Tobacco Cessation Services

Date: 03/14/17

Quitting tobacco is one of the most important things your patients can do to protect their health. It can also be the most difficult to accomplish. Studies show that using interventions like individual, group and/or telephone counseling and medications can improve success rates.

The Department of Health Care Services (DHCS) recently updated their Comprehensive Tobacco Prevention and Cessation Services for Medi-Cal Beneficiaries All Plan Letter (APL). Here is an overview of the requirements and coverage for tobacco cessation services (Note: the APL does not apply to e-cigarettes):

What’s Required?

DHCS requires that providers must:
Institute a tobacco user identification system as recommended by the United States Preventive Services Task Force.
Identify (initially and annually) all members (of any age) who use tobacco products and note this use in the member’s medical records.
Note: Smoking status can be assessed annually through the use of the Staying Healthy Assessment - which is the DHCS approved Individual Health Education and Behavioral Assessment.
Ask tobacco users about their current tobacco use and document in their medical record at every visit.
Ask all pregnant members if they use tobacco or are exposed to tobacco smoke.
Offer all pregnant members who use tobacco at least one face-to-face tobacco cessation counseling session per quit attempt.
Ensure pregnant members who use tobacco are referred to a tobacco cessation quit line, such as the California Smoker’s Helpline.
Refer to the tobacco cessation guidelines by the American College of Obstetrics and Gynecology (ACOG) before prescribing tobacco cessation medications during pregnancy.
Provide interventions, including education or counseling, in an attempt to prevent initiation of tobacco use in school-aged children and adolescents in accordance with the American Academy of Pediatrics Bright Futures periodicity schedule and anticipatory guidance.

What Tobacco Cessation Services Are Covered?

California Health & Wellness covers individual, group and telephone counseling for members of any age who want to quit using tobacco. Four 10 minute counseling sessions for two separate quit attempts are covered each year without prior authorization.

The following FDA-approved medications are covered:

Buproprion SR
Nicotine gum
Nicotine inhaler
Nicotine lozenge
Nicotine nasal spray
Nicotine patch
Varenicline

What Resources Are Available?

For members who use tobacco products, you can:
Refer them to the California Smoker’s Helpline at 1-800-NO-BUTTS.
Encourage them to participate in a tobacco cessation program offered by California Health & Wellness. Members can call Member Services for more information. 1-877-658-0305 For TTY, contact California Relay by dialing 711 and provide the Member Services number: 1-877-658-0305.
Refer them to a local community resource. (See the table below)

County Resource	Phone
Alpine County Tobacco Education and Prevention	530-694-2146 ext. 242
Amador County Tobacco Reduction of Amador County	209-223-6409
Butte County Tobacco Education Program	530-538-6109
Calaveras County Tobacco Prevention Program	209-754-6460
Colusa County Tobacco Education Program	530-458-0380
El Dorado County Tobacco Use Prevention Program	530-621-6142
Glenn County Tobacco Control Program	530-934-6588
Imperial County Tobacco Education Project	760-482-4908
Inyo County Tobacco Control Program	760-872-0900
Mariposa County Tobacco Education Program	209-966-3689
Mono County Health Department	760-924-1830
Nevada County - American Lung Association	1-800-LUNG-USA
Placer County - American Lung Association	1-800-LUNG-USA
Plumas County Tobacco Reduction Program	530-283-6427
Sierra County Human Services Tobacco Prevention	530-993-6745
Sutter County Public Health	530-822-7215
Tehama County Tobacco Education Program	530-527-6824
Tuolumne County Tobacco Education & Prevention Program	209-533-7419
Yuba County Health and Human Services Department	530-749-6366

Clinical Practice Guidelines

Overview of the “Clinical Practice Guideline, Treating Tobacco Use and Dependence: 2008 Update” (SDL # 11-007): http://bphc.hrsa.gov/buckets/treatingtobacco.pdf
American College of Obstetrics and Gynecology for Tobacco Cessation during Pregnancy http://www.acog.org/-/media/Departments/Tobacco%20Alcohol%20and%20Substance%20Abuse/SCDP.pdf?dmc=1&ts=20141006T1346437182
American Academy of Pediatrics, Bright Futures for Children and Adolescents, Performing Preventive Services: A Bright Futures Handbook http://brightfutures.aap.org/continuing_education.html

Training/CME Opportunities

Continuing Medical Education (CME)-accredited training on tobacco cessation and behavioral health: https://cmecalifornia.com/Activity/1023974/Detail.aspx
Center for Tobacco Cessation Web-based trainings: https://www.nobutts.org/free-training
University of California San Francisco’s Smoking Cessation Leadership Center Webinars for CME/Continuing Education Unit Credit http://smokingcessationleadership.ucsf.edu/webinars
Smoking Cessation for Pregnancy and Beyond: A Virtual Clinic https://www.smokingcessationandpregnancy.org/

Tobacco Cessation Tools & Resources

University of California Quits https://smokingcessationleadership.ucsf.edu/uc-quits
University of California San Francisco’s (UCSF) Smoking Cessation Leader Center’s Tools and Resources: http://smokingcessationleadership.ucsf.edu/Resources.htm
California Smokers’ Helpline Web-based Referral Service http://www.californiasmokershelpline.org/
ICD-10 Codes Tobacco/Nicotine Dependence, and Secondhand Smoke Exposure, Effective October 1, 2015: http://www.ctri.wisc.edu/documents/icd10.pdf

Visit the California Health & Wellness website at www.cahealthwellness.com for more information and resources.