NACCHO, District of Columbia
July 20, 2017
NACCHO, District of Columbia
July 20, 2017
The Center for Disease Control and Prevention’s (CDC) Tips from Former Smokers™ Campaign (Tips™) encourages tobacco users to quit by sharing the real‐life experiences of smokers. In 2017, the National Association of County and City Health Officials (NACCHO) partnered with the CDC to provide technical assistance to three local health departments (LHDs) and their associated healthcare providers to examine whether the placement of Tips™ materials in clinical settings would increase the number of tobacco cessation conversations between healthcare providers and patients.
To accomplish this project, LHD staff worked with clinical staff to track the baseline number of healthcare provider – patient cessation conversations happening before Tips™ materials were placed into the clinics. Then, LHD staff placed Tips™ video and/or print materials (which are always free‐of‐charge from the CDC) into clinic waiting rooms and patient rooms. Clinic staff were educated on evidence‐based tobacco cessation intervention strategies (e.g. the 5As) and free tobacco cessation resources, such as state QuitLines. For the next eight weeks, clinic staff tracked the number of tobacco cessation conversations occurring between patients and clinic staff. The data from each LHD demonstrates how the placement of Tips™ materials in clinical settings is an easy, low‐cost approach to increasing tobacco cessation.
The Utah County Health Department (UCHD) serves the second largest county in Utah (pop. 600,000) and is committed to promoting the health of the community by preventing avoidable disease and injury, by monitoring the health of their community, responding to public health emergencies, and assuring conditions in which people can be healthy. While Utah County’s adult smoking rate is 4.5%, UCHD strives to reduce that rate to zero using the CDC’s Best Practices for Comprehensive Tobacco Control Programs and endgame strategies for tobacco prevention and cessation. UCHD’s Tobacco Prevention and Control Program (TPCP) focuses on preventing tobacco use among youth, lowering the tobacco use rates, and reducing secondhand smoke (SHS) exposure. UCHD also has a long‐term relationship with the Molina Healthcare Clinic, which serves an area that has higher tobacco use rates. The Molina Healthcare Clinic specializes in treating Spanish‐speaking, uninsured, and low‐income populations.
During the 10‐week implementation period, Molina Healthcare Clinic staff reported a remarkable 500% increase in cessation conversations in April compared to the baseline data rates. A 420% increase in cessation conversations occurred in the entire month of May compared to the baseline data. Finally, a 460% increase in cessation conversations occurred in June compared to the baseline data. Prior to the implementation of the Tips™ campaign strategy, Molina Healthcare Clinic staff rarely asked about patients’ tobacco use. Following the intervention, the staff reported putting forth more effort to provide tobacco cessation resources to patients and to connect with them on a personal level regarding their tobacco use. A key factor might have facilitated the adoption of the Tips™ campaign across the clinic. The clinic staff reported a strong commitment to helping their Spanish‐speaking, low‐income patients quit using tobacco and believed the Tips™ campaign would be an effective strategy. One longtime smoker said she had tried to quit “so many times” but was unsuccessful in her attempts. The medical assistant used the support skills gained through the Tips™ campaign training to initiate a conversation about the patient’s tobacco use and the long‐ and short‐term health effects, demonstrated the commitment of the clinic to supporting the patient, and provided several resources, including the QuitLine number, Spanish language Tips™campaign materials, and a free ‘Quit kit’. The medical assistant was empowered to help the patient, and the patient reported a renewed desire to quit smoking and direction for starting.
The Tips™ campaign and training empowered clinic staff to hold cessation conversations by increasing their basic knowledge of tobacco use and providing accessible resources for hard‐to‐ reach populations. One medical assistant noticed that some patients that were not ready to talk about quitting tobacco would pick up print materials at the clinic. This indication of interest motivated her to follow up in later visits and provide resources. Gaining buy‐in from all medical assistants was important to the success of this intervention. Molina Healthcare Clinic intends to continue implementing the Tips™ campaign. For more information, please contact Linnea Fletcher at Utah County Health Department at LinneaF@utahcounty.gov