North Country Healthy Heart Network is subcontracting with Glens Falls Hospital to implement the Health Systems for a Tobacco Free NY initiative in Clinton, Essex, Franklin and Hamilton counties. The initiative is a NYS Bureau of Tobacco Control funded program that helps health systems develop, adopt and monitor implementation of an evidence-based standard of care for tobacco dependence. To date, Adirondack Health, Citizen’s Advocates and the Northern Adirondack Medical Home have all signed participation agreements.
As participants in the Health Systems for a Tobacco Free NY initiative, these organizations agreed to develop evidenced-based tobacco dependence treatment policies and procedures. They also agreed to monitor tobacco treatment activity and related patient outcome indicators as part of their system’s quality program.
So how does one know if they are getting “evidence-based” treatment for their tobacco use?
The U.S. Department of Health and Human Services – Public Health Service recommends use of the 5 A’s Behavior Change Model to treat tobacco dependence (Treating Tobacco Use and Dependence, 2008). Patients in an office that treats tobacco dependence using all 5 As would experience the following: They would regularly be asked if they use tobacco. If a tobacco user, they would be advised to quit and assessed to determine whether or not they are ready to do so. If ready to quit, they would be provided assistance, including counseling to help set a quit date, to help them anticipate barriers to their success and information about over the counter and prescription medications that will help reduce nicotine withdrawal symptoms. The provider office would then arrange follow-up for the patient to occur within a week of their quit date. If not ready to quit, assistance would consist of an intervention designed to stimulate patient thinking; thinking that may increase the patient’s readiness to quit. Follow-up would occur at the next visit when the patient is asked again about their tobacco use.
According to the U.S. Department of Health and Human Services, Public Health Service, “evidence indicates that full implementation of the 5 A’s in clinical settings may yield results that are superior to partial implementation,” (p. 40). While counseling or medication alone increase the likelihood of long-term abstinence by 14.6 – 21.7 percent respectively, patients whose health care providers offer treatment that includes both are up to 30% more likely to quit for good.
For more information about the 5 A’s, read the U.S. Department of Health and Human Services, Public Health Service’s Treating Tobacco Use and Dependence, 2008 Update. You may also contact Ann Morgan, Project Coordinator, at (518) 891-5855.