Rx for Change: Clinician-Assisted Tobacco Cessation was designed to address an identified need to enhance the tobacco cessation education of health professionals.
Rx for Change, which draws heavily from the Clinical Practice Guideline for Treating Tobacco Use and Dependence, is a comprehensive, turn-key program for training students and licensed clinicians in virtually any health professional field. Our teaching strategies are varied and include selected readings, lecture with animated PowerPoint slides, videotape (an introductory segment, trigger tapes, counseling sessions), and role playing with case scenarios. All materials have been externally reviewed and are updated continuously to reflect current science for the treatment of tobacco use and dependence. Currently, we offer the following versions:
- Rx for Change: Clinician-Assisted Tobacco Cessation (“5 A’s” approach)
Our complete curriculum, including all core and optional modules, requires approximately 12 hours for implementation. These materials are applicable to any health profession. Our most common implementation scenario is 6 to 8 hours, which includes all core modules plus the Forms of Tobacco module. Slides are supplemented with ancillary handouts, role playing with case scenarios, and video segments.
- Rx for Change: Ask-Advise-Refer (brief intervention)
Recognizing that many clinicians are unable to integrate the full 5 A’s approach into routine practice, we created an abbreviated, 90-minute training that focuses on asking patients about tobacco use, advising patients to quit, and referring patients to other resources for additional assistance—such as the toll-free tobacco quitline, local group programs, and internet-based programs. This approach is applicable to any profession, but is particularly relevant to assistants of clinicians, such as medical assistants, dental assistants, and pharmacy technicians, for whom implementation of the 5 A’s would be inappropriate. Lecture slides are supplemented with video counseling sessions modeling the Ask-Advise-Refer approach.
Tailored versions are available for:
- Psychiatry Rx for Change
The prevalence of smoking among patients with mental illness is 2 to 4 times that seen in the general population. Co-occurring mental illness or addictive disorders can present unique challenges when working with a patient to quit smoking. Dr. Jodi Prochaska and colleagues at the University of California, San Francisco have created a 4-hour curriculum that is specific to psychiatry and has shown very promising results in changing the knowledge, attitudes, confidence, and clinical practices of psychiatry residents for treating tobacco use and dependence in their patients.
- Cancer care providers
Smoking impacts nearly every facet of cancer treatment: surgery, chemotherapy, and radiation. This 2-hour program targets cancer care providers, of all disciplines, in helping patients with cancer to quit smoking. Also available as a web-based CME/CE course.
- Cardiology Rx for Change
Heart disease is the leading cause of death among smokers. Funded by the Flight Attendant Medical Research Institute, Drs. Prochaska and Grossman at the University of California, San Francisco created a 1-hour training for cardiology care providers that addresses tobacco use and secondhand smoke exposure.
- Mental health peer counselors
This 2-hour program was created to equip peer counselors with the necessary knowledge and skills to assist mental health consumers with tobacco cessation. Created in collaboration with the National Mental Health Partnership for Wellness and Smoking Cessation.
- Surgical care providers
Tobacco cessation improves surgical outcomes. Created in collaboration with the American Society of Anesthesiologists, this 90-minute version targets clinicians who provide care to surgical patients.
Structure and components of Rx for Change
- PowerPoint slides: each slide is complete with instructor notes and current literature citations
- Case scenarios for role playing: a wide variety of cases for a variety of disciplines and practice settings
- Video segments:
- Introductory video: 7 min (provided by Frank Vitale, MA)
- Counseling sessions: ranging from brief to comprehensive, modeling the 5A’s and the Ask-Advise-Refer approaches
- Trigger tape vignettes: brief video clips for eliciting clinical problem-solving discussion
- Ancillary handouts: a series of handouts, which are "tools" for use when assisting patients
Seven turn-key continuing education programs are provided to facilitate outreach efforts. These programs range from 1 to 3 hours in duration. Learning objectives, slides, and audience handouts are provided.
Who can use the Rx for Change materials?
Our goal is to improve both the quantity and the quality of tobacco cessation counseling that occurs in clinical practice. Toward this goal, we openly share our materials with others. However, all persons receiving any components of the program must register on this web-site, which includes acceptance of our End-User Licensing agreement (EULA) prior to gaining access to the program materials. Rx for Change is a non-profit program and cannot be used, in any venue, for profit. Please refer to the End-User Licensing agreement (EULA) for more information about use of the Rx for Change program materials.
Development and dissemination of our materials over the years has been made possible by the National Cancer Institute, the University of California Tobacco-Related Disease Research Program, the Flight Attendants Medical Research Institute, and the Walther Cancer Foundation, Inc. The Smoking Cessation Leadership Center at the University of California San Francisco, through funding from the Robert Wood Johnson Foundation and the American Legacy Foundation, has assisted with development of several of the tailored versions as well as ongoing dissemination of the Rx for Change program.