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Tobacco Systems Change Resources

Curated here are the best resources and tools to help increase the capacity of health systems to routinely intervene with their patients that use commercial tobacco.

training and resource tools


"How To" Tools and Resources

Agency for Health Care Research and Quality
This website provides clear systems change strategies; recommendations; evidence and the cost effectiveness on systems change efforts to treat tobacco use dependence.

American Academy of Family Physicians Ask and Act: A Tobacco Cessation Program Manual
This manual provides information on assessing your current health system and defining a new system based on the Ask and Act protocol. It also includes helpful tips around motivational interviewing, referrals and follow-up, and standardizing your systems change approaches.

DIMENSIONS: Tobacco Free Toolkit for Healthcare Providers
This is designed for a broad range of health care providers and includes information on tobacco use, skills for tobacco cessation discussions and interventions, and efficient methods to assess a patient's readiness to quit, plus cessation treatment resources. You'll also find several supplements for priority populations, including those with mental illness, low-income individuals and pregnant and postpartum women.

Health Systems Change Case Studies
In 2014 and 2015, ClearWay MinnesotaSM funded five organizations for two years to help them improve their ability to assess and address tobacco use with their patients. An external evaluator conducted a process evaluation, and Clearway MinnesotaSM worked with the grantees to develop individual case studies that tell their stories.

Healthcare Provider Reminder Systems, Provider Education, and Patient Education
This action guide provides information on working with health care delivery systems to improve the delivery of tobacco use treatment to patients. It includes clear implementation action steps, determining your resource needs and key resources.

Help Your Patients Quit Tobacco Use: An Implementation Guide for Community Health Centers
This popular guide provides clear steps on how to plan, prepare and implement tobacco treatment interventions into Community Health Centers. It includes a section on how to deal with challenges and a sample intervention model and EHR builds with specific case studies shared at the end of the guide.

Million Hearts Tobacco Cessation Protocols
This website includes a number of tools and resources. There are also templates where providers can "Create your own Protocols" for tobacco cessation interventions.

New York City Department of Health and Mental Hygiene: Tobacco Quit Kit
The Tobacco Quit Kit contains clinical tools, resources for providers, and patient education materials to promote evidence-based practices for tobacco cessation.


Other Provider Tools

American Academy of Family Physicians: Coding Reference

American Academy of Family Physicians: Pharmacologic Product Guide

Free Cessation Services Available to Medical Assistance and MinnesotaCare Enrollees

Health Care Providers Can Help Minnesota Smokers Quit – Provider Factsheet

Million Hearts Tobacco Cessation Action Guide
Identifying and treating patients who use tobacco: An action guide for clinicians. This is a short and simple action guide that includes three tables; 1) Actions to improve tobacco cessation delivery systems design; 2) The 5 A’s Tobacco Cessation Brief Intervention Model; and 3) FDA- Approved Tobacco Cessation Medications

Million Hearts Protocol for Identifying and Treating Patients Who Use Tobacco

Return on Investment for Tobacco Cessation

The Brief Tobacco Intervention 2 A’s & R and 5A’s Pocket Card

Tobacco Use Fact Sheets for the Clinical Team

WellShare International
WellShare International utilizes a Community Health Worker model for all of its programs including its East African and Karen Smoke-Free Programs. You can find free health education resources on their website, including Somali and Karen-language educational videos.



Training and CME Courses for Providers

American Academy of Pediatrics – Training and CME Courses
This website provides a comprehensive list of effective training and CME courses to build tobacco use cessation and secondhand smoke exposure knowledge. This includes a list of courses from the AAP and other organizations.

Rx for Change – Clinician-Assisted Tobacco Cessation
Rx for Change: Clinician-Assisted Tobacco Cessation is a comprehensive tobacco cessation training program that provides health professional students and practicing clinicians with evidence-based knowledge and skills for assisting patients with quitting (University of California, San Francisco).

Tobacco Treatment Specialist Training Information


Specialty Populations & Settings

American Indian Community

  • HeathCare Partnership – Native American Resources
    This website provides key reports, resources and specific tools to set up and implement a commercial tobacco dependence treatment process. It includes an assessment survey tool, a patient intake form, and a follow-up form that can be freely modified to fit your needs.

