Provider information about tobacco or nicotine cessation

Resources about encouraging patients to quit smoking/vaping or using other tobacco products as a healthcare professional or social service provider.

Table of Contents

What we know

Encouraging patients to quit smoking/vaping or using other tobacco* products is one of the most important things you can do as a healthcare professional or social service provider. Brief clinician interventions can increase the likelihood of short-term smoking abstinence by 30%. (1)  

You may need to repeatedly coach your patients who use tobacco, just as you would when assisting patients with managing any chronic condition; most people who use tobacco try to quit multiple times before they are successful.

In addition to a brief intervention/coaching with you, connecting your patients who use tobacco/nicotine with evidence-based treatments, including FDA-approved medications and behavioral counseling, greatly increases their chances of success (which might look different for each patient such as cutting down on tobacco/nicotine consumption or abstinence). People who use both medications AND counseling are more than twice as likely to quit for good. (2)

It is important to acknowledge we live and work within systems that have policies and practices that perpetuate inequities. These policies and practices result in different, less favorable, and worse health outcomes for certain groups of people. However, you have the power, within your sphere of influence, to promote health equity and to provide equitable access to services to assist your patients along their tobacco and nicotine recovery journey.

What you and your office staff can do

You and your staff can do a lot toward ensuring ALL your patients have a fair and equitable chance at being nicotine-free.

  • Check your implicit bias.
    Everyone has biases. Seek additional information about the biases you may not be aware you have (implicit bias). Bias can impact the way you interact with your patients, what kinds of resources you offer them, and what kind of care you provide. You can challenge biases in the care you provide. 
  • Use a trauma-informed approach.
    One way to challenge biases is by applying trauma informed care practices and principles into your work. Assume that every patient you see has some sort of trauma. Whether they suffered adverse childhood events, are affected by social determinants of health or daily discrimination, or suffered other traumatic events in their lives, your patient’s trauma frames the way they interact with you and your organization. Learn more about how to approach your patients about quitting tobacco with this in mind.
  • Apply a health equity lens to your work.
    Learn more about health equity, and other ways you can work to ensure you provide all your patients with the resources they need to be nicotine-free. See the health equity information from the Centers for Disease Control and Prevention, including information on Tobacco related inequities (pay specific attention to the Tobacco Industry Marketing and Influence section of these pages to understand how the industry has targeted these groups, leading to many of the inequities listed).  Also visit the Quitline’s online portal for information on populations burdened by tobacco.
  • Ask every patient at every visit about their tobacco/nicotine use.
    According the 2020 U.S. Surgeon General’s Report on Smoking Cessation, four out of every nine adult cigarette smokers who saw a health professional during the past year did not receive advice to quit.  Ask about tobacco/nicotine use, including smoking, vaping, smokeless tobacco, etc. Even if you don’t think a patient is interested in quitting, ask anyway. Ask about tobacco/nicotine use, advise them on all the pathways to recovery, and connect them to resources.
    • When you ask your patients about their tobacco/nicotine use, be mindful of your patient’s lived experience which may influence their ability to stop smoking or lead them to return to smoking.
      • They may belong to groups of people historically targeted by the tobacco industry such as people of color, people who identify as LGBTQ+; people with mental health conditions; and youth.
      • They may live in neighborhoods with a high density of tobacco retailers and advertisements which means images of tobacco are all around them as they try to quit.
      • They may use tobacco to self-medicate life’s big and small stresses, including the burden they may feel from daily discrimination in their lives or from past traumas.
      • They may have a history of being ignored by the healthcare system or see the healthcare system as not trustworthy given its history of harm, experimentation, sterilization, and the like among their community members. This holds true for social service systems as well.
      • They may have negative experiences with free resources (the tobacco industry has manipulated certain populations with free menthol cigarettes, sponsorship of events, etc.).
    • For your patients with mental health diagnoses or substance use disorders, quitting nicotine can have a positive impact on their mental health and recovery journey. Research shows quitting tobacco/nicotine use helps an individual’s chances of staying in recovery. (3, 4)
  • Understand your patient’s barriers to quitting.
    Use motivational interviewing techniques to understand your patient’s relationship with tobacco/nicotine and their major barriers to quitting. Keep in mind their history of trauma, and the tobacco and vaping industries have historically targeted specific groups of people with their products. In addition, some of your patients live in neighborhoods that have a high density of tobacco retailers or hold occupations where the tobacco use rate is high (e.g., construction, service industry).
  • Know about the free quit resources MA has to offer. 
    Familiarize yourself with the free coaching and support resources available to Massachusetts residents to quit tobacco/nicotine.  More information about 1-800-QUIT-NOW, Massachusetts’ Quitline for tobacco/nicotine is available at You can order free materials for yourself or your patients through the Massachusetts Health Promotion Clearinghouse.
  • Connect your patient to 1-800-QUIT-NOW via the Quitworks program.
    You refer them, and the Quitline calls your patient or can text them to enroll (if consent to text is given). You receive status updates on their enrollment with the Quitline’s programs. Quitworks can also help your organization establish e-referrals or can assist with other referral workflow needs.
    • If your organization provides its own tobacco treatment program, assess whether this program is a good fit for your patient. If so, refer to this program and provide information on 1-800-QUIT-NOW to your patient for additional support.
    • Communicate what to expect with your patient. Provide your patient with information about what to expect from 1-800-QUIT-NOW whether they call themselves or you refer them via Quitworks. A short video about the Quitline is available at and information on the Quitline’s programs is also available on this site or it can be downloaded/ordered.
    • Some patients may want to quit “cold turkey” and many individuals often succeed in this manner. Provide information on 1-800-QUIT-NOW for additional support and offer to provide resources later if quitting “cold turkey” does not work for them.
  • Connect your patient with other community resources.
    If your patient is facing other challenges in addition to their tobacco/nicotine use, connect them with community resources that can help address their needs (examples include food and clothing banks, housing assistance, etc.). 211 is also a resource for patients to find essential community services (via phone or online).

