise the patient to quit using tobacco in a clear, strong, and personalized manner.3. Remind the patient that it might take multiple attempts to quit (on average, 3 - 8 times.) 4. Tobacco users who are willing to quit should receive intervention to help in their quit attempt.5. Those who are unwilling to quit now should receive interventions to increase their motivation to quit6. Those who recently quit using tobacco should be provided relapse prevention treatment7. Tobacco dependence is a chronic disease that often requires repeated inter vention and multiple attempts to quit. Effective treatments exist, however, that can significantly increase rates of long-term abstinence8. It is essential that clinicians and healthcare delivery systems consistently identify and document tobacco use status and treat every tobacco user seen in a healthcare setting9. Brief tobacco dependence treatment is effective. Clinicians should offer every patient who uses tobacco at least the brief treatments shown to be effective in the Guideline10. Telephone quitline counseling is effective with diverse populations and has a broad reach. Therefore, clinicians and healthcare delivery systems should both ensure patient access to quitlines and promote quitline use11. Tobacco dependence is a chronic disease that often requires repeated interven-tion and multiple attempts to quit. Effective treatments exist, however, that can significantly increase rates of long-term abstinence.

Tobacco Cessation for Healthcare Providers 7

The Utah Quit Line

Tobacco Cessation for Healthcare Providers 8

Utah Tobacco Quit Line - A Free Tobacco Cessation Service

The Utah Tobacco Quit Line is a free tobacco cessation service for Utah residents. Physicians can refer their patients the Utah Quit Line.

1. Research shows that telephone counseling is one of the most effective ways to help people quit 1

2. Telephone-based support is more likely to be used than other types of quitting services3. When a person calls the Quit Line, they will:4. Be connected with a trained coach who will help them develop a person alized quit plan 5. Receive up to five individually tailored sessions with a coach.6. Get a self help booklet and information about other local resources.7. Receive information about how to help a friend or family member to quit8. Be able to discuss options for medications, including free Nicotine Re placement Therapy to eligible callers (youth are not eligible for NRT)9. Quit Line is free and confidential.

The Utah Quit Line offers two levels of services:Level one is for callers not interested in quitting tobacco, or for those who are only wanting cessation information.

Callers interested in additional services will have the option of enrolling in the Quit Lines full coaching program (Level 2), which includes a series of five calls over two months. The cessatoin coach will explore the callers strengths and barriers of quit-ting tobacco.

(1) Treating Tobacco Use and Dependence, Clinical Practice Guideline 2008 Update, U.S. Dept of Health and Human Services, p. 92.

Tobacco Cessation for Healthcare Providers 9

The Fax Referral Form

Tobacco Cessation for Healthcare Providers 10

Fax Referral FormThe fax referral form allows physicians to fax a request for the Quit Line to contact the patient. Please have the patient fill out and sign the form below.

National Jewish Health November 2009

PATIENT INFORMATION (PRINT CLEARLY)

Patient name (Last) ______________________________ , (First) _______________________ Date of birth ____________________

Gender M F

Address __________________________________ City _____________________, State UT Zip code ______________

Phone #1 (______) _______ - ___________ #2 (______) ________ - ___________ E-mail ___________________________

Cell Phone # (______) _______ - ___________ Text Message: Yes No

Best times to call 6 AM to 9 AM 10 AM to 1 PM 2 PM to 5 PM 6 PM to 9 PM Weekend: Yes No

May we leave a message? Yes No

Language English Spanish; Other ________________ Are you hearing impaired and need assistance? Yes No

______ I am ready to quit tobacco and request that the Utah Tobacco Quit Line contact me to help with my quit Initial plans.

I understand that the Utah Tobacco Quit Line will inform my provider about the services and cessation medications provided to me.

Patient signature _____________________________________________ Date ________________

This release shall be valid for one year after the above date.

PROVIDER INFORMATION (PRINT CLEARLY)

Clinic/Hosp/Dept Contact name

Address E-mail

City/State/Zip Phone

Fax

PLEASE COMPLETE FORM AND FAX OR MAIL TO:

FAX 1-800-483-3076 Utah Tobacco Quit Line

National Jewish Health™ 1400 Jackson St., M302

Denver, CO 80206

Confidentiality Notice: This facsimile contains confidential information. If you have received this in error, please notify the sender immediately by telephone and confidentially dispose of the material. Do not review, disclose, copy or distribute.

Utah Tobacco Quit Line Fax Form

Fax to: 1-800-483-3076

Tobacco Cessation for Healthcare Providers 11

Tobacco Prevention and Cessation

Tobacco Cessation InterventionsFor Utah health care providers

Table of Contents

Tobacco Statistics 3 4United States Tobacco Statistics for 2011 4United States Tobacco Statistics 4Utah Tobacco Statistics 4

Health Care Providers Role 5The Health Care Providers Role 6

The Utah Quit Line 7Utah Tobacco Quit Line - A Free Tobacco Cessation Service 8The Utah Quit Line offers two levels of services: 8Fax Referral Form 10

Tobacco Statistics

United States Tobacco Statistics for 2011

Tobacco use is the leading the leading cause of death among both men and women in the United States. Tobacco use also causes numerous other disease and conditions, in-cluding emphasyma, bronchitis, and heart disease. Because of this, tobacco users may experience a significantly lower qualiy of life than non tobacco users.

