The Washington State Department of Health (DOH) appreciates your continued efforts to discourage use of tobacco and vapor products. You can help patients quit by using proven and effective treatments for nicotine addiction, including brief counseling and medications. DOH recommends guiding patient conversations using the 5 A’s
- Ask each patient about tobacco and vapor product use at every visit.
Include this as a vital sign, integrating prompts and reminders into your workflow. ICD-10 codes:
Cigarette smoking (F17.21-), chewing tobacco (F17.22-), and nicotine vaping (F17.29-). - Advise patients who use tobacco or vape to quit.
Urge them to quit in a clear, strong, and personalized manner. Your brief, professional advice increases their likelihood of trying to quit. - Assess patients’ willingness to make a quit attempt.
Ask if they are willing to try quitting. For patients not ready to make an attempt, help motivate them by identifying reasons to do so, building their confidence to make a quit attempt. Tobacco and Vapor 21 and other product restrictions may be motivating factors. - Assist patients in their quit attempt.
Counsel or refer them to the Washington State Tobacco Quitline, and prescribe medication approved by the FDA for tobacco cessation, including nicotine replacement therapy (NRT) and non-nicotine prescription medication. - Arrange follow-up visits.
Schedule follow-up visits to review progress toward quitting. If a relapse occurs, encourage them to try again; insist that every try counts and to never quit quitting!
Free Resources
- Washington State Tobacco Quitline: 1-800-QUIT-NOW Coaching is available in 200+ languages. You can refer any patient for help quitting – smoking or vaping – to the Quitline via fax or quitline.com. You can also request free, printed promotional materials.
- Smartphone apps: doh.wa.gov/quit Apps are research-based and use an Acceptance and Commitment Therapy model to help Washingtonians quit smoking or vaping, for free. Patients age 18-20 are currently eligible for a free two-week nicotine patch starter kit through the Smoking & Tobacco app.
- Text-message programs: SmokefreeTXT text “QUIT” to 47848 to receive tips, advice, and encouragement to help patients overcome challenges and stay motivated to quit. This Is Quitting (for teen/young adult vaping): text “DITCHJUUL” to 88709 to get help through cravings, stresses, and slips with the first-ever text-to-quit vaping service.
Use this table for counseling and medication info based on patients’ insurance and payer:
For questions, contact Nick Fradkin, Tobacco Cessation Consultant.
Visit the DOH Tobacco and Vapor 21 webpage for more information about the new law.