Tobacco Treatment Program Policy and Procedure
The following steps should be followed for every patient age 10 and older at every visit.
Step #4 should be done for every patient whether or not they use tobacco.
(M.A.) 1. Ask patient if he/she uses tobacco. Record answer on SOAP note. If yes, move on to
step 2. If no, reinforce patient’s choice to not use tobacco and congratulate those who
have successfully quit. Move on to step 4.
(M.A.) 2. Ask patient how much tobacco he/she currently uses and how frequently. Record
answer on SOAP note. Move on to step 3.
(M.A.)3. Assess patient’s willingness to quit using tobacco. Record answer on SOAP note.
Provide patient with appropriate handout, either Quit Plan (green handout) or Thinking About Quitting (blue handout), based on patient’s willingness to quit. Move on to step
(M.A.)4. Ask if patient is exposed to environmental tobacco smoke (ETS), which is secondhand
smoke, at home, work, or play. Record answer on SOAP note. For those who use tobacco move on to step 5.
(Provider/ 5. Advise patient to quit using tobacco.
- If patient is ready to quit, ask if he/she would like to meet with the tobacco cessation counselor. Discuss Quit Plan handout. Indicate that you have discussed the handout by checking “tobacco cessation” under patient education on the SOAP note.
- If patient is not willing to try to quit at this time, discuss the Thinking About Quitting handout with him/her. Indicate that you have discussed the handout by checking “tobacco cessation” under patient education on the SOAP note.
(Provider/ 6. To refer a patient to individual or group counseling, check the box in the referral
Nurse) section of the SOAP note. Ask M.A./Nurse to schedule an appointment in Entity for the
patient to see the tobacco cessation counselor.
(Provider/7. If a patient is ready to quit, but does not want to meet with the tobacco cessation
Nurse) counselor, discuss the Quit Plan handout with him/her. Indicate that patient has
received the Quit Plan handout by checking “tobacco cessation” under patient
education. The health educator will be able to determine which intervention was
given (Thinking About Quitting or Quit Plan) based on the patient’s willingness to
quit using tobacco.
(M.A.)8. For patients who are ready to quit make an appointment in Entity before the patient
leaves the health center. (New appointments are 60 minutes and are listed under Tobacco Nw. Follow-up appointments are 30 minutes and are scheduled under Follow-up. Phones sessions are also available and are listed under Tobacco Ph.)
(Counselor)9. Cessation Counselor meets with patient at the scheduled time and place.
(Counselor) 10. Progress notes about counseling sessions are filed under the blue counseling tab in the
patient’s medical chart, which allows the medical team to be informed about the
patient’s tobacco cessation treatment and (if applicable) medication use.