| 8:00 a.m. – 8:30 a.m | Registration | |
| 8:30 am – 8:35 am | Introduction and Objectives | Lorinda L. Coan, LDH, MS |
| 8:35 am – 9:35 am | Nicotine Dependence 101 | Dr. Arden Christen |
| 9:35 am - 9:45 am | Break | |
| 9:45 am – 10:15 am | Oral health and Tobacco | Dr. Arden Christen L. Coan |
| 10:15 am – 11: 15 am | Systemic Health and Tobacco | Dr. Stephen Jay |
| 11:15 am – 11:30 am | Molecular Biology of Tobacco | Dr. Jack Windsor |
| 11:30 am – 12:15 pm | Pharmacotherapy and Cessation Aids | Dr. Laura Romito |
| 12:15 pm – 1:15 pm | Lunch | |
| 1:15 pm – 2:45 pm | Behavioral Interventions | Lorinda L. Coan, LDH, MS |
| 2:45 pm – 3:00 pm | Break | |
| 3:00 pm– 3:45 pm | The Office Model for Implementing a Tobacco Cessation Program | Lorinda L. Coan, LDH, MS |
| 3:45 pm – 4:15 pm | Community Partners and Resources | Department of Health County Representatives |
| 4:15 pm – 4:30 pm | Course Wrap Up | Lorinda L. Coan, LDH, MS |
| 4:30 PM | Adjournment |
Table 1. Agenda for the Continuing Education Course, “Tobacco Cessation in Clinical Practice-A Team Approach”
CE Location |
County |
Smoking Rate (2011) |
Goshen |
Elkhart |
21% |
Lafayette |
Tippecanoe |
17% |
Madison |
Jefferson |
28% |
Richmond |
Wayne |
28% |
Tell City |
Perry |
26% |
Vincennes |
Knox |
31% |
Indiana (overall) |
|
25.6% |
Table 2: Tobacco Use Rates by Location of Continuing Education Course
|
Question |
Total N |
Great (1) |
Moderate (2) |
Slight (3) |
None (4) |
Mean (SD) |
Before |
Q1: Knowledge of oral effects of tobacco |
248 |
46 (19%) |
165 (67%) |
37 (15%) |
0 (0%) |
2.0 (0.6) |
|
Q2: Clear understanding nicotine addiction |
248 |
23 (9%) |
126 (51%) |
98 (40%) |
1 (0%) |
2.3 (0.6) |
|
Q3: Knowledge of pharm of NRT, bupropion and varenicline |
247 |
7 (3%) |
49 (20%) |
158 (64%) |
33 (13%) |
2.9 (0.7) |
|
Q4: Knowledge of NRT, bupropion, varenicline dosing requirements |
248 |
6 (2%) |
27 (11%) |
86 (35%) |
129 (52%) |
3.4 (0.8) |
|
Q5: Knowledge of adverse effects of NRT, Bupropion, varenicline |
246 |
7 (3%) |
30 (12%) |
116 (47%) |
93 (38%) |
3.2 (0.8) |
|
Q6: Knowledge of communication techniques for tobacco cessation |
247 |
10 (4%) |
85 (34%) |
135 (55%) |
17 (7%) |
2.6 (0.7) |
|
Q7: Knowledge of selection of community and state resources |
247 |
9 (4%) |
35 (14%) |
143 (58%) |
60 (24%) |
3.0 (0.7) |
|
Q8: Clear understanding ISDH local community resources services |
246 |
5 (2%) |
25 (10%) |
126 (51%) |
90 (37%) |
3.2 (0.7) |
|
Q9: Clear understanding of Quitline service |
246 |
12 (5%) |
26 (11%) |
101 (41%) |
107 (43%) |
3.2 (0.8) |
Immediate |
Q1: Knowledge of oral effects of tobacco |
247 |
211 (85%) |
35 (14%) |
1 (0%) |
0 (0%) |
1.1 (0.4) |
|
Q2: Clear understanding nicotine addiction |
248 |
203 (82%) |
44 (18%) |
1 (0%) |
0 (0%) |
1.2 (0.4) |
|
Q3: Knowledge of pharm of NRT, bupropion and varenicline |
247 |
149 (60%) |
91 (37%) |
7 (3%) |
0 (0%) |
1.4 (0.5) |
|
Q4: Knowledge of NRT, bupropion, varenicline dosing requirements |
247 |
129 (52%) |
106 (43%) |
12 (5%) |
0 (0%) |
1.5 (0.6) |
|
Q5: Knowledge of adverse effects of NRT, Bupropion, varenicline |
247 |
135 (55%) |
103 (42%) |
9 (4%) |
0 (0%) |
1.5 (0.6) |
|
Q6: Knowledge of communication techniques for tobacco cessation |
246 |
