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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 l.jpg

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 l.jpg

Cessation Partnerships What Works

Helping Clinicians Become

Tobacco Interventionists


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The Smoking Cessation Leadership Center What Works

  • Robert Wood Johnson Foundation National Program Office

  • Housed at UCSF

  • About three years old

  • Director is Steven A. Schroeder, M.D., former RWJF president


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The Mission What Works

  • 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


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Eight Key Partnerships What Works

  • Nurses

  • Dental Hygienists

  • Pharmacists

  • Family Physicians

  • Emergency Physicians

  • Physician Assistants

  • Respiratory Therapists

  • Anesthesiologists


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Seven Key Projects What Works

  • 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


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Why the Focus on Quitlines? What Works

  • 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


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And… What Works

  • They have made the difference in persuading clinician groups to become tobacco interventionists


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From National to State and Local Levels What Works

  • 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


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How Our Message Has Evolved What Works

  • 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


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Honing the Message What Works

  • Dr. Schroeder’s July 2005 JAMA article further refined the message

  • Of four responses to smoking patients, three are acceptable….


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The Three Choices What Works

  • Do the full Five A’s

  • Do a brief intervention (A-A-R including pharmaceuticals)

  • Work on change within your system

  • (Or some combination)


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The National Card What Works


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And Order Cards… What Works

  • 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


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Partnerships--A Way to Stretch Scarce Resources What Works

  • 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


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The Four Questions Model What Works

  • 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)


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An Example: The Smoking Cessation Initiative of the ADHA What Works

  • Thirteen dental hygienists formed a task force

  • Leadership from elected president of ADHA

  • Support from Smoking Cessation Leadership Center

  • Expert facilitator


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How ADHA Answered the Four Questions What Works

  • 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.


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The ADHA’s SCI Communication Plan What Works

  • 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


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Examples of State Initiatives What Works

  • 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


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And Now– The Place-Based Partnership What Works

  • 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?


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Thank you! What Workshttp://smokingcessationleadership.ucsf.edu


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