Purpose

To identify and facilitate tobacco cessation interventions for patients in the Otolaryngology--Head and Neck Surgery Clinic

Procedure

1. Tobacco status will be identified and documented. A systems based reminder will be placed on charts to encourage clinicians to address smoking cessation in current smokers.
2. All patients identified as tobacco users will be advised to quit, and offered the opportunity for cessation counseling and pharmacotherapy.
3. Patients who state that they do not wish to stop using tobacco will be informed of educational materials regarding the adverse effects of tobacco and the benefits of cessation.
4. Patients who state that they are interested in quitting within the next 30 days will be given information regarding cessation methods. An action plan will be developed specific to patients' needs and desires.
5. Follow-up arrangements will be made to assess progress and offer continued support. Referral to Pulmonary Rehabilitation will be made for intensive counseling, pharmacotherapy, and encouragement of quitline use.

Online Resources

1. For Health Professionals
   • US Department of Health and Human Services Cessation Guidelines site. Contains the most definitive literature on tobacco cessation.
   • The National Center for Chronic Disease Prevention and Health Promotion of the Centers for Disease Control and Prevention. https://www.cdc.gov/chronicdisease/index.htm
   • American Cancer Society data site: http://www.cancer.org/Healthy/StayAwayfromTobacco/index
   • The World Health Organization http://www.who.int/topics/tobacco/en/
   • National Cancer Institute
2. For Patients
   • CDC tobacco website https://www.cdc.gov/tobacco/php/data-statistics/smoking-cessation/index.html
   • The National Cancer Institute
   • Smokefree Website, the Tobacco Control Research Branch of the National Cancer Institute https://smokefree.gov/
   • American Heart Association: http://www.americanheart.org
   • NIH http://www.nlm.nih.gov/medlineplus/smokingcessation.html
   • American Lung Association Freedom From Smoking http://www.freedomfromsmoking.org/
   • Iowa Department of Public Health website dedicated to assisting Iowans with smoking cessation: https://hhs.iowa.gov/programs/welcome-iowa-medicaid/iowa-medicaid-programs/smoking-cessation

QuitLine Resources

1. State Quitline: 1-800-QUIT-NOW
2. The National Cancer Institute of the National Institute of Health quitline: 1-877-44U-QUIT

Medical Therapy

1. Nicotine Replacement Therapy
   • Patches used as baseline replacement
   • Ad-lib replacement for acute cravings with gum, lozenges, inhaler, or nasal spray
2. Bupropion
3. Varenicline 

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