Smoking Cessation Counseling: Tips and Tricks for Providers. Megan DePumpo, AM and Anna Poss, M.Ed., LCPC

Transcription

1 Smoking Cessation Counseling: Tips and Tricks for Providers Megan DePumpo, AM and Anna Poss, M.Ed., LCPC

2 Continuing Education Disclosure Commercial Support or Sponsorship None Speaker or planner relationships with commercial interests None For CME credit or attendance certificate - Full session attendance + completion of on-line evaluation: Smoking-Cessation OR

3 Our Speakers Megan DePumpo, AM Research Operations and Projects Manager for Lindau Lab at University of Chicago Anna Poss Clinical Director for Cook County Health and Hospital System's Healthy Lungs Initiative

4 Smoking Cessation Counseling: Tips and Tricks for Providers Megan DePumpo, AM and Anna Poss, M.Ed., LCPC

5 Learning Objectives After the presentation you will be able to: 1. Outline the steps of Ask Advise Refer 2. Apply motivational interviewing techniques in the clinical encounter 3. Describe guidelines and uses for tobacco cessation medication 4. Apply brief cessation counseling during the clinical encounter

6 Overview I. Ask Advise Refer II. Motivational Interviewing III. Tobacco Cessation Medication IV. Use Cases

7 I. Ask Advise Refer

8 Ask Advise Refer A briefer version of the 5 A s Intended to be brief 3 minutes or less ASK Every patient about tobacco use at every visit What kind of tobacco and how often ADVISE Advise to quit REFER Don t have a smoking cessation counselor? Refer to the local Quitline! Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs 2014.Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.

9 The Quitline?! Yes the Quitline Underutilized resource Among low-income smokers, greater use of QL is associated with higher abstinence 1 1 Bernstein S, Weiss J, Toll B, Zbikowski S. Association between utilization of quitline services and probability of tobacco abstinence in low-income smokers. Journal Of Substance Abuse Treatment [serial online]. December 2016;71:58-62.

10 II. Motivational Interviewing

11 MI: The Basics Four Principles Express Empathy (build rapport) Develop Discrepancy (elicit pros and cons) Roll with Resistance (respect patient autonomy) Support Self-Efficacy (communicate the patient is able to change) Bray, J., Ph.D., Kowalchuk, A., DO, & Waters, V., MS, PA-C. (n.d.). Brief Intervention Stages of Change and Motivational Interviewing. Retrieved March 20, 2017, from

12 MI Skills OARS Open-ended questions What negative consequences have you had as a result from your smoking? or what do you not like about smoking? Affirming and supporting You ve been able to quit smoking in the past. You can use the skills used and lessons learned from that quit attempt this time. Reflective listening What I hear you saying is that you are worried about gaining weight if you quit smoking. Summary statements Highlights motivation and key take-aways from discussion, review pros and cons Bray, J., Ph.D., Kowalchuk, A., DO, & Waters, V., MS, PA-C. (n.d.). Brief Intervention Stages of Change and Motivational Interviewing. Retrieved March 20, 2017, from

13 I have no time for this! It s client-centered You will get less resistance Patient shares their ambivalence (out loud!) Bray, J., Ph.D., Kowalchuk, A., DO, & Waters, V., MS, PA-C. (n.d.). Brief Intervention Stages of Change and Motivational Interviewing. Retrieved March 20, 2017, from

14 III. Cessation Medications

15 Does it really work? Do not be afraid of medications! They can double your patients chances of quitting Anczak, J. D., & Nogler, R. A. (2003). Tobacco Cessation in Primary Care: Maximizing Intervention Strategies. Clinical Medicine and Research, 1(3),

16 Medication 411 Pros and Cons Contraindications My patient has used it in the past and it hasn t worked what do I do now? Don t be afraid to use this!

17 IV. Use Cases

18 John John is a 56 year old male and has been smoking his whole life. He started at 12 when he would go and pick up cigarettes for his mom at the corner store. He now smokes about 20 cigarettes a day and is thinking about cutting down. What do you do?

19 Viola Viola is a 30 year old woman and has recently started smoking again. She smoked a little in high school. She s smoking again to deal with stress; her mom was recently diagnosed with cancer and Viola is her primary caretaker. What do you do?

20 Sharon Sharon is a 65 year old woman and smokes socially. She smokes when she is out friends (a couple), and never smokes inside. She is a breast cancer survivor and has no interest in quitting smoking. What do you do?

21 Hank Hank is a 45 year old man and has been actively trying to reduce his smoking. He smoked about 10 cigarettes per day and in the past 6 months is now down to 1 cigarette a day. He is having a hard time giving up his morning cigarette with coffee. What do you do?

22 Thank you! Please reach out if there are any additional questions: Meg DePumpo: Anna Poss:

23 Continuing Education Certificate For CME credit or attendance certificate - Full session attendance and completion of on-line evaluation: OR Thank you!