183 (74%) |
60 (24%) |
3 (1%) |
0 (0%) |
1.3 (0.5) |
|
Q7: Knowledge of selection of community and state resources |
247 |
148 (60%) |
91 (37%) |
8 (3%) |
0 (0%) |
1.4 (0.6) |
|
Q8: Clear understanding ISDH local community resources services |
244 |
120 (49%) |
105 (43%) |
18 (7%) |
1 (0%) |
1.6 (0.6) |
|
Q9: Clear understanding of Quitline service |
245 |
170 (69%) |
67 (27%) |
8 (3%) |
0 (0%) |
1.3 (0.5) |
3 month |
Q1: Knowledge of oral effects of tobacco |
136 |
90 (66%) |
44 (32%) |
2 (1%) |
0 (0%) |
1.4 (0.5) |
|
Q2: Clear understanding nicotine addiction |
135 |
75 (56%) |
58 (43%) |
2 (1%) |
0 (0%) |
1.5 (0.5) |
|
Q3: Knowledge of pharm of NRT, bupropion and varenicline |
136 |
21 (15%) |
83 (61%) |
32 (24%) |
0 (0%) |
2.1 (0.6) |
|
Q4: Knowledge of NRT, bupropion, varenicline dosing requirements |
136 |
17 (13%) |
60 (44%) |
49 (36%) |
10 (7%) |
2.4 (0.8) |
|
Q5: Knowledge of adverse effects of NRT, Bupropion, varenicline |
136 |
18 (13%) |
73 (54%) |
40 (29%) |
5 (4%) |
2.2 (0.7) |
|
Q6: Knowledge of communication techniques for tobacco cessation |
136 |
71 (52%) |
55 (40%) |
10 (7%) |
0 (0%) |
1.6 (0.6) |
|
Q7: Knowledge of selection of community and state resources |
136 |
56 (41%) |
60 (44%) |
20 (15%) |
0 (0%) |
1.7 (0.7) |
|
Q8: Clear understanding ISDH local community resources services |
135 |
56 (41%) |
56 (41%) |
20 (15%) |
3 (2%) |
1.8 (0.8) |
|
Q9: Clear understanding of Quitline service |
134 |
76 (57%) |
42 (31%) |
14 (10%) |
2 (1%) |
1.6 (0.7) |
Table 3: Clinicians’ Self-Reported Tobacco Dependence and Treatment Knowledge Before, Immediately After, and 3 Months After the Tobacco CE Program
Time |
Question |
Total N |
Strongly Agree (1) |
Agree (2) |
Undecided (3) |
Disagree (4) |
Strongly Disagree (5) |
Mean (SD) |
Immediate |
Q10: will improve ability to play active role in team plan |
247 |
92 (37%) |
142 (57%) |
12 (5%) |
0 (0%) |
1 (0%) |
1.7 (0.6) |
|
Q11: will improve ability to use communication strategies |
247 |
115 (47%) |
128 (52%) |
3 (1%) |
0 (0%) |
1 (0%) |
1.6 (0.6) |
|
Q12: will implement the brief tobacco intervention strategies |
246 |
69 (28%) |
139 (57%) |
36 (15%) |
2 (1%) |
0 (0%) |
1.9 (0.7) |
|
Q13: will refer interested patients to local resources |
246 |
102 (41%) |
132 (54%) |
10 (4%) |
2 (1%) |
0 (0%) |
1.6 (0.6) |
|
Q14: will refer interested patients to the Indiana Quitline |
244 |
129 (53%) |
104 (43%) |
9 (4%) |
1 (0%) |
1 (0%) |
1.5 (0.6) |
3 month |
Q10: currently play active role in team based tobacco cessation |
130 |
10 (8%) |
68 (52%) |
22 (17%) |
22 (17%) |
8 (6%) |
2.6 (1.1) |
|
Q11: applying the communication strategies learned in the course |
129 |
23 (18%) |
86 (67%) |
13 (10%) |
4 (3%) |
3 (2%) |
2.1 (0.8) |
|
Q12: implemented brief tobacco intervention strategies |
128 |
15 (12%) |
75 (59%) |
18 (14%) |
15 (12%) |
5 (4%) |
2.4 (1.0) |
Table 4: Clinicians’ Self-Reported Intention to Implement Tobacco Intervention Behaviors and Actual Implementation 3 Months Post-CE
Time |
Question |
Total N |
0 |
1-5 |
6-10 |
11-15 |
16 or more |
3 month |
Q14: #pts referred to local counselors since CE program |
130 |
62 (48%) |
58 (45%) |
8 (6%) |
0 (0%) |
2 (2%) |
3 month |
Q15: # pts referred to Indiana Quitline since CE program |
