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Clinician Training on Tobacco Dependence for Respiratory Therapists


The goal of this course is to increase the proficiency of respiratory therapists in the 5A’s (and AAR) model and in pharmacotherapy recommendations by utilizing modules specifically designed for respiratory therapists.

The training will provide the RT with guidance for delivery of personalized, tailored tobacco cessation interventions, which may be offered in a variety of environments. This training will build upon existing resources to improve the knowledge, behaviors and self-efficacy for providing brief interventions. The program addresses the need for tailored, interactive, behaviorally focused video examples to demonstrate appropriate interactions with the tobacco user.

This course was developed through a grant from the Independent Grants for Learning & Change (IGLC) at Pfizer, Inc.

Successful completion of this course requires a score of 70% on the post-test.

**Please note that all programs require the participant to view the entire program prior to taking the final quiz and obtaining a course certificate.**
2023

Approved for 5.00 CRCE Hours.


SEMINAR OBJECTIVES

Describe the prevalence of tobacco use across the United States.
Describe health consequences associated with tobacco use.
Describe health benefits associated with tobacco cessation.
List compounds contained in tobacco smoke that can cause harm to humans.
Describe tobacco and nicotine containing products.
Describe the pharmacokinetic profile of nicotine (absorption, distribution, metabolism, and excretion).
Describe the pharmacodynamic effects of nicotine on the central nervous and cardiovascular systems.
List neurotransmitters that are affected by nicotine and their effects.
Describe the dopamine reward pathway and its role in nicotine addiction.
List symptoms of nicotine withdrawal and their peak and duration.
Explain in lay language to a patient the physiological and behavioral components of nicotine addiction and treatment for each of these components.
List non-nicotine pharmacologic aids for cessation
Select appropriate pharmacologic agent(s) based on patient-specific factors.
Describe the efficacy of the various non-nicotine pharmacologic aids for cessation (Bupropion SR, Varenicline)
Describe the proper use of the following nicotine replacement therapy agents (including dosing, instructions on use, potential side effects, and precautions): Nicotine polacrilex gum, Nicotine polacrilex lozenge, Nicotine transdermal patch, Nicotine nasal spray, Nicotine inhaler
Describe how certain beverages can affect the absorption of nicotine from the buccal mucosa.
Describe the relative daily costs of the pharmacologic aids for cessation compared to cigarette smoking.
Assess appropriateness of combination pharmacotherapy.
Assess a tobacco user’s readiness to quit.
List and describe the 5 A’s.
Describe the key counseling strategies for patients who are not ready to quit, including the 5 R’s.
Describe the AAR model.
Describe the use of Motivational Interviewing as an evidence-based method for brief interventions in the treatment of tobacco use and dependence.
Describe the constructs of Motivational Interviewing to help change behavior.
Assess the patient’s stage of change given a patient scenario.
Identify Motivational Interviewing techniques given a patient scenario.
List the health risks associated with teen tobacco use.
Describe effective smoking cessation strategies for adolescent patients.
Describe effective strategies to decrease exposure to environmental tobacco smoke.
List the cardiovascular health risks associated with smoking.
Describe effective smoking cessation strategies for patients with cardiac disease.
Describe appropriate use of medications to aid in smoking cessation for patients with cardiac disease.
List health risks associated with smoking during pregnancy.
Describe effective smoking cessation strategies for pregnant smokers.
Describe appropriate use of medications to aid in smoking cessation for pregnant smokers.
Describe appropriate responses to challenging patient statements.
Describe the reimbursement codes for tobacco cessation counseling.
Discuss development of an interdisciplinary tobacco dependence treatment and counseling program.
Describe strategies to answer common questions asked by tobacco users.
Discuss other opportunities to facilitate tobacco dependence treatment.


CHAPTERS

Assisting Patients with Quitting

At the end of this module, the learner will be able to:

Assess a tobacco user’s readiness to quit.
List and describe the 5 A's.
Describe the key counseling strategies for patients who are not ready to quit, including the 5 R’s.
Describe the AAR model.

The video in this module is approximately 18 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, pages 17-22.


Speaker Information

Sarah Varekojis PhD, RRT


Course Introduction

Welcome to the AARC’s Clinician Training on Tobacco Dependence for the Respiratory Therapist. This course was funded by a grant from the Independent Grants for Learning & Change at Pfizer, Inc.

Brand names of products may be used as examples of available medications or technology. No endorsement of any one product or device is intended. The course faculty discloses no conflicts related to this course.

The goal of this course is to increase the proficiency of respiratory therapists in the 5A’s (and AAR) model and in pharmacotherapy recommendations by utilizing modules specifically designed for respiratory therapists. The course content is supported by the 2014 AARC publication “Clinician’s Guide to Treating Tobacco Dependence.”

The video in this module is approximately 5 minutes in length.

This chapter is followed by a pre-test so that you can check your knowledge prior to the course. This pre-test is not graded and does not affect your course outcomes.


Speaker Information


Difficult Questions

At the end of this module, the learner will be able to:

Describe appropriate responses to challenging patient statements.

The video in this module is approximately 6 minutes in length.