United States Tobacco StatisticsDeaths per Year 443,000Secondhand smoke Deaths per year 49,000Percent of Tobacco use in the U.S. 19%Percent of High Schoolers who use Tobacco 16%

Utah Tobacco Statistics Deaths per Year 1,156Children exposed to secondhand smoke 11,400Percent of Tobacco use in the Utah 11.3%Percent of High Schoolers who use Tobacco 5.9%

Tobacco attributed medical and productivity costs

$663 million

Tobacco advertising expenditure $57.9 million

Health Care Providers Role

The Health Care Providers Role

1. Tobacco users expect their health care provider to advise them to quit2. When speaking to patients, it is important to advise the patient to quit using tobacco in a clear, strong, and personalized manner.3. Remind the patient that it might take multiple attempts to quit (on average, 3 - 8 times.) 4. Tobacco users who are willing to quit should receive intervention to help in their quit attempt.5. Those who are unwilling to quit now should receive interventions to increase their motivation to quit6. Those who recently quit using tobacco should be provided relapse prevention treatment7. Tobacco dependence is a chronic disease that often requires repeated intervention and multiple attempts to quit. Effective treatments exist, however, that can significantly increase rates of long-term abstinence8. It is essential that clinicians and healthcare delivery systems consistently identify and document tobacco use status and treat every tobacco user seen in a healthcare setting9. Brief tobacco dependence treatment is effective. Clinicians should offer every patient who uses tobacco at least the brief treatments shown to be effective in the Guideline10. Telephone quitline counseling is effective with diverse populations and has a broad reach. Therefore, clinicians and healthcare delivery systems should both ensure patient access to quitlines and promote quitline use11. Tobacco dependence is a chronic disease that often requires repeated intervention and multiple attempts to quit. Effective treatments exist, however, that can significantly increase rates of long-term abstinence.

The Utah Quit Line

Utah Tobacco Quit Line - A Free Tobacco Cessation Service

The Utah Tobacco Quit Line is a free tobacco cessation service for Utah residents. Physicians can refer their patients the Utah Quit Line.

1. Research shows that telephone counseling is one of the most effective ways to help people quit 1

2. Telephone-based support is more likely to be used than other types of quitting services3. When a person calls the Quit Line, they will:4. Be connected with a trained coach who will help them develop a personalized quit plan 5. Receive up to five individually tailored sessions with a coach.6. Get a self help booklet and information about other local resources.7. Receive information about how to help a friend or family member to quit8. Be able to discuss options for medications, including free Nicotine Replacement Therapy to eligible callers (youth are not eligible for NRT)9. Quit Line is free and confidential.

The Utah Quit Line offers two levels of services:Level one is for callers not interested in quitting tobacco, or for those who are only wanting cessation information.

Callers interested in additional services will have the option of enrolling in the Quit Lines full coaching program (Level 2), which includes a series of five calls over two months. The cessatoin coach will explore the callers strengths and barriers of quit-ting tobacco.

(1) Treating Tobacco Use and Dependence, Clinical Practice Guideline 2008 Update, U.S. Dept of Health and Human Services, p. 92.

The Fax Referral Form

Fax Referral FormThe fax referral form allows physicians to fax a request for the Quit Line to contact the patient. Please have the patient fill out and sign the form below.

National Jewish Health November 2009

PATIENT INFORMATION (PRINT CLEARLY)

Patient name (Last) ______________________________ , (First) _______________________ Date of birth ____________________

Gender M F

Address __________________________________ City _____________________, State UT Zip code ______________

Phone #1 (______) _______ - ___________ #2 (______) ________ - ___________ E-mail ___________________________

Cell Phone # (______) _______ - ___________ Text Message: Yes No

Best times to call 6 AM to 9 AM 10 AM to 1 PM 2 PM to 5 PM 6 PM to 9 PM Weekend: Yes No

May we leave a message? Yes No

Language English Spanish; Other ________________ Are you hearing impaired and need assistance? Yes No

______ I am ready to quit tobacco and request that the Utah Tobacco Quit Line contact me to help with my quit Initial plans.

I understand that the Utah Tobacco Quit Line will inform my provider about the services and cessation medications provided to me.

Patient signature _____________________________________________ Date ________________

This release shall be valid for one year after the above date.

PROVIDER INFORMATION (PRINT CLEARLY)

Clinic/Hosp/Dept Contact name

Address E-mail

City/State/Zip Phone

Fax

PLEASE COMPLETE FORM AND FAX OR MAIL TO:

FAX 1-800-483-3076 Utah Tobacco Quit Line

National Jewish Health™ 1400 Jackson St., M302

Denver, CO 80206

Confidentiality Notice: This facsimile contains confidential information. If you have received this in error, please notify the sender immediately by telephone and confidentially dispose of the material. Do not review, disclose, copy or distribute.

Utah Tobacco Quit Line Fax Form

Fax to: 1-800-483-3076

Tobacco Prevention and Cessation