Promoting Smoking Cessation
Quick facts about smoking cessation
- Approximately 70 percent of people who use tobacco products see a physician each year, so family physicians have the opportunity to make a significant impact on their patients' tobacco use, including those who have behavioral health disorders.1
- Approximately 42,000 lives could be saved if physicians would advise 90 percent of smokers to quit and offer them medication or other assistance.1
- Tobacco cessation more than doubles when evidence-based intervention programs are used.1
Tobacco and behavioral healthPeople with mental and/or substance use disorders account for 40 percent of all cigarettes smoked in the United States. Research shows that quitting smoking can improve mental health and addiction recovery outcomes. To reduce the disparate use of tobacco by people with behavioral health conditions, the Substance Abuse and Mental Health Services Administration (SAMHSA) recommends the adoption of tobacco-free facility/grounds policies and the integration of tobacco treatment into behavioral health care. For more information, download SAMHSA’s Tobacco and Behavioral Health: The Issue and Resources (PDF). 3
Ask, Advise, and Refer
Use these three steps — Ask, Advise, and Refer — sometimes called the "2A and R" brief tobacco intervention. Some of these steps can be delegated to members of your health care team
Step 1: Ask.
While collecting vital signs, a nurse or medical assistant can ask the patient whether the patient smokes or uses other forms of tobacco, and document the patient's tobacco use status in the chart or electronic health record.
Step 2: Advise.
You can briefly advise the patient to quit by saying something like, "I see that you smoke. Quitting smoking is one of the most important things you can do for your health right now. Have you thought about quitting?" This advice works best when delivered in a nonjudgmental tone.
You can make the advice more compelling by personalizing it, for example, by linking it to the reason for the patient's visit.
Step 3: Refer.
For patients who are interested in trying to quit, you, a nurse, or other members of your team can refer patients Pennsylvania’s Quitline or other community counseling resources.2
PA Free Quitline
The PA Free Quitline number (for patient self-referral) is 1-800-QUIT-NOW (784-8669).
PA Free Quitline services include:
- Up to five quit coach calls.
- Two or more weeks of nicotine replacement therapy.
- Unlimited inbound calls for additional support during times of high risk for using tobacco.
- Pregnancy/Postpartum Protocol (PDF) designed specifically to help women during and after pregnancy.
- Spanish quitline services available at 1-855-DEJELO-YA.
- Follow-up calls conducted at three, six, and 12-month periods to establish quit rates.
Providers can use the Fax to Quit program. This program allows health care and non-health-care professionals to refer tobacco-using individuals to PA Free Quitline services for expert, evidence-based, and confidential coaching to become tobacco-free.
Available to our members:
- Members may receive 70 tobacco cessation counseling sessions per calendar year (each session is a 15-minute face-to-face counseling session, either individually or in a group).
- No referral is needed from the primary care practitioner (PCP) for a member to go to a counseling session.
- Members who are eligible for prescription services may get tobacco cessation drug products, such as bupropion and the generic nicotine patch, with a written prescription from their provider.
- Members may access tips for quitting on our websites, AmeriHealth Caritas Pennsylvania and AmeriHealth Caritas Northeast.
Information for providers:
- The provider holding the smoking cessation sessions must participate in the Pennsylvania Medical Assistance program and be approved by the Pennsylvania Department of Health.
- On August 7, 2017, the Pennsylvania Department of Human Services issued MA Bulletin 99-17-07 (Procedure Code Change for Tobacco Cessation Counseling Services) stating that tobacco cessation counseling conducted after August 7, 2017, should be billed as CPT code 99407. Providers must provide more than 10 minutes of face-to-face counseling in order to submit a claim for a tobacco cessation counseling visit. This does not apply to federally qualified health centers (FQHCs) and rural health clinics (RHCs).
- Tobacco control intervention clinical policy 17.02.00 (PDF) for AmeriHealth Caritas Pennsylvania.
Other resources and trainings:
- Bambi Meets Godzilla: Addressing young adult tobacco use
- E-Cigarettes Fact Sheet (PDF)
- External Resources on E-Cigarettes (PDF)
- Rx for Change: Clinician-Assisted Tobacco Cessation
- Smokefree.gov: A trusted source for evidence-based smoking cessation tools and content. The tools below can be useful for both researchers and health care providers.
- Peers Helping Peers: Ways to Quit Tobacco with Rx for Change
- The Impact of E-Cigarettes on the Lung (PDF)
- Tobacco Cessation Education: A Training Program for Faculty
1 Tobacco and Nicotine Prevention and Control. American Academy of Family Physicians.
2 Tim McAffe M.D., M.P.H. A Brief Intervention to Help Patients Quit Smoking.
3 Tobacco. The Substance Abuse and Mental Health Services Administration (SAMHSA).