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.
- Desai, H.D. (2001). Smoking in patients receiving psychotropic medications: a pharmacokinetic perspective. CNS Drugs, 15(6), 469-494.
- 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.
- 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.
- 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.
- Berrios-Colon, E. (2008). Smoking-cessation options for adolescents. US Pharm., 33(7), 4-10.