HealthPOWER! Prevention News (Fall 2011)—Online Tobacco Resources 

Online Tobacco Cessation Resources Available to Clinicians and Veterans

The prevalence of smoking in American adults has decreased dramatically since the peak tobacco use of the 1960's,¹ yet recent U.S smoking rates have reached an apparent plateau in which year-to-year changes have been small and inconsistent.² From 2005 to 2010, smoking prevalence declined, from 20.9 to 19.3 percent,² yet during this time period, for example, this figure also increased slightly from 2007 to 2008.³

Smoking trends in Veterans have in some ways been similar to that of American adults. Veterans' smoking rates have significantly decreased since peaking after the armed conflicts of the middle 20th century, but have flattened out more recently. About one-third of VHA-enrolled Veterans reported in 1999 that they used tobacco, and this number has steadily declined.⁴ Smoking rates among Veterans enrolled for care in VA are similar to the general U.S. population, falling from 22.2 percent in 2005⁵, to 19.8 percent in 2008⁶ and 19.7 percent in 2010.⁷

Veterans continue to need access to effective tobacco cessation resources. Research has shown that the typical tobacco-user

• Will make multiple attempts before he/she successfully quits⁸
• Is more likely to stop using tobacco when part of an evidence-based cessation program that includes counseling and medications⁹
• Is more likely to abstain from tobacco use when supported by a social network⁹

Clinicians are key partners in this process and the support that they provide is critical to the success of those trying to stop using tobacco.⁷

New DoD Online Resources

Excellent cessation resources are available online for VHA health care providers and Veterans. The DoD's Quit Tobacco—Make Everyone Proud campaign works with a variety of counselors, health care professionals, public affairs offices, and military installations to decrease tobacco use. NCP and VHA’s Public Health Strategic Healthcare Group have collaborated with DoD to provide VHA-enrolled Veterans comprehensive cessation support through the Quit Tobacco—Make Everyone Proud Web site (http://www.ucanquit2.org). By clicking on the VA Veterans page of this site, clinicians and Veterans can access VHA-approved cessation tools and programs. These resources, which are discussed below, can effectively augment the behavioral counseling and U.S. Food and Drug Administration-approved smoking cessation resources provided by clinicians to help Veterans quit.

 

Live support. Available 24 hours a day and 7 days a week, Live Help is a real-time online chat that allows Veterans to get confidential, one-on-one guidance from trained cessation coaches. These "quit coaches" can effectively augment clinical care by answering Veterans' questions about successfully starting and maintaining a tobacco-free life.

 

Train2Quit. This confidential, interactive system allows Veterans to create a free, customizable, self-paced program for quitting tobacco. A Train2Quit account offers self-assessment questionnaires, a quit plan/calendar to track progress, and tips on how to address the physical and emotional challenges associated with kicking the tobacco habit.

 

Medication information. Veterans can use the Medications to Help You Quit tool to get information on the over-the-counter and prescription tobacco cessation medicines available to them through the VA health care system.

 

Social media. Facebook, Twitter, a quit blog, and a message board are examples of the community-oriented media available to Veterans who want to share experiences, get support, and inspire others to stop using tobacco.

Motivational tools. Veterans can view and download a variety of engaging Web-based games, quizzes, banners, and widgets that encourage tobacco cessation. A personalized savings calculator, for example, helps Veterans tally the money that can be saved by not smoking or chewing tobacco.

 

These resources, and the DoD Web site in general, are particularly effective because they are

• Topical and relevant, especially to younger Veterans
• Easy to customize for individual Veterans' needs
• User-friendly, intuitive, and easily navigated
• Comprehensive in terms of information, tools, and resources
• Motivational, as well as progress- and goal-oriented

Using the Resources

The Quit Tobacco—Make Everyone Proud resources discussed above should be an integral part of the clinical services provided to Veterans. Posters and wallet cards advertising the Web site are available for download at http://vaww.publichealth.va.gov/smoking/publications.asp#Online;* print copies can also be ordered from the VA Publications Depot.

 

VA Resources

Additionally, VHA clinicians can access clinical cessation tools on the VA Intranet (http://vaww.publichealth.va.gov/smoking/clinical.asp)* that include

• Clinical pocket guides, booklets, and practice guidelines
• Information on the wide variety of cessation medications and nicotine replacement therapies available in the VHA formulary
• VHA-oriented posters that raise awareness about smoking cessation and services
• Rules, regulations, directives, reports, and surveys from U.S. Government Agencies such as the Surgeon General's Office, VA, and VHA

These and other print-ready tobacco cessation resources can be downloaded from http://vaww.publichealth.va.gov/smoking/publications.asp.* Bulk items can also be ordered through the VA Publications Depot.

Additionally, the Public Health Strategic Health Care Group of the VHA's Office of Public Health office provides clinical updates to VHA health care providers through the monthly Tobacco Cessation Clinical Update audio-conference series that is presented the 4th Monday of each month.

Veterans need to know that they are not alone in their fight to quit tobacco—and that through their clinicians and a variety of effective Web-based resources, help is available.

For additional information, please contact Dr. Kim Hamlett-Berry, Director, Public Health Policy and Prevention, of the Public Health Strategic Health Care Group at kim.hamlett@va.gov or (202) 461-1040.

 

REFERENCES

1. Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Trends in Current Cigarette Smoking among High School Students and Adults, United States, 1965–2007. Available at: http://www.cdc.gov/tobacco/data_statistics/tables/trends/cig_smoking. Accessed September 9, 2011.
2. Centers for Disease Control and Prevention. Vital signs: current cigarette smoking among adults aged ≥18 Years—United States, 2005–2010. MMWR. 2011;60(35):1207–1212.
3. Centers for Disease Control and Prevention. Cigarette smoking among adults and trends in smoking cessation—United States, 2008. MMWR. 2009;58(44):1227–1232.
4. Office of Quality and Performance, Veterans Health Administration. Health behaviors of veterans in the VHA: tobacco use. In: 1999 Large Health Survey of Enrollees. Washington, DC: Veterans Health Administration; 2001.
5. Office of the Assistant Deputy Undersecretary for Health for Policy and Planning, Department of Veteran Affairs, Veterans Health Administration. 2005 Survey of Veteran Enrollees' Health and Reliance on VA. Veterans Health Administration; September 2006. Available at: http://www.va.gov/HEALTHPOLICYPLANNING/reports/FinalSOE_05.pdf. Accessed September 14, 2011.
6. Office of the Assistant Deputy Undersecretary for Health for Policy and Planning, Department of Veteran Affairs, Veterans Health Administration. 2008 Survey of Veteran Enrollees' Health and Reliance on VA. Veterans Health Administration; September 2009. Available at: http://www.va.gov/HEALTHPOLICYPLANNING/SoE2008/2008_SoE_Report.pdf. Accessed September 14, 2011.
7. Office of the Assistant Deputy Undersecretary for Health for Policy and Planning. Department of Veteran Affairs. Veterans Health Administration. 2010 Survey of Veteran Enrollees' Health and Reliance on VA. Veterans Health Administration; July 2011. Available at: http://www.va.gov/HEALTHPOLICYPLANNING/Soe2010/SoE_2010_Final.pdf. Accessed September 12, 2011.
8. American Lung Association. Don’t quit on your resolution to quit smoking!. February 25, 2010. Available at: http://www.lungusa.org/press-room/press-releases/dont-quit-on-your.html. Accessed September 13, 2011.
9. Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service; May 2008. Available at: http://www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdf. Accessed September 9, 2011.

*Intranet site is only accessible by VA staff

 

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