Wednesday, July 22, 2015

Quit Now Alabama: a free, statewide tobacco cessation resource

By: Alabama Department of Public Health

Overview of Services

Tobacco use continues to be the leading cause of preventable death in the United States and Alabama. Approximately 8,600 Alabamians die each year as a result of their own tobacco use and nearly 300,000 children are exposed to secondhand smoke. The Alabama Tobacco Quitline (Quit Now Alabama) was established by the Alabama Department of Public Health in 2005 to help combat this serious issue. Quit Now Alabama is a free telephone and online tobacco cessation program available to any tobacco user in the state. To date, more than 150,000 calls have been received and thousands of Alabamians have been helped to quit and stay quit. As providers, it is important to know recent changes to the program. Referrals may be made by fax and web-based referral and Medicaid now covers seven FDA-approved tobacco cessation medications to all Medicaid recipients. Read below to learn how to refer your patients.

Quit Now Alabama services can be accessed by calling 1-800-QUIT-NOW (1-800-784-8669) or visiting ,and are provided by National Jewish Health (NJH), the leading respiratory hospital and the largest nonprofit provider of tobacco cessation services in the United States. Services are available seven days a week between 6 a.m. and midnight and include the following:

• Tobacco cessation coaching programs

• *Eight-week supply of nicotine replacement therapy patches, if enrolled in coaching and medically eligible (*while supplies last)

• E-mail, text messaging, and mobile apps

• Printed support materials

• Web-based and fax referral program for healthcare providers

Tobacco Cessation Coaching Program

Coaching services are offered to all tobacco users accessing the quitline for support throughout the process of quitting. Five proactive, outbound coaching calls are offered to tobacco users and are provided by coaches with extensive training in tobacco cessation. Coaches use protocols developed from evidence-based theoretical foundations including Motivational Interviewing, Social Cognitive Theory, Transtheoretical Model of Behavior Change, Cognitive-Behavioral Theory, Goal Setting Theory and Relapse Prevention Theory. Coaching calls are individualized to tobacco users’ situations and motivational levels ensuring a flexible and positive treatment experience.

Special protocols are in place for pregnant/post-partum women and American Indians. The Pregnancy/Post-Partum cessation program offers a dedicated coach, additional coaching calls and tailored text and email messages to enhance engagement in the program. The American Indian (AI) cessation program is staffed by AI coaches and uses protocols to provide more culturally sensitive services.

Nicotine Replacement Therapy

Research has indicated that the combination of cessation coaching and medications is more effective than either intervention alone. Therefore, Quit Now Alabama began a nicotine replacement therapy program in 2006 to offer additional cessation assistance to tobacco users in Alabama. Quit Now Alabama offers free nicotine transdermal patches to all *eligible callers who are enrolled in coaching and medically eligible. To determine medical eligibility, all tobacco users undergo a medical screening during the initial call and a physician consent form is faxed, emailed, or mailed to tobacco users’ physicians if any of the following conditions are reported:

• Recent heart attack

• Recent stroke

• Uncontrolled high blood pressure

• Pregnant or Breastfeeding

Patches are sent in two-week increments and shipped directly to eligible tobacco users’ homes to lower barriers to their quit attempts. Quit Now Alabama currently provides up to **eight weeks of patches to eligible callers, and continued participation in coaching is required to receive patch shipments.

*Tobacco users with Medicaid do not receive NRT from Quit Now Alabama (see below for Medicaid benefits)
**The amount of NRT offered is contingent upon funding availability and changes as needed.

Healthcare Provider Referral Program

Healthcare providers may refer patients directly to Quit Now Alabama by completing a fax or web-based referral form. Quit Now Alabama attempts contact with referred patients within 24 hours of receiving the referral. By referring patients directly, Quit Now Alabama will also provide up to five progress reports regarding patients’ activity with the program.

Quit Now Alabama understands that the capability for eReferral programs through electronic health records (EHR) is the future. NJH is an industry leader in eReferral capabilities for tobacco cessation and is seeking partners in Alabama to implement a fully integrated, bi-directional eReferral program. Once implemented, the Quit Now Alabama eReferral program will reduce the time required to produce referrals and incorporate progress reports into a patient’s EHR, help demonstrate Meaningful Use, and increase the number of tobacco users referred to evidence-based tobacco cessation treatment programs.

Medicaid Smoking Cessation Benefits

The Alabama Medicaid Agency expanded the coverage of seven FDA-approved tobacco cessation medications to all Medicaid recipients on January 1, 2014. These medications are available to Plan First recipients and pregnant tobacco users without prior authorization. All other Medicaid recipients require prior authorization and referral to Quit Now Alabama.

Prior Authorization Form 470 and the Quit Now Alabama referral form must be completed and faxed (1-800-748-0116) or mailed to Health Information Design. The Quit Now Alabama referral form must also be faxed to NJH at 1-800-261-6259. Prior authorizations are processed as soon as possible, and patients should be able to pick up cessation products from their pharmacy within one business day. Quit Now Alabama will attempt contact with the referred patient within 24 hours of receiving the referral.

Additional benefits are also available for Medicaid-eligible pregnant women. The Alabama Medicaid Agency will reimburse for up to four face-to-face counseling sessions in a 12-month period. The reimbursement period begins in the prenatal period and continues through the post-partum period (60 days after delivery or pregnancy end). Documentation must support each counseling sessions. The Alabama Medicaid policy for this benefit can be accessed here.

As described above, tobacco cessation services and benefits are readily available to all tobacco users in Alabama. Quit Now Alabama encourages all healthcare providers to ask patients about tobacco use, advise tobacco users to quit, refer patients to cessation programs as needed and prescribe cessation medications when appropriate. These steps will ensure that the negative impacts of tobacco use in Alabama will decrease over time.

For more information about Quit Now Alabama or materials for your practice, contact the Alabama Department of Public Health at 334-206-3830.

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