Impacting smoking cessation through interprofessional health teams

The graph depicts the number of individuals who enrolled in a tobacco cessation program through the LA Smoking Cessation Trust over the past 4 years. This number has increased as more organizations are providing smoking cessation education within their communities and advertising the opportunity. Over one million Louisianians smoke. While the percent increase of individuals enrolled in the program is wonderful, I wonder what would the slope of this curve look like if ALL health professionals recommended, referred and followed-up on the referral to a smoking cessation program? Louisiana spends less per person on tobacco cessation than other states, but I wonder if health teams collaborated more on primary and secondary prevention, could we be as successful....just in a more efficient manner?

There are two foundational messages in this article: 1) Collaboration among health teams and 2) evidence-based practices. I will address the evidence-based practice first for behavioral change. At the end of the article, there are 2 ideas to integrate into your practice. As for collaboration, most believe that collaboration has to occur face-to-face. While I do agree that it is great to have face-to-face discussions, interprofessional health teams can collaborate through the development of trusting relationships. If the goal is to decrease the use of tobacco, members of health teams can work in separate physical spaces and commit to addressing the problem. This commitment is a form of interprofessional collaboration.

The positive change related to smoking cessation is wonderful to see. However, I know we can do better. For those health professionals who do not directly address smoking habits in their practice, my challenge to you is....modify the way you practice to incorporate more prevention strategies. As a team, we can make an impact!

Identify use and appropriate intervention (5 A’s)

• ASK – identify and document status for every patient/client at every visit
• ADVISE – be clear and strong in your message, use a personalized approach
• ASSESS – readiness to behavioral change
• ASSIST – promote behavioral change through intervention (treatment, education, referral, etc)
• ARRANGE – for intervention; follow up within a week

Motivational Approach (5 R’s)

• RELEVANCE – why is quitting personally relevant
• RISKS – negative consequences of tobacco use
• REWARDS – benefits of stopping tobacco use
• ROADBLOCKS – barrier to tobacco cessation
• REPETITION – repeat intervention as needed