the ohio partners for smoke-free families 5a’s rhonda huckaby – ohio department of health katie...
TRANSCRIPT
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The Ohio Partners for Smoke-Free Families
5A’s
Rhonda Huckaby – Ohio Department of Health
Katie Graham – Ohio Department of Health
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Helping the Quit Process: Using the 5 A’s
Source: Clinical Practice Guideline: Treating Tobacco Use and Dependence (2008). US Dept. of Health and Human Services
Website: http://www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdf
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Helping the Quit Process
• We can help with the process of quitting smoking by targeting the way in which we do two things:
– Interact with the individual
– Ask questions
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Why is it so hard to quit?
• Smoking has physiological, emotional, social and behavioral components, all of which must be addressed.
• No one picks up his or her first cigarette hoping to destroy their health – they pick it up for emotional and social reasons, and continue to smoke for these same reasons.
• These issues are usually ignored in smoking cessation.
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Helping the Quit Process
• If we recognize the perspective of the person who is addicted to nicotine, it becomes easier to relate and interact.
• The types of questions we ask will allow us to have a more productive conversation.
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The 5 A’s
• Brief Intervention: The 5 A’s
– Ask about current tobacco use
– Advise them to quit
– Assess willingness to make a quit attempt
– Assist the person with quitting
– Arrange for follow up
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The 5 A’s
ASK
Action Step: Implement an office-wide system that ensures that, for every person, at every visit, tobacco use status is queried and documented.
Strategy: Include tobacco use as a part of the assessment process.
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The 5 A’s
• How to ASK:
– Are you a current or former smoker?
– Tell me about your smoking history.
– Tell me more about your smoking.
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The 5 A’s
ADVISE
Action: In a clear, strong and personalized manner, urge every tobacco user to quit.
Clear Advice: “I think it is important for you to quit smoking now
and I can help you.” “Cutting down while you are ill is not enough.”
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The 5 A's
ADVISEStrong Advice:“As a healthcare professional, I need you to know that
quitting smoking is the most important thing you can do to protect your health now and in the future. Your healthcare professional and I will help you.”
Personalized Advice:Tie tobacco use to current health/illness, and/or its social and economic costs, motivation level/readiness to quit, and/or the impact of tobacco use on children in the household.
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The 5 A's
ASSESS
Action: Ask every tobacco user if he or she is willing to make a quit attempt a this time.
Strategy: • If the individual is willing to make a quit attempt
at this time, provide assistance.• If the individual will participate in an intensive
treatment, deliver such a treatment or refer to intensive intervention.
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The 5 A's
ASSESS, cont.
• If the individual clearly states he or she is unwilling to make a quit attempt at this time, provide a motivational intervention.
• If the individual is a member of a special population consider providing additional information.
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The 5 A's
ASSIST
Actions:• Help the individual find resources to quit
• Provide practical counseling and problem solving/skills training
• Provide social support
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The 5 A's
ASSIST continued…
Actions:• Help individuals obtain treatment and social support
• Recommend approved providers and tobacco cessation programs and services
• Provide supplementary materials
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The 5 A'sARRANGE
Action: • Schedule follow-up contact, either in person or via
telephone.
Strategy: • Timing: At your next home visit or clinic visit ask the
individual about their smoking status, encourage if they are in quit process, assess and refer if still smoking.
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Things to Remember
You may need to repeat this process several times before the individual finally quits.
You may not get through all 5 A’s at every visit and that is O.K.
This process is also helpful when dealing with someone who has relapsed.
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Resources
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Ohio Partners for Smoke Free Families: 5 A’s Intervention Record
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Smoke-Free Pledge
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Ohio Tobacco Quit Linehttps://ohio.quitlogix.org/
• Served populations• Pregnant women• Uninsured• Medicaid fee-for-service• Members of Ohio Tobacco Collaborative
• Services delivered• Intake call• Five outgoing coaching calls• Unlimited inbound calls• Two week course of nicotine patches or lozenges (if eligible)• Pregnancy Protocol • Text messaging• Online cessation program:Quitlogix• Warm Transfers
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Quit Line Pregnancy Protocol• The program offers special rewards to pregnant
callers, including:
• A $5 rewards card after the first call
• A $5 rewards card per completed call during
pregnancy (up to $25)
• A $10 rewards card per completed call after
childbirth (up to $40)
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Other Benefits…
• Text messaging options• Nicotine replacement therapy (if applicable
and approved)• Online counseling and individual, telephone
counseling• Most importantly: a healthy, tobacco-free
future for mothers and babies!
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Thank You!