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Step 6: Implement Patient Goals: Assessment, Treatment, and Empowerment

Step 6 includes implementing strategies and tactics to address patients’ nicotine addiction, such as reducing the rate of tobacco addiction amongst your patients and increasing motivation to seek treatment. The ATTOC Approach provides specific tools to help with screening, assessment, diagnosis, treatment planning, discharge planning, referral to quit lines, and motivation-based treatment interventions that can be delivered at the agency in individual or group format. Review how patients flow in and out of your program to determine when and where tobacco use and addiction should be assessed and treated and by whom.

Three achievable goals are

  1. Add tobacco addiction to the treatment plan for all tobacco users.
  2. Refer all tobacco users to Quit Lines and/or Nicotine Anonymous,
  3. Start a new treatment option (medication, group treatment, individual treatment, education) on site.





Task 1. Assess how a patient flows through your agency and identify opportunities to prevent, treat on site, and refer for tobacco addiction treatment outside the agency.

The Tobacco Leadership Group or a work group can focus on what services are provided and what are already provided and refine plans to implement agency goals. Some agencies will provide extensive treatment; others will provide assessment, treatment planning, referral, and ongoing encouragement for recovery. To be successful, provide excellent education, training, and communication to staff who will need to perform new functions. Once the Champion and key managers create the new treatment model and intervention points, revise existing policies and procedures (such as requirements for documentation) to incorporate tobacco addiction.

Task 2. Require assessments and treatment planning to be documented in charts.

Develop intake assessment and discharge forms. Discharge / Referrals might be made to your state’s Quit Line for treatment medications (such as nicotine patch) or psychosocial treatment (Nic A, support groups, quitters groups, etc). Purchase a CO meter and be sure staff know how to use it.

Task 3. Provide treatment and recovery assistance for patients.

Include tobacco addiction on the treatment plan for all tobacco users. Match treatment to motivational level to quit. Provide motivational literature, referral information, and treatment option information. Identify treatment needs, barriers, and motivation to quit. Increase medication options on site if staffing and resources are available.

Task 4. Incorporate tobacco issues into patient education.

Patient education on hazards of use, impact on others, and treatment options can be provided in many ways (for example, through brochures, posters, and treatment groups).

Task 5. Empower patients to help each other and help develop Peer Specialists.

Peer Specialists can help clients recover from nicotine dependence, just as they help clients recover from alcoholism or drug use. Nicotine Anonymous can be started on site and also may be available in the community.

Task 6. Track progress in this work area and adjust the plan as needed.

A key principle is to keep moving in areas where you can move, even when you are blocked in others. When major problems develop in one area, the Champion and Tobacco Leadership Group should not allow themselves to be so distracted that they forget to monitor, encourage, and support progress in other areas. .