Community Health Centers

Dental Setting

  • Tobacco Cessation Toolkit for Indiana Dental Practices
    This toolkit provides information needed to effectively address patient tobacco use, including a step-by-step process for developing a tobacco cessation program with key roles for each member of the dental team. It also include common barriers and potential solutions. PDF shared with permission of the Indiana Dental Association.

Hospital Systems


  • CEASE The Clinical Effort Against Secondhand Smoke Exposure (CEASE), is a program developed at Massachusetts General Hospital to effectively address family tobacco use.

People Living with Mental Health & Substance Abuse Disorders


Respiratory Health

Veterans & Military


Background Reading

A Time to Lead: The Case for Integrating Treatment of Tobacco Use in the Treatment of Other Substance Use and Mental Health Disorders
"A Time to Lead" is an appeal for action. Its purpose is to bring to light the urgent need to integrate evidence-based treatment of nicotine dependence into the protocols for treating substance use and mental disorders in the United States. March 2017.

American Academy of Family Practice 2008 Clinical Practice Guidelines See Chapter 5, Systems Interventions – Importance to HealthCare, Administrators, Insurers, and Purchasers

An Argument for Change in Tobacco Treatment Options Guided by the ASAM Criteria for Patient Placement, Williams, Jill Journal of Addiction Medicine, September-October 2016.

Best Practices for Comprehensive Tobacco Control: Cessation Interventions (2014)

Best preventive care? Get vaccines, and don't smoke.
These research findings, sponsored in part by the U.S. Centers for Disease Control and Prevention, could influence how doctors across the country conduct thousands of regular patient visits each year. Minneapolis Star Tribune, January 9, 2017.

  • Read the editorial that accompanied the published research, co-authored by George Isham, MD, MS, HealthPartners Institute. Annals of Family Medicine, January/February, 2017.

Louisiana State University Health System Tobacco Control Initiative Treatment Protocol

Q&A with Harvard Vanguard Medical Associates and Atrius Health about Health Systems Change to Address Smoking


Videos & Webinars

How Can the EHR Help You Identify and Intervene with Patients Who Use Tobacco? Electronic health records (EHRs) contain tools that can improve how you identify, document, track, and treat patients who use tobacco. One challenge is knowing what tools are available and how to get started making system changes. This presentation explores ways that you can leverage the EHR to deliver efficient evidence-based tobacco dependence treatment interventions and where to start within your organization.

Presenters will include Amy Skora, Regional Outreach Specialist, from the Center for Tobacco Research and Intervention (CTRI) at the University of Wisconsin. Jill Doberstein from Essentia Health will also be sharing their work on how they have been able to utilize their EHR to advance systems change efforts.

Tackling Tobacco Through Re-engineered Primary Care recorded webinar and PowerPoint copy: Hailing from a New York state federally-qualified healthcare clinic (FQHC), Daren Wu, M.D., Chief Medical Officer of Open Door Family Medical Clinics will discuss how team-based care and other innovative systemic changes have successfully translated into improving Tobacco Screening and Cessation strategies. The same concepts can apply to a host of other healthcare topics and disease conditions. 

American Academy of Family Physicians: Office Champions, A Systems Change Approach Includes a 25 minute training video.

Smoking Cessation Leadership Center Webinar Series on a variety of tobacco control and cessation topics


Materials from Our Events

Addressing Nicotine Dependence – An Integrated Approach
Pete Dehnel, MD & Grace Higgins, MPH, Physician Advocacy Network

How to Ask About Tobacco Without Starting a Fire
Joel Spoonheim, HealthPartners

Medication Education for Tobacco Dependence
Krista Rouse, PharmD, Essentia Health

Smoking Cessation 2017: The Patient Perspective
Nabeel Ailabouni, DO, CentraCare Big Lake Clinic

Tobacco Dependence Treatment: A System's Change Approach
Jill Doberstein, MAPL, CTTS, Essentia Health



Updated 02/27/18