Support for Systems Conducting Tobacco Cessation Work Gillian Schauer, Program Manager, TCRC

Produced by the Tobacco Cessation Resource Center. 2 Agenda Introduction Why Tobacco Cessation? What is TCRC? Resources and Tools Upcoming Events Q & A and Discussion

Produced by the Tobacco Cessation Resource Center. 3 Why Don’t They Just Quit? Chain of Addiction: Biologically Addictive Psychologically Addictive Culturally Addictive

Produced by the Tobacco Cessation Resource Center. 4 The Opportunity Most tobacco users want to quit. Half make a serious attempt each year. 80% see a healthcare provider each year.

Produced by the Tobacco Cessation Resource Center. 5 Benefits Benefits of a focus on tobacco cessation? Patient Satisfaction 1 Improved Outcomes Cost Effective 2, 3 Reimbursable 1 Solberg, LI et al.Patient Satisfaction and Discussion of Smoking Cessation During Clinical Visits. Mayo Clin Proc. 2001;76: Cummings SR, Rubin SM, Oster G. The costeffectiveness of counseling smokers to quit.JAMA 1989;261:75–79. 3 Tsevat J. Impact and cost-effectiveness of smoking interventions. American Journal of Medicine 1992;93:43S–47S.

Produced by the Tobacco Cessation Resource Center. 6 The Tobacco Cessation Resource Center (TCRC) Mission Statement: TCRC exists to provide training, mentoring, and resources to Health Care Providers, Health Delivery Systems, and those who work with Health Care Providers. Objective: To increase the number of Health Care Providers who effectively intervene with their patients who use tobacco.

Produced by the Tobacco Cessation Resource Center. 7

Produced by the Tobacco Cessation Resource Center. 8 5As Brief Intervention ASK about tobacco use. ARRANGE for follow-up. ASSIST the patient in quitting. ASSESS readiness to quit. ADVISE the patient to quit.     The 5A Intervention

Produced by the Tobacco Cessation Resource Center. 9 2A and R Brief Intervention ASK about tobacco use. ASSESS ASSIST ARRANGE REFER to resources internal or external entity that completes the rest of the 5As. ADVISE the patient to quit.    Schroeder (2005), JAMA. The 2A and R Intervention

Produced by the Tobacco Cessation Resource Center. 10 Free State Resources Free State Tobacco Quit Line Free Patient and Provider Materials Free Training and Technical Assistance

Produced by the Tobacco Cessation Resource Center. 11 WA State Tobacco Quit Line Free telephone counseling support and medication. A Quit Kit of stage and language appropriate materials. A personalized quit plan. Tools to cope with withdrawal symptoms. Medication decision support QUIT-NOW or NO-FUME

Produced by the Tobacco Cessation Resource Center. 12 WA State Tobacco Quit Line All adult residents in Washington have access to free telephone-based coaching and medications. In some cases, the overall benefit may be more if covered by Medicaid, their employer or health plan QUIT-NOW or NO-FUME

Produced by the Tobacco Cessation Resource Center. 13 Who is Covered? Coverage from July 1, 2008 – June 30, 2009 (subject to change) Services provided in Spanish and in over 100 additional languages. Fax Referral Program available for proactive outreach to tobacco users. to request fax referral Updated regularly. Last updated: 9/02/2008. For the most recent coverage update, go to: AgeEligible PopulationQuit Line ProgramLimitations AdultsSpecific Populations - Uninsured - Indian Health Services - Referred by Veteran’s Administration Multiple-Call Program Details: 1 participant-initiated call, 4 Quit Line-initiated calls  Stage appropriate “self-help” materials  8 weeks of Nicotine Replacement Therapy (NRT), if appropriate  Enrollment once per year, but participant may call Quit Line as needed  Age 18 and over  Prepared to quit within 30 days OR already quit AdultsResidents with WA State Medicaid Multiple-Call Program Details: 1 participant-initiated call, 4 Quit Line-initiated calls  Stage appropriate “self-help” materials  12 weeks of Nicotine Replacement Therapy (NRT) OR 12 weeks of buproprion or varenicline (with a prescription), if appropriate. AdultsPregnant Women (regardless of insurance status) Multiple-Call Program Details: 1 participant-initiated call, 9 Quit Line-initiated calls  Population-specific “self-help” materials  8 weeks of NRT, if appropriate (only with Medical Override) AdultsAny Washington State resident (regardless of insurance status) Note: Some callers may be eligible for additional services through their employer, a community resource or their health plan. 1-Call Program Details: 1 participant-initiated call  Stage appropriate “self-help” materials  If prepared to quit in 30 days OR already quit, participant is eligible to receive a 2-week starter kit of NRT (if appropriate)  Multiple calls per year, but must be initiated by participant  Age 18 and over Age 17 & under Youth (age 17 and under)1-Call Program Details: 1 participant-initiated call  No materials or NRT can be provided.  Multiple calls per year, but must be initiated by participant  Age 17 and under QUIT-NOW or NO-FUME

Produced by the Tobacco Cessation Resource Center. 14 Fax Referral Program Allows you to refer patients to the Quit Line using a fax referral process. Benefits: -Saves Time and Resources -Ensures Proactive Follow-up -Eliminates Patient Barriers -Creates Opportunity

Produced by the Tobacco Cessation Resource Center. 15 Patient and Provider Resources

Produced by the Tobacco Cessation Resource Center. 16 How to order? To access directions go to: --> click on “Order Tobacco Cessation and/or Quit Line materials.

Produced by the Tobacco Cessation Resource Center. 17 TCRC Provider Training On-Site Healthcare Provider Training Online Training and e-Learning Quit Line Fax Referral Brief Intervention

Produced by the Tobacco Cessation Resource Center. 18 Online 2A and R Training

Produced by the Tobacco Cessation Resource Center. 19 Technical Assistance Assistance helping organizations to: Set up systems to document tobacco use Develop tobacco cessation referral systems Tailor Electronic Medical Records Amend policies and procedures Implement smokefree campus policies

Produced by the Tobacco Cessation Resource Center. 20 Upcoming Events Webinar series (Winter, Spring 2009): Pharmacotherapy Reimbursement Setting up Systems to Identifying and Referring Tobacco Users

Produced by the Tobacco Cessation Resource Center. 21 Questions / Discussion

Produced by the Tobacco Cessation Resource Center. 22 Thank you!