Public Health Detailing Program

Tobacco Quit Kit

Clinical Tools | Provider Resources | Patient Education Materials

Clinical Tools

• • Adult Preventive Care Flow Sheet
  To help monitor and document physical examinations, test results, counseling, and immunizations.
• • Materials Request Form
  Reorder materials before you run out, or request additional materials from your Health Department representative.
• • Smoking Questionnaire
  This patient self-screener can assist you in assessing your patients' smoking habits and readiness to quit.
• • Vital Signs Chart Stickers
  Use these stickers in the medical record to incorporate tobacco status into your patient's vital signs. Ask your receptionist, medical assistant or nurse to place one at the top of the visit notes.
  • Print using standard size 2 3/4" x 3 1/2" labels.
    1. Go to Print
    2. Select Color Printer
    3. Page Scaling - NONE
    4. Print

Provider Resources

• • "Preventing 3 Million Premature Deaths and Helping 5 Million Smokers Quit: A National Action Plan for Tobacco Cessation"
  Fiore, M.C., et al. American Journal of Public Health. February 2004, Vol. 94, No. 2, pp 205-210.
• • "Treating Tobacco Use and Dependence. A Systems Approach"
  U.S. Department of Health and Human Services. Public Health Service. November 2000.
  Provides an overview of the clinical practice guidelines for treating tobacco use and dependence.
• • City Health Information: Treating Nicotine Addiction (Updated and Revised; April 2005)
  Provides basic information on assessing nicotine dependence, readiness to quit and medication and cessation aids.
• • Health Bulletin #15: Take Care New York (March 2004)
  Other languages: [En Español] [中文] [عربي] [한국어] [Русский]
  Details ten important steps every New Yorker can take to improve their health.
• • Treating Nicotine Addiction Pocket Guide (Updated and Revised; April 2005)
  A pocket guide of the City Health Information listed above.

Patient Education Materials

• • Everybody Loves a Quitter Easel
• • Everybody Lovers a Quitter Palm Card
  Other languages: [En Español]
• • Everybody Loves a Quitter Poster
  Other languages: [En Español] Also features an easy reference calendar.
• • Health Bulletin #2: Be Tobacco-Free (New and Updated; March 2005; Revised/Reprinted: March 2005)
  Other languages: [En Español] [中文] [Русский]
  Lists benefits of quitting and offers tips for becoming tobacco-free.

Other Materials

• • Folder Cover
• • Letter from the Health Commissioner