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Clinical Practice Guidelines: 2A and 1R

Why 2As and 1R?

The alternative protocol to the gold standard 5As (Ask, Advise, Assess, Assist, Arrange).

The U.S. Public Health Service Clinical Practice Guideline, Treating Tobacco Use and Dependence 2008 Update calls for systems level tobacco intervention efforts using the 5As. However, working the 5As into the practice's current workflow may be overwhelming, particularly if providers are not connected to the State's Helpline resources. As Meaningful Use rolls out, QuitWorks-NH via the NH Tobacco Prevention and Control Program (TPCP), can provide training and technical assistance for practices integrating tobacco treatment into electronic medical records (EMR) using the 2A (Ask and Assist) and R (Refer to QuitWorks-NH) so that providers have a resource to refer patients that want to quit.

Best Practices for Smoking Cessation: Pregnancy and Beyond

"Smoking Cessation for Pregnancy and Beyond: A Virtual Clinic" is an updated online training, based on the "Virtual Practicum" model. The training is intended for health care professionals who will be assisting their female patients in quitting smoking, in particular, patients who are pregnant or in their child-bearing years. Health care professionals include physicians, physician assistants, nurse-midwives, registered nurses, licensed practical/vocational nurses, nurse practitioners, certified health educators, other health educators, pharmacists, health professional students, and other professionals that may interact with women of reproductive age. Earn up to 4.5 Continuing Education Credits.

U.S. Preventive Services Task Force (USPSTF) Final Updated Recommendation on Tobacco Cessation

Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women: U.S. Preventive Services Task Force Recommendation Statement. The USPSTF gives tobacco cessation treatments an 'A' for efficacy. The Affordable Care Act requires most health insurance plans to cover all preventive services given an 'A' or 'B' recommendation by USPSTF. The USPSTF concludes that the current evidence is insufficient to recommend electronic nicotine delivery systems (e-cigarettes, etc) for tobacco cessation in adults, including pregnant women. The USPSTF recommends that clinicians direct patients who smoke tobacco to other cessation interventions with established effectiveness and safety.

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