Speaker Information

Georgiana Sergakis PhD, RRT, FAARC
Sarah Varekojis PhD, RRT, FAARC


Epidemiology of Tobacco Use

At the end of this module, the learner will be able to:

Describe the prevalence of tobacco use across the United States.
Describe health consequences associated with tobacco use.
Describe health benefits associated with tobacco cessation.
List compounds contained in tobacco smoke that can cause harm to humans.
Describe tobacco and nicotine containing products.

The video in this module is approximately 25 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, pages 1-12.


Speaker Information

Georgiana Sergakis PhD, RRT, FAARC


Motivational Interviewing

At the end of this module, the learner will be able to:

Describe the use of Motivational Interviewing as an evidence-based method for brief interventions in the treatment of tobacco use and dependence.
Describe the constructs of Motivational Interviewing to help change behavior.
Assess the patient’s stage of change given a patient scenario.
Identify MI techniques given a patient scenario.

The video in this module is approximately 21 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, pages 23-26.


Speaker Information

Georgiana Sergakis PhD, RRT, FAARC


Nicotine Pharmacology & Principles of Addiction

At the end of this module, the learner will be able to:

Describe the pharmacokinetic profile of nicotine (absorption, distribution, metabolism, and excretion).
Describe the pharmacodynamic effects of nicotine on the central nervous and cardiovascular systems.
List neurotransmitters that are affected by nicotine and their effects.
Describe the dopamine reward pathway and its role in nicotine addiction.
List symptoms of nicotine withdrawal and their peak and duration.
Explain in lay language to a patient the physiological and behavioral components of nicotine addiction and treatment for each of these components.

The video in this module is approximately 17 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, pages 13-16.


Speaker Information

Georgiana Sergakis PhD, RRT, FAARC


Nicotine Replacement Therapy

At the end of this module, the learner will be able to:

Describe the proper use of the following nicotine replacement therapy agents (including dosing, instructions on use, potential side effects, and precautions): Nicotine polacrilex gum, Nicotine polacrilex lozenge, Nicotine transdermal patch, Nicotine nasal spray, and Nicotine inhaler
Describe how certain beverages can affect the absorption of nicotine from the buccal mucosa.
Describe the relative daily costs of the pharmacologic aids for cessation compared to cigarette smoking.
Assess appropriateness of combination pharmacotherapy.

The video in this module is approximately 29 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, pages 27-30.


Speaker Information

Lori Wilken PharmD, BCACP, TT-S, AE-C


Non-Nicotine Pharmacotherapy

At the end of this module, the learner will be able to:

List non-nicotine pharmacologic aids for cessation
Select appropriate pharmacologic agent(s) based on patient-specific factors.
Describe the efficacy of the various non-nicotine pharmacologic aids for cessation (Bupropion SR, Varenicline)

The video in this module is approximately 22 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, pages 27-30.


Speaker Information

Lori Wilken PharmD, BCACP, TT-S, AE-C


Reimbursement

At the end of this module, the learner will be able to:

Describe the reimbursement codes for tobacco cessation counseling

The video in this module is approximately 8 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, pages 45-47.


Speaker Information

Georgiana Sergakis PhD, RRT, FAARC


Self-Assessment Module

This module allows the participant to provide recommendations for furthering the smoking cessation conversation for a given scenario.
At the end of this module, the learner will be able to:

Describe an appropriate response to a given patient scenario.

The video in this module is approximately 6 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, pages 45-47.


Speaker Information

Lori Wilken PharmD, BCACP, TT-S, AE-C


Special Populations - Patients with Cardiac Disease

At the end of this module, the learner will be able to:

List the cardiovascular health risks associated with smoking.
Describe effective smoking cessation strategies for patients with cardiac disease.
Describe appropriate use of medications to aid in smoking cessation for patients with cardiac disease.

The video in this module is approximately 10 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, pages 31-33.


Speaker Information

Sarah Varekojis PhD, RRT, FAARC


Special Populations - Pregnancy

At the end of this module, the learner will be able to:

List health risks associated with smoking during pregnancy.
Describe effective smoking cessation strategies for pregnant smokers.
Describe appropriate use of medications to aid in smoking cessation for pregnant smokers.

The video in this module is approximately 8 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, pages 33-34.


Speaker Information

Sarah Varekojis PhD, RRT, FAARC


Special Populations - Teens

At the end of this module, the learner will be able to:

List the health risks associated with teen tobacco use.
Describe effective smoking cessation strategies for adolescent patients.
Describe effective smoking cessation strategies for adolescent patients.

The video in this module is approximately 12 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, page 38.


Speaker Information

Sarah Varekojis PhD, RRT, FAARC


Systems and Pharmacology Q&A

At the end of this module, the learner will be able to:

Discuss development of an interdisciplinary tobacco dependence treatment and counseling program.
Describe strategies to answer common questions asked by tobacco users.
Discuss other opportunities to facilitate tobacco dependence treatment.

The video in this module is approximately 20 minutes in length.

Recommended reading: Clinician's Guide to Treating Tobacco Dependency, pages 39-44 and 48-50.


Speaker Information

Georgiana Sergakis PhD, RRT, FAARC
Sarah Varekojis PhD, RRT, FAARC
Lori Wilken PharmD, BCACP, TT-S, AE-C