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Resources for Pharmacists and Patients

There are multiple avenues both nationally and locally for pharmacists to train and prepare to provide tobacco cessation services. When patients need further support, pharmacists can also direct them to the national Quit Line (1-800-QUIT-NOW).

Opportunities for Pharmacists to Expand Knowledge of Tobacco Cessation Services

The PSW Tobacco Cessation Clinical Pocket Toolkit is supportive to this toolkit. It contains the 5A’s for tobacco cessation counseling and a medication resource to select the appropriate tobacco cessation medications and important clinical pearls to consider for each patient. The pocket-sized toolkit also contains specific motivational strategies for ambivalent tobacco users and questions that can be used when interacting with patients. As the patient perseveres through the quit attempt, pharmacists can use this toolkit to provide support with behavioral and cognitive coping strategies before and during the quit attempt.

PSW’s Motivational Interviewing (MI) Tip Sheet which pharmacists can use to increase their understanding of patient motivations and bolster the effectiveness of conversations. This resource provides definitions of terms commonly used in MI, reasoning behind MI, and practical applications. It covers the five main communication principles: express empathy, develop discrepancy, support self-efficacy, roll with resistance, and avoiding argumentation. There are links to the ACCP MI document as well as an online CE course on “Using MI to Create Change.”

For pharmacists who are looking for a national guideline, the 2008 Update on the Treating Tobacco Use and Dependence Guideline provides ten key recommendations when providing successful tobacco cessation services.1 The seven chapters analyze the effectiveness of 11 areas identified by the panel (proactive quit lines, combined counseling and medication, varenicline, combination medications, long-term medications, low socioeconomic status/limited health literacy, adolescent smokers, pregnant smokers, patients with psychiatric disorders, combined substance use disorders, focus on health benefits and provider training options) and outlines related strategies. This report further analyzes the importance of health care system support and coordinated interventions for these services. The information contained in these guidelines would also be helpful for pharmacists who are putting together a business case for the impact that tobacco cessation services can have.

References:

  • Tobacco Use and Dependence Guideline Panel. Treating Tobacco Use and Dependence: 2008 Update. Rockville (MD): US Department of Health and Human Services; 2008 May. Available from: https://www.ncbi.nlm.nih.gov/books/NBK63952/

Tobacco Cessation Worksheet

The following template may be useful when helping a tobacco cessation patient in your pharmacy (click to enlarge):

Additional Techniques for Helping Counsel on Smoking Cessation:

  1. Set a quit date
  2. Stress that tobacco cessation is not a cure
  3. Reiterate that tobacco cessation is hard, it requires overcoming physical and mental addiction
  4. Ask what they will do instead of using tobacco
  5. Keep a quit log with information on cravings and when tobacco was used/cigarettes were smoked
  6. Use a physical object to replace holding the cigarette in hand
  7. Place tobacco cessation where usually store tobacco
  8. Change routine or avoid triggers
  9. Don’t loiter after meals if they are a trigger, do something else right after like dishes
  10. Change route to work or music listened to in car
  11. Prepare house one week prior to quit date by airing out and washing clothing to avoid tobacco scent
  12. Practice by cutting back prior to quitting (e.g., cut cigarettes in half, throw away half a pack)
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