Implementation of inpatient and outpatient tobacco-cessation programs

Two programs in which pharmacists have an active role in the provision of tobacco-cessation education are described.

An algorithm for tobacco- cessation education was created for use in an inpatient tobacco-cessation program. Patient education handouts were created, and the content of each handout varied by the patient's level of readiness to make a quit attempt. Doctor of pharmacy students who were assigned to the general internal medicine clerkship rotation at the hospital provided tobacco-cessation education to patients. During monthly rotations, these students assess the smoking status of each patient, gauge the patient's readiness to quit, and provide brief tobacco-cessation education to those who smoke. Patients who are willing to quit smoking are asked if they can be contacted by a representative of the health system's tobacco-cessation program. This program includes a series of three group classes focusing on behavior modification and pharmacotherapy provided at a discounted price. An outpatient tobacco-cessation clinic was initiated to provide all patients of the network an opportunity to participate and have access to tobacco-cessation services. The clinic consists of group and individual classes using the principles and interventions highlighted in national clinical practice guidelines. All referred patients must attend an initial one-on-one visit with the clinical pharmacist before enrollment into the group class. During this visit, general medical information is collected, and the patient's stage of change and willingness to set a quit date are determined. A medication review for drug-smoking interactions is conducted, individual goals are discussed, and a care plan is created.

Tobacco-cessation services were implemented by pharmacists working in inpatient and outpatient settings.