Treating Patients Who Use Tobacco

Because tobacco use and dependence often requires repeated interventions, long-term support is necessary to help patients quit. Wherever a patient is in their journey, encourage tobacco cessation by:

• Asking permission to talk about their tobacco use and readiness to quit.
• Advising them to quit.
• Offering brief counseling.
• Prescribing cessation medication.
• Connecting them to additional resources, like a quit line.
• Following up with continuous support to help prevent relapse.

Tobacco cessation counseling

Counseling is critical to the success of tobacco dependence treatment. Providers are encouraged to provide counseling for at least ten minutes at every relevant visit and/or refer patients to Resources for Quitting.

For patients who are not ready to quit, the CDC recommends providing a motivational message, setting expectations, and leaving the door open to future conversation. For example, “I feel strongly about tobacco use and its effect on your health. I understand that quitting can be hard, but I am here to support you. I will ask you about it the next time I see you.”

Additional resources for quitting

Combined with your ongoing counseling and treatment, referring patients to quit lines or other cessation support resources can help your patients quit for good. Share these resources with your patients to support them on their quitting journey.

Kick it California

A program that is proven to help people quit with coaching sessions over the phone and text reminders. To learn more, patients can visit www.kickitca.org or call:

• English: 1-800-300-8086 or Text “Quit Smoking” or Quit Vaping” to 66819
• Español: 1-800-600-8191 o Envie “Dejar de Fumar” o “No Vapear” to 66819
• 中文 (Chinese): 1-800-838-8917
• 한국인 (Korean): 1-800-556-5564
• Tiếng Việt (Vietnamese): 1-800-778-8440

Providers may also refer tobacco users to Kick it CA electronically (e-referrals). E-referrals are secure and easy. Refer patients today!

Tobacco cessation mobile apps

These resources are only for patients that own a smartphone and can download apps. During visits, ask whether your patients have a smartphone that can download apps. If so, your patients can download the Smokefree App and Quit Vaping App.

For other programs/resources

Call HPSM’s Health Promotion Unit at 650-616-2165www.hpsm.org/break-the-habit.

Tobacco Cessations medications

For most patients, a combination of pharmacotherapy and behavioral therapy is required to stop smoking. There are several medication options that providers can prescribe to assist with tobacco cessation. Medication treatment options include:

• Medications to reduce cravings:
  • Bupropion SR (Zyban).
  • Varenicline (Chantix) AND;
• Nicotine replacement therapy such as:
  • Skin patches.
  • Lozenges.
  • Nicotine gum.
  • Nicotine nasal spray.
  • Nicotine inhalers.

The FDA has only approved medications for tobacco cessation in adults (ages 18+). To learn more about pharmacologic cessation support for youth, visit the American Academy of Pediatric Recommendations. For more information on tobacco use and exposure in youth visit our Vulnerable Populations webpage.

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