Pharmacists

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Pharmacists could play a unique role in tobacco cessation efforts, due to the quality and quantity of the knowledge about prescription medication and their possible interactions with nicotine replacement therapy (NRT; nicotine patches, gum, etc.).

PHARMACISTS

Pharmacists play a unique role in tobacco cessation efforts due to their knowledge about medications and their possible interactions with nicotine replacement therapy (NRT).

Prevention

  • Discourage the use of tobacco products through no-smoking signs and refusal to sell tobacco products at your pharmacy.  San Francisco was the first city in the United States to implement a tobacco ban in retail pharmacies.
  • Ask your patients who are prescribed cardiovascular and psychotropic medications or birth control, if they are using tobacco products that may cause interactions (e.g., increased risk of blood clots).

Intervention

  • Help your patients who are willing to quit develop a quit plan tailored to their needs and follow up with them periodically.
  • Instruct patients who decide to use prescription or OTC NRT how to use them properly.
  • Review your patients’ prescription profiles often to ensure continued compliance of prescription NRT.
  • Smokers who want to quit are willing to make repeated pharmacotherapy-assisted quit attempts; consult with patients often to increase rates of smoking abstinence.
  • Attend classes to refresh your knowledge on tobacco cessation interventions.

Policy Issues

  • Most pharmacies keep NRT products behind the counter or within a locked case, encourage additional advertising of these products within your pharmacy.  Additionally, support policies that provide easier access to NRT.
  • The inability to speak with a primary care physician due to being uninsured or underinsured leads patients to seek out free consultations from Pharmacists.
  • NRT cannot be purchased by individuals under the age of 18 in Maryland, recommend that interested individuals consult their physician about a quit plan.  Ask for permission to provide education about the effects of smoking, focusing on risks that might be most meaningful to young people: premature aging, staining of teeth and nails, and smoker's breath.

Helpful Resources

Rx for Change: Ask-Advise-Refer (Brief Intervention)
Recognizing that many clinicians are unable to integrate a full intervention into routine practice, clinicians can access a 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. http://rxforchange.ucsf.edu.

Fax to Assist

See Fax to Assist for more information on our Fax Referral Program.

 

Did you know that the Medicaid population is significantly more likely to use tobacco than the general population? Do you want to enhance your skills at reaching and intervening with Medicaid patients who use tobacco? MDQuit has an online training to teach you the strategies that can be utilized with all patients—regardless of their health insurance status. You can sign-up for this FREE self-paced online training by going to https://HABITSLabTraining.litmos.com/self-signup/ and entering the training code, "medicaid". 

 
 
Last updated: September 26, 2016
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References
  1. Desai, H.D. (2001). Smoking in patients receiving psychotropic medications: a pharmacokinetic perspective. CNS Drugs, 15(6), 469-494.
  2. Okuyemi, K.S., Nollen, N.L., & Ahluwalia, J.S. (2006). Interventions to facilitate smoking cessation. American Family Physician, 74(2). Obtained from http://www.aafp.org/afp/20060715/262.html on 2/26/10.
  3. Ellerbeck, E,  Mahnken, J, et.al. (2009). Effect of varying levels of disease management on smoking cessation a randomized trial. Annals of Internal Medicine, 150(7), 437-446.
  4. Martin, B, Bruskiewitz, R, & Chewning, B. (2003). Effect of a tobacco cessation continuing professional education program on pharmacists' confidence, skills, and practice-change behaviors. Journal of the American Pharmacists Association, 50(1), 9-16.
  5. Berrios-Colon, E. (2008). Smoking-cessation options for adolescents. US Pharm., 33(7), 4-10.