Quit Now Indiana Indiana Tobacco QuitLine & Tobacco Prevention and Cessation (TPC) Indiana Tobacco QuitLine & TPC Preferred Provider Network October, 2011 1

Presentation Overview Indiana Tobacco QuitLine Success w/Preferred Provider Network 2

Work To Be Done Indiana smoking rate = 21% down from 27% National smoking rate = 18% Over 1 million smokers in Indiana Continue working for a tobacco-free Indiana

We can help them/you achieve this. Adult Population 80% want to quit 60% of Hoosier adult tobacco user attempt quitting through a variety of methods each yr Multiple attempts Health Care professionals need a place to refer their diverse populations for successful quit We Can Help! 2002 & 2008 Indiana Adult Tobacco Survey . Healthcare professionals need a place to refer their patients to that can service their diverse populations for successful quit. We can help them/you achieve this.

Quit-Now Indiana Program A Solution… Telephone-based cessation services Offered toll-free to the general public Evidence-based Reactive or Proactive Quit-Now Indiana Program ~Refer to Preferred Employer Toolkit~

What Is A QuitLine? Telephone-based Cessation Services Offered Toll-free Evidence-based Proactive Coaches Highly trained in cognitive behavioral therapy 240 hours of training Spanish speaking competency (170 other languages) Educated up to graduate level Over 50% with 3+ years prior experience in counseling 6 6

Overcome Barriers Improves cessation rates by increasing the percentage of smokers making a quit attempt & reduce the probability of relapse (Cummins, Bailey, Campbell, Koon-Kirby, & Zhu, 2007a; McAfee, 2007; Zhu, et al., 2002). Access transportation especially rural / remote areas Appeal to those reluctant to take part in group (Zhu, Anderson, Johnson, Tedeschi, & Roeseler, 2000) Successfully extended the reach of more traditional programs (Zhu, Rosbrook, Anderson et al., 1995).

Benefits Confidential Free National call number 1-800-QUIT-NOW Provides intensive one on one counseling Unlimited access as long as necessary HIPAA Compliant Entity Assess ability to all tobacco users Easy to use Initial call does not need to be made by tobacco users, but by Quit Coach™ 8 8

QUIT RATES Quitline evaluation Using random sampling, we have evaluated the INQL by surveying callers 7- and 13-months after they have registered and received Quitline Services. The goal was to compare the satisfaction and quit rates between participants who received NRT benefits from the INQL and those who did not. 7-month survey Consisted of 784 participants that had registered in the INQL between December 1, 2007 and September 30, 2008. Of the 794 participants, 392 were NRT recipients, and 392 were non-recipients. The sample was composed of 263 uninsured, 260 Medicaid recipients, and 270 insured non-Medicaid. 13 month survey Consisted of 983 participated that registered in the INQL between June 1, 2007 and March 31, 2008. Of to the 983 participants, 393 were NRT recipients and 590 were non-recipients. The sample was composed of 328 uninsured, 328 Medicaid recipients, and 327 insured non-Medicaid.

KEY PROGRAM COMPONENTS Four prearranged calls w/coach Ten prearranged calls for pregnant woman (special program) Web coach Unlimited call in privileges and access to coaches Free 2 wk NRT starter kit (uninsured, Medicaid, Medicare) Support Materials Our treatment approach is comprised of 4 key program components – the Quit Coach, Web Coach, Medication and Quit Guide. Whether through out Quit Coaches, Web Coach or in our printed Quit Guide, our participants learn how to overcome their addiction by following The 4 Essential Practices to Quit For Life. QUIT COACH Highly trained in addiction studies and behavior change, our coaches are experts in helping participants over the phone and online to successfully quit tobacco use. Coaches must complete 240 hours of rigorous training and evaluation before they are qualified to speak independently with participants. WEB COACH QUIT GUIDE MEDICATION DECISION SUPPORT NOTES: The 4 Essential Practices

2 wk starter kit (patches or gum) THE PARTICIPANT EXPERIENCE 1. Fax Referral or Person Calls 3. Professional Coach 2. Intake Specialist 4. Professional Web Coach Physician RX or OTC 2 wk starter kit (patches or gum) Medicaid Medicare Uninsured

Something For Everyone www.in.gov/quitline www.quitnowindiana.com www.in.gov/isdh/tpc   Mention each of the links participants can click on Smoker Provider Employer Family & Friends Connect w/Quit Coach…they will call you back New consumer website here www.quitnowindiana.com The new look for the website should be live in the next week or so. 12 12

The Program Works Practices based on 25 yrs of research helped hundreds of thousands of smokers quit & stay quit Choose own Quit Date, personal Quit Coach help prepare & get ready Learn when & where urges strike & how to cope & manage stress w/o smoking Recommend meds right for each participant and teach how to use correctly QUIT for good-support to make this the LAST Quit, help with weight issues Quit at personal pace Conquer urges to smoke Use Pharmaco so they really work Don’t just Quit, become NON-SMOKER The participant sets the “quit date” Tools for coping w/triggers & stress Answer questions re NRT & RX meds and watch for red flags Unlimited access 13 13

Preferred Provider Network Preferred Provider Patients Preferred Employer Employees Preferred Organization Clients/Participants/Other ~Refer to Preferred Provider Toolkit~ 14

Preferred Provider = Multiple Benefits Patients 2.5 x more likely to quit if you tell them to quit A place to send patients to help them quit smoking Access to professional evidence based resources Exclusive tobacco cessation services and materials Unlimited QUIT NOW fax referring privileges Promotional and educational materials Data on participating fax referred patients Pharmacotherapy chart w/insurance reimbursement codes Direct access to ITPC cessation specialists ITPC support every step of the way Your patients look to you for direction about their individual health issues. Your help and guidance can give them the power to curb this devastating problem. Please enroll today in this lifesaving program and begin referring patients to the Indiana Tobacco Quitline immediately. We are with you every step of the way.

Join Our Preferred Provider Network YOU ARE READY: Promote the Indiana Tobacco QuitLine to patients Begin referring patients who are ready to quit to 1-800-QUIT-NOW Simple easy form to fill out, fax, email or leave w/me today 16 16

Recommend a medication, if appropriate Brief Intervention (less than 3 minutes) Ask Advise Refer We now know that this brief 3 minute approach to the 5 A’s is very if not more effective. 2 As and an R… Staff can record this during intake Provider simply needs to reinforce 1-800-QUIT-NOW Recommend a medication, if appropriate

Fax Referral You fax it… We take it from there… Clinic Employer Information You fax it… We take it from there… Review specific areas of the form Captive audience Provides intensive counseling option often not feasible in busy clinic environment Implementation in a variety of settings Easy to use form Initial call not made by tobacco users, but by Quit Coach™ Outcomes reported back to physician/clinic 18 18

Conclusions Treatment of tobacco use = at least same attention that other chronic diseases demand Providers need to: Engage in effective behavioral interventions Enroll PPN-enhance your services Optimize medication use Have knowledge of support and utilize resources Fax Referral is the cornerstone of diverse cessation success.

Take Action NOW! ?QUESTIONS? Camille Kalil, Director of Tobacco Treatment Tobacco Prevention and Cessation Commission Indiana State Department of Health ckalil@isdh.in.gov 20