Implementation Toolkit

• Clinical Practice Guideline for Treating Tobacco Use and Dependence (2008)
• Centers for Disease Control and Prevention (CDC) clinical tools
• Summary map of states where pharmacists can prescribe tobacco cessation medications
• Helpful handouts:
• 5 A’s Tobacco Cessation Counseling Guidesheet
• Implementing Ask-Advise-Refer
• Drug Interactions with Smoking Table
• Pharmacologic Product Guide
• Relapsed Smokers Protocol

Handouts for behavioral aspects of quitting:

• Benefits of Quitting
• Withdrawal Symptoms Handout
• Coping with Quitting
• Tobacco Use Log
• Planning for Quitting

Patient-friendly medication handouts:

• Nicotine patch
• Nicotine gum
• Nicotine lozenge
• Nicotine inhaler
• Nicotine nasal spray
• Varenicline
• Bupropion SR

Consider having patients calculate their cost savings associated with quitting smoking.

Recommended referral resources:

• Tobacco quitline, 1-800-QUIT NOW: contact your State Health Department for free quitline cards and brochures.
• Web-based programs and apps: consider referring your patients to additional resources, such as Becomeanex.org and Smokefree.gov, which have tailored versions available for veterans, women, teens, 60+, and in Spanish.

• List your pharmacy on the Quit Smoking Pharmacies website: QuitSmokingPharmacies.com
• Protocol implementation forms – these 4 sample forms can be downloaded and modified, as needed, to meet your state’s documentation requirements.
1. Patient Intake: key information to gather from your patient.
2. Treatment Plan Summary: for your files and for faxing to the Primary Care Physician (if applicable in your state).
3. Initial Follow-up: documenting a check-in with patient within 14 days after the quit date.
4. Final Contact: finalize the cessation service, documenting outcomes.
• Workflow integration suggestions for community pharmacies (who does what?).
• Modifiable marketing tools:
• Instagram template
• Facebook template
• Poster
• Flyer

We recommend a minimum of 2.0 hours of CE for licensed health professionals who are making medication recommendations. Some states require their pharmacists to complete a designated training; check with your Board of Pharmacy for state-specific requirements..

Web-based training programs

Rx for Change provides live and web-based CE programs at no cost, for various health professional disciplines: medicine, nursing, respiratory care, and pharmacy. We also offer a 30-minute Ask-Advise-Refer CE program for pharmacy technicians. See Rxforchange.ucsf.edu/continuing_education.php

For learners who wish to move “beyond the basics,� we will soon be providing longer training programs (6 hours). Also, we provide a 6-hour train-the-trainer program for faculty who wish to integrate the Rx for Change content at their school. More intensive Tobacco Treatment Specialist programs are offered by other institutions: Attud.org (fees apply)

If you are interested in attending a live webinar, you can select one from the table below. If you have questions or would like a tailored training provided for a large group, please contact us at rxfc@ucsf.edu.

Upcoming live webinars

Program Name	CE Hrs	Date	Time	Discipline	Registration Link
Pharmacists’ prescribing for tobacco cessation medications	2.0	March 4, 2022	12:30 PM - 3:30 PM ET	Pharmacy	tinyurl.com/3yzdy77x
Pharmacists’ prescribing for tobacco cessation medications	2.0	March 6, 2022	10:00 AM – 12:00 PM ET	Pharmacy	tinyurl.com/3yzdy77x