Resources for Health Care Providers

Integrating Tobacco Cessation Interventions in Your Health Care Practice

The Affordable Care Act and related health reform initiatives have created opportunities to implement system changes in health care to reduce tobacco use, with the goal of improving services, improving health and reducing costs.

The U.S. Public Health Service (USPHS) clinical practice guideline "Treating Tobacco Use and Dependence 2008 Update" calls on clinicians to change or improve the practice patterns in their offices to ensure that 1) every patient is screened for tobacco use status and tobacco use status is documented, and 2) patients who use tobacco are advised to quit and provided options for evidence based treatments.

While primary health care settings are often motivated to begin addressing the high prevalence of tobacco use in their client population they may have questions about how to implement these services into daily practice. A tobacco cessation workflow helps provide practical strategies for how to offer these services. The workflow should identify who carries out each step of the intervention, when each step occurs in the course of the clinical encounter, and what information is needed at each step. A clinic workflow is not only essential to the design of the delivery system but is an integral part of developing or modifying the EHR.

Fortunately there are many tools available to help get started. You can start with some of the resources below that are designed to help implement tobacco cessation interventions in your health care practice, or contact Gwyn Ashcom, tobacco prevention coordinator, at 503-846-4544.


DIMENSIONS: Tobacco Free Toolkit for Health Care Providers

This toolkit is designed for a broad continuum of health care providers. Materials are intended for direct providers, as well as administrators and health care organizations.

The toolkit contains a variety of information and step-by-step instructions for education about tobacco use, skills for engaging individuals in tobacco cessation discussions, efficient methods for assessing people's readiness to quit, and information and research on treatments.


DIMENSIONS: Tobacco-Free Toolkit for Health Care Providers – Behavioral Health

This toolkit is designed to assist providers who work in a behavioral health setting with providing smoking interventions for those with behavioral health issues, including mental illnesses and addictions.

The toolkit contains information on tobacco use and health, why individuals with behavioral health conditions use tobacco, assessment and planning for change, tobacco cessation treatment, and specific findings regarding tobacco cessation medications and behavioral health conditions.


Treating Tobacco Use and Dependence: A Toolkit for Dental Office Teams

This toolkit is designed to assist dental offices with integrating the brief intervention, recommended by the U.S. Department of Health and Human Services, into standard office procedures and successfully intervene with patients who use tobacco.

The Campaign for Dental Health and the Julius B. Richmond Center of Excellence of the American Academy of Pediatrics have created a new resource, Addressing Tobacco in Dental Settings: A Resource for Dental Professionals, with a corresponding resource for families, How to Avoid Harmful Tobacco Products.


Clinical Tobacco Cessation Work Flow Examples

1. Tobacco Cessation Counseling Workflow: Example Template.

2. American Academy of Family Practice (AAFP) Office Champions: A Systems Based Approach.

Trauma-Informed Treatment Policy
You can use this template as a basis for developing a policy for your organization. The policy is to support staff in engaging clients in empowering, culturally appropriate and trauma-informed conversations about the impacts of tobacco use and exposure to secondhand smoke, and to provide support and encouragement toward reducing dependence on tobacco products.

RX for Change - Clinician-Assisted Tobacco Cessation Course
This is an online comprehensive tobacco cessation training program that equips health professionals of all disciplines with evidence-based knowledge and skills for assisting patients with quitting.
Treating Tobacco Use in Oregon: Tools for Helping Your Patients Quit - Provided by the Oregon Health Authority, this self-paced 45 minute course focuses on Brief Tobacco Intervention and Motivational Interviewing techniques that will improve your care team's ability to help patients quit tobacco. The course can be started, paused and resumed as needed. This training has been reviewed and is accepted for up to 1.0 prescribed credit from the American Academy of Family Physicians (AAFP). For other licensing boards that may not pre-approve continuing education credits (for example, the Board of Licensed Professional Counselors and Therapists), please submit the certificate of participation to your accrediting body.


Using the Oregon Tobacco Quit Line Service

1. Oregon Tobacco Quit Line

2. Tobacco Education and the Oregon Quit Line –A 101 for Health Care Providers

3. Quit Line Materials

4. E-Referrals Frequently Asked Questions

5. Fax Referrals Frequently Asked Questions

6. Verbal Consent Fax Referral Form - A staff signature is now only needed to note that a client gave consent to be referred to the Quit Line.

7. Standard Fax Referral Form (English)

8. Standard Fax Referral Form (Spanish)


CDC's Tips from Former Smokers Campaign

The Centers for Disease Control and Prevention's Tips from Former Smokers™Campaign encourages tobacco users to quit by sharing real‐life experiences of smokers.The campaign offers a variety of resources for providers to use in their clinics, such as social media content, video and print materials, FAQs, expert talking points and more.


Tobacco Resources

  1. CDC:Quitting Smoking
  2. CDC: Quit Smoking Resources
  3. Additional web resources for patients who want to quit can be found on the Washington County's I want to Quit website.

If you already have a clinic plan in place to treat tobacco dependence, your next step may be to start a quality improvement project to determine efficiency, effectiveness, outcomes and other indicators that will ensure the services you are providing are meeting the needs of your patients, as well as your team, in the best way possible.