When a family physician prepares to treat a patient who is trying to quit smoking, he or she might consider looking at the bigger picture of treating patients in a patient-centered medical home (PCMH) along with the outside factors that have shaped the addiction.
There are great resources available to put tobacco control in context, whether it is looking at what's working now, which will be covered in an upcoming webinar(attendee.gotowebinar.com), or at how tobacco use grew in popularity through targeted marketing efforts and how that has shaped the history of anti-smoking efforts, information that is provided by the Center for the Study of Tobacco and Society(csts.ua.edu) at the University of Alabama, Tuscaloosa.
Tobacco Control and the Patient-Centered Medical Home
The AAFP and the American Academy of Pediatrics (AAP) Julius B. Richmond Center of Excellence are co-sponsoring a free webinar(attendee.gotowebinar.com) April 16 from 1-2 p.m. CDT that will address how tobacco prevention and control efforts delivered in the practice setting complement and fit easily into the medical home model.
- The AAFP is co-sponsoring a free webinar April 16 from 1-2 p.m. CDT that will address how tobacco control efforts in the practice setting align with and complement the patient-centered medical home.
- Alan Blum, M.D., founded the Center for the Study of Tobacco and Society at the University of Alabama in 1998 to preserve materials on the history of tobacco marketing and anti-smoking campaigns to serve as an international resource on tobacco issues.
- Blum encourages family physicians to visit the Center for the Study of Tobacco and Society either in person or online.
AAFP members Adam Goldstein, M.D., M.P.H., and Sam Weir, M.D., will lead the session, along with Judy Groner, M.D., of the AAP.
"A business case for smoking cessation involves demonstrating the value of evidence-based interventions to health insurance plans, payers, employers and other tobacco-control stakeholders," Goldstein told AAFP News. "Health insurance coverage of medication and counseling increases the use of effective treatments."
Tobacco cessation measures also can be tied to PCMH initiatives, he added.
"The PCMH is allied in many circumstances with meaningful use criteria for Medicaid and Medicare," said Goldstein, referring to the programs' electronic health record-based incentive initiatives. "Recording smoking status and counseling on cessation can improve quality, safety, efficiency and reduce health disparities."
PCMH-supported quality improvements in tobacco control and prevention measures can involve creating patient advisory arrangements for tobacco users and efforts focused on increased counseling or use of pharmacotherapy for eligible individuals. Setting up a tobacco registry or giving feedback to clinicians to improve counseling rates also could help improve cessation rates, Goldstein said.
"All of these measures are supported by evidence and data from the CDC," he noted. "Billing for tobacco-use treatment is supported now in fee-for-service, capitated plans, quality incentives and in direct contracts."
Center for Study of Tobacco and Society
AAFP member Alan Blum, M.D., founded the Center for the Study of Tobacco and Society in 1998 to preserve every bit of information he could gather that was related to the history of tobacco marketing and anti-smoking campaigns to serve as an international resource on tobacco issues.
The archive offers an interdisciplinary approach to tobacco problems, cutting across the fields of medicine, public health, communications, law, business, sociology, anthropology and history, and includes newspapers, magazines, trade journals, annual reports, advertisements, point-of-sale displays, posters, signs, toys, videotapes, audiotapes and more than 25,000 photographs and slides.
"In essence, the Center is the only resource on tobacco that covers the full spectrum of the issue -- not just smoking cessation or anti-smoking campaigns, but rather both sides of the issue," Blum told AAFP News. "The goal for the collection, which I began amassing in the 1970s when I started Doctors Ought to Care (DOC), has always been to create a national tobacco museum and training center.
"Few others are identifying and confronting allies of the global tobacco industry. I'd like to think that the center is both a watchdog of the tobacco industry (and its allies) and a conscience of tobacco control."
The center's website currently displays "only a tiny fraction" of the hundreds of thousands of items in the collection, but the plan is to greatly expand those online offerings to include hundreds of video and audio recordings, Blum said.
Blum's early research identified trends in tobacco industry strategies, including the targeting of women and minorities and the sponsorship of sports and the arts.
Then, in 1977, Blum gave a presentation at the (then) AAFP National Conference of Family Practice Residents and Medical Students that precipitated his founding of DOC, launched as a national organization that placed satirical messages aimed at countering the marketing of unhealthy products in the mass media. In its 25-year history, DOC established chapters at more than 80 medical schools and residency programs to get physicians and medical students engaged in health promotion in the clinic, classroom and community.
The center's work includes a number museum exhibits (12 to date), with the most recent example being "The Surgeon General vs. The Marlboro Man: Who Really Won?" to commemorate the 50th anniversary of the Surgeon General's Report on Smoking and Health, Blum said.
Blum also produced a film to accompany the exhibit titled "Blowing Smoke: The Lost Legacy of the Surgeon General's Report,"(www.youtube.com) which has been screened at several medical schools.
"I also create original presentations on tobacco-related and non-tobacco related health issues, including tanning beds, alcohol advertising, obesity and the media, electronic cigarettes and numerous others," he said. "The Center fields numerous questions from journalists, students, physicians, public health experts and others, as well."
In 1993, Blum received the AAFP's first National Public Health Award for his anti-smoking advocacy.
Blum encourages family physicians to visit the Center for the Study of Tobacco and Society either in person or online to access its resources to inform their tobacco control efforts with patients. He also invited stakeholders to contact him directly at email@example.com with any questions.
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