You are an important link to helping your patients address their tobacco/nicotine addiction.  You can link them to evidence-based resources.  Quitting nicotine is one of the most important steps your patient can take to improve their health.

Additional resources

Want to learn more about health equity, implicit bias, and trauma-informed care?

Need to report a case of E-cigarette/Vaping-Associated Lung Injury (EVALI?) 

Need more information about 1-800-QUIT-NOW and QuitWorks? 

Want more information and resources for helping your patients along their quit journey? 

Need technical assistance? 

The University of Massachusetts Medical School’s Center for Tobacco Treatment Research and Training provides free technical assistance and training to Massachusetts health systems to meet Meaningful Use requirements, Patient-Centered Medical Home requirements, and/or Joint Commission standards. Assistance is also available for quality improvement efforts of existing tobacco intervention programs. Recent research shows that a comprehensive tobacco cessation program can assist hospitals in preventing readmissions.

Want to learn more and earn CMEs/CNEs/CPEs?

Get access to tools, resources and education modules to help you care for people with tobacco dependence. Trainings benefit anyone who serves people who use commercial tobacco, from healthcare professionals to social workers to school staff.

Looking for guidelines? 

The U.S. Public Health Service’s Clinical Practice Guideline Treating Tobacco Use and Dependence: 2008 Update was designed to assist clinicians in identifying and assessing tobacco users and in delivering evidence-based tobacco dependence treatment. The Quick Reference Guide for Clinicians provides a summary of guideline cessation intervention strategies for use on a day-to-day basis.

Need materials? 

The Massachusetts Health Promotion Clearinghouse offers free brochures and guides for your patients about quitting smoking. Order materials for your office today.

Work with youth? 

Visit the Get Outraged! Toolkit, which includes information about youth vaping for School AdministratorsCurriculum Coordinators, Health Educators, and Teachers, and Healthcare Providers.

* All references to tobacco are commercial tobacco and not the sacred or traditional forms used by American Indian and other indigenous populations.

  1. Reid RD, Pritchard G, Walker K, Aitken D, Mullen KA, Pipe AL. Managing smoking cessation. CMAJ. 2016 Dec 6;188(17-18):E484-E492.
  2. U.S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020.
  3. Prochaska, J. J., Delucchi, K., & Hall, S. M. (2004). A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery. Journal of consulting and clinical psychology, 72(6), 1144–1156.
  4. Prochaska J. J. (2010). Failure to treat tobacco use in mental health and addiction treatment settings: a form of harm reduction? Drug and alcohol dependence, 110(3), 177–182.

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