Smoking Cessation & Prevention Workshop (2011)

Many women know that smoking is dangerous but few know that it is especially dangerous for women and children, that smoking related disease kills almost half the women in the US and reduces their life expectancy by 14.5 years. Both the scope of the problem and its economic costs are enormous.

Women are more susceptible to the harm of smoking and second-hand smoke than men. The fastest growing segment of the smoking population is young women. Smoking has a negative impact on 40 different physiological functions.

Meanwhile, the tobacco industry continues to aggressively market colorful candy-flavored nicotine products to young people. And funding for smoking cessation programs has been cut.

Fortunately, the recommendation by a provider to quit smoking increases the quit rate by 30%, especially when the right words are used, and counseling with medication is recommended.
More information: RI Tobacco Control Network

Good to Know

New tobacco screening measures will become mandatory in the next few years.

Government and community health policies aggressively seek to make tobacco use less normal, less available, more expensive and considered an environmental pollutant.

70& of smokers would like to quit. Only 15% are offered help.

Stats show providers are less likely to make a smoking diagnosis or order spirometry in women.

Women will quit smoking for the health of their unborn child. Then start again, not knowing that smoking contributes to post-natal morbidity.

A non-smoker who lives with a smoker has a 20% increased risk of disease.

Acupuncture reduces addiction in patients who are willing to quit, at the same rate of effectiveness as medicine and counseling.

Roadmap to Care

Each of the following interventions doubles the likelihood of quitting:

  • Physician’s recommendation
  • Counseling longer than 10 minutes
  • Cessation Medication beginning with the patch

A study of 4000 smokers in RI showed that 42% don’t consider quitting an option, and another 40% aren’t ready to quit.

Assess their motivational levels by asking:

  • “On a scale of 1 -10, how motivated are you to quit smoking right now?”
  • “What makes you not a 1 or a 2?”
  • “What will it take for you to get up to an 8 or 9?”
  • “What would it take to make you more motivated?

When they’re ready to quit, prescribe cessation medication (patch, gum, lozenge, inhaler, nicotine spray, buproprion, varenicline) and refer them toQuitWorks–RI for cessation counseling.

In Your Practice

The combination of counseling and medication have the highest quit rate, but only 6% of smokers take advantage of this combination.

To make the right thing to do the easiest thing to do in your practice:

  • Screen for tobacco use
  • Recommend quitting
  • Offer cessation medication
  • Encourage counseling
  • Follow-up

Remember that lecturing, labeling and statistics reduce motivation to quit. One way to increase motivation is to “develop a discrepancy.” Change is more likely to occur when a behavior is seen to be conflicting with important goals or values.

Step 1: Discover what is most important to the person (a value, relationship, goal or hobby)

Step 2: Explore the reasons why the person smokes

Step 3: Develop discrepancy by asking:

  • How does continuing to smoke move you closer to what is most important to you?
  • How does continuing to smoke move you further from getting what is most important to you?
  • What do you make of this difference?

Agenda from the Smoking Cessation & Prevention Workshop (2011)

A free workshop, focused on what you can do now, using available resources, to help your patients quit.


5:30-5:40    Welcome and Introductions
Event Moderator Karen Rosene-Montella, MD

5:40-6:10    How We Are Helping
Reimbursement, Regulations and Public Policy Patricia A. Nolan, MD, MPH; Jennifer Wood, JD

6:10-6:40    Assessing the Risks
Getting your patient’s attention Margaret Miller, MD; Athena Poppas, MD

6:40-7:10    Motivating Patients
Recognizing teachable moments Belinda Borrelli, PhD; Sara Ryan, DAc

7:10-7:40    Making It Work
Incorporating cessation practices Theresa Mrozak, RN; Amity Rubeor, DO

7:40-7:55    How You Can Help
Integrating what you already know?with what we’ve learned today Karen Rosene-Montella, MD

7:55-8:00    Closing Comments
Mary Reich Cooper, MD, JD

Slides from the Smoking Cessation & Prevention Workshop (2011)

Smoking Cessation 1: Margaret Miller, MD. Assessing the many risks associated with smoking. Women know that it’s dangerous but don’t understand its relevance to them.

Smoking Cessation 2: Athena Poppas, MD. Statistics about increased risk of smoking and second hand smoke for women. Women are more susceptible to the effects of tobacco.

Smoking Cessation 3: Belinda Borrelli, PhD.  How to increase motivation to quit through motivational interviewing.

Smoking Cessation 4: Sara Ryan DAc. Acupuncture and the NADA Protocol have a 31% quit rate and 90% relief of recidivism.

Smoking Cessation 5: Theresa Mrozak, RN How to create a sustainable quit practice using Quit WorksRI.

Smoking Cessation 6: Amity Rubeor, DO. An action plan for initiating a smoking cessation program.

Report Cards from the Smoking Cessation & Prevention Workshop (2011)

2011 Smoking Report Card: What RI is doing right, i.e., passing the 2009 Smokefree Workplace & Public Place Law vs. under spending on state tobacco control programs.

Pocket Cards from the Smoking Cessation & Prevention Workshop (2011)

Smoking Cessation, Smoking Prevention: A series of 7 cards expand on the traditional Ask & Advise, Assess, Assist protocol (Assist: Positive ReinforcementAssist: Pregnant Women Who SmokeAssist: Second Hand Smoke). These cards include the kinds of tobacco use to look for, the stages of readiness to quit (Assist: Unwilling to QuitAssist: Willing to Quit) how to move a patient towards quitting and how to help when they’re ready. Cards also address how to help pregnant women who smoke quit, and the risks of second hand smoke