This newly updated resource is your go-to guide for enhancing tobacco cessation treatment in your practice! The 2017 issue includes the latest information on pharmacotherapy, billing, ENDS, and trauma-informed care.
Practice Bulletin
Use this resource to guide your 5As counseling with patients and to record information about their tobacco use. Prenatal version.
Prenatal Five As Intervention Record (FAIR Form)
Use this resource to guide your 5As counseling with patients and to record information about their tobacco use. Postpartum version.
Postpartum Five As Intervention Record (FAIR Form)
Use this resource to guide your 5As counseling with patients and to record information about their tobacco use. Non-pregnant version.
Non-Pregnant Five As Intervention Record (FAIR Form)
A proactive referral to the Quitline can help your patients quit tobacco for good. As HIPAA protected entities, providers can receive patient outcome report from the Quitline. Be sure to check "yes" by the statement "I'm a HIPAA-Covered..."
QuitlineNC Fax Referral Form (English)
A proactive referral to the Quitline can help your patients quit tobacco for good. As HIPAA protected entities, providers can receive patient outcome report from the Quitline. Be sure to check "yes" by the statement "I'm a HIPAA-Covered..."
QuitlineNC Fax Referral Form (Spanish)
Clinics can create standing orders so that any Public Health Registered Nurse who has proper certification (including the You Quit, Two Quit training we provide!) can provide tobacco cessation counseling.
Sample Standing Orders
This comprehensive 2014 guide helps clinicians and administrators implement tobacco cessation programs in a variety of healthcare settings. It offers tools, resources, and suggested processes to support effective tobacco-cessation programs.
Blueprint for Implementing Clinically-Based Tobacco Cessation Programs
An appropriate tobacco-related diagnosis must be filed in addition to the Evaluation and Management code and submitted with the CPT code.
Medicaid Billing Information