133 |
50 (38%) |
64 (48%) |
12 (9%) |
3 (2%) |
4 (3%) |
Table 5: Clinicians’ Self-Reported Referrals to Local Cessation Resources and Indiana Tobacco Quitline 3 Months Post-CE
|
|
|
3 month |
|
|
|
|
|
|
|
Referral |
Immediate |
Total N |
0 |
1-5 |
6-10 |
11-15 |
16 or more |
Mean (SD) |
p-value |
Correlation |
Local |
Strongly Agree (1) |
58 |
32 (55%) |
22 (38%) |
4 (7%) |
0 (0%) |
0 (0%) |
1.5 (0.6) |
0.0700 |
0.16 |
|
Agree (2) |
65 |
28 (43%) |
31 (48%) |
4 (6%) |
0 (0%) |
2 (3%) |
1.7 (0.8) |
|
|
|
Undecided (3) |
3 |
0 (0%) |
3 (100%) |
0 (0%) |
0 (0%) |
0 (0%) |
2.0 (0.0) |
|
|
|
Disagree (4) |
1 |
0 (0%) |
1 (100%) |
0 (0%) |
0 (0%) |
0 (0%) |
2.0 (.) |
|
|
Quitline |
Strongly Agree (1) |
77 |
30 (39%) |
36 (47%) |
7 (9%) |
1 (1%) |
3 (4%) |
1.8 (0.9) |
0.7427 |
0.02 |
|
Agree (2) |
49 |
16 (33%) |
26 (53%) |
4 (8%) |
2 (4%) |
1 (2%) |
1.9 (0.9) |
|
|
|
Undecided (3) |
4 |
2 (50%) |
1 (25%) |
1 (25%) |
0 (0%) |
0 (0%) |
1.8 (1.0) |
|
|
|
Strongly Disagree (5) |
1 |
1 (100%) |
0 (0%) |
0 (0%) |
0 (0%) |
0 (0%) |
1.0 (.) |
|
|
Table 6: Numbers of Patients Referred to Local Cessation Resources and Indiana Tobacco Quitline Reported by Clinicians’ 3 Months Post-CE
Time |
Immediate |
3 Month |
p-value |
||
Survey Question |
Total N |
Yes |
Total N |
Yes |
|
Q15: Tobacco cessation resources are currently provided |
241 |
85 (35%) |
NA |
NA |
|
Q16: Resources-Literature display in reception area |
245 |
47 (19%) |
133 |
32 (24%) |
|
Q16: Resources-Literature display in treatment area |
245 |
50 (20%) |
133 |
44 (33%) |
p=0.0173 |
Q16: Resources-Video in treatment area |
245 |
4 (2%) |
133 |
4 (3%) |
|
Q16: Resources-Distributed directly to patient |
245 |
53 (22%) |
132 |
66 (50%) |
p<.0001 |
Q16: Resources-Practice website |
245 |
4 (2%) |
133 |
4 (3%) |
|
Q16: Resources-Other |
245 |
11 (4%) |
133 |
13 (10%) |
|
Q17: Barrier-Lack of time to distribute resources |
240 |
29 (12%) |
133 |
27 (20%) |
|
Q17: Barrier-Lack of time to discuss resources |
240 |
48 (20%) |
132 |
16 (12%) |
|
Q17: Barrier-Patient acceptance |
240 |
30 (13%) |
132 |
39 (30%) |
p=0.0004 |
Q17: Barrier-Lack of referral agencies in area |
240 |
19 (8%) |
132 |
49 (37%) |
|
Q17: Barrier-Locating and obtaining resources |
240 |
49 (20%) |
132 |
9 (7%) |
p=0.0003 |
Q17: Barrier-Space for resource materials |
240 |
23 (10%) |
132 |
10 (8%) |
|
Q17: Barrier-Cost of resource materials |
240 |
28 (12%) |
132 |
17 (13%) |
|
Q17: Barrier-Other |
240 |
30 (13%) |
132 |
11 (8%) |
|
Q18: Prescribe/Recommend NRT gum |
245 |
51 (21%) |
132 |
17 (13%) |
p=0.0082 |
Q18: Prescribe/Recommend NRT lozenge |
245 |
20 (8%) |
132 |
30 (23%) |
p=0.0009 |
Q18: Prescribe/Recommend NRT patch |
245 |
45 (18%) |
132 |
55 (42%) |
p=0.0431 |
Q18: Prescribe/Recommend NRT inhaler |
245 |
7 (3%) |
132 |
30 (23%) |
|
Q18: Prescribe/Recommend NRT nasal spray |
245 |
5 (2%) |
132 |
46 (35%) |
|
Q18: Prescribe/Recommend NRT bupropion |
245 |
13 (5%) |
132 |
9 (7%) |
|
Q18: Prescribe/Recommend NRT varenicline |
245 |
30 (12%) |
132 |
4 (3%) |
p=0.0330 |
Q18: Prescribe/Recommend no pharmacotherapy |
245 |
135 (55%) |
132 |
16 (12%) |
|
Table 7: Clinician’s Self-Reported Tobacco Cessation Resources and Perceived Barriers Before and 3 Months Post-CE