10-185
Effectiveness of a university on-campus pharmacist
directed tobacco cessation program
Brittany L. Long, PharmD, TTS, Michael J. Rush, PharmD, CDE, BCACP, TTS, Karen L. Kier, Ph.D., M.Sc., R.Ph., BCPS, BCACP, TTS
 Despite a smoking prevalence decline from 2005 to 2014,
approximately 40 million adults in the USA are classified as
current smokers (16.8%).1
 In the USA, tobacco use is currently the number one
preventable cause of disease and death, each year leading
to greater than 480,000 deaths and $300 billion dollars
spent in economic cost related to this behavior.1,2
 Smoking among college-aged students and adult employees
is a large problem in the USA. Data published in 2015 shows
smoking rates are approximately 16.7% for adults aged 1824 and 20% for adults aged 25-64.1
 Many college and university campuses have instituted
tobacco-free policies. According to Americans for
Nonsmokers’ Rights, around 1,130 colleges and universities
are completely tobacco free in the USA, including cigarettes
and smokeless tobacco.3
 Studies show pharmacists are beneficial for tobacco
cessation by speaking to patients about cessation and
providing counseling or information on quit-lines with or
4,5,6
Data on use of
without pharmacologic cessation agents.
pharmacists in ambulatory outpatient clinics in college or
university cessation programs is apparently lacking.
 Primary objective: Effectiveness of a university, on-campus
pharmacist-led tobacco cessation program on tobacco
cessation rates
 Secondary objectives: Tobacco abstinence through one
month following treatment period end, medication safety in
terms of side effect occurrence, effect of side effects on
compliance, occurrence rate and severity of nicotine
withdrawal, blood pressure change in the nicotine
replacement therapy (NRT) group, change in attitudes and
beliefs of participants about tobacco use, the campus-wide
ban, and the benefit of utilizing pharmacists in quitting
 Patient visits take place at ONU HealthWise, an on-campus
employee and student health and wellness clinic
 Inclusion: aged > 18; current user of tobacco or tobacco
product line extensions; current ONU student, employee, or
dependent; agrees to counseling and/or pharmacotherapy
 Exclusion: Pregnancy; fails to meet inclusion criteria
 Patients are recruited by posters, presentations, e-mails, and word-of-mouth.
Each signs an informed consent form prior to study inclusion.
 Patients have an initial visit with an ONU HealthWise pharmacist to gather
baseline medical data. Information regarding tobacco use history (habits, goals,
past cessation attempts, current motivations to quit) is collected (see figure
below, left). A tobacco cessation workbook is given and explained to the patient
by a pharmacist. A quit date and treatment plan is determined at this visit.
 If NRT is the chosen cessation aid, patients return to the clinic to receive the first
month supply prior to the quit date. If a prescription option is chosen, patients
are referred to discuss this therapy with their primary care provider.
 Patients are seen face-to-face or contacted via telephone or email on quit day
and at 1 week, 4 weeks, 8 weeks, 12 weeks, and end of treatment. Continued
abstinence is assessed with follow up at 14 and 30 days following treatment end.
 At each visit tobacco use, reason of use, withdrawal symptoms experienced, and
medication side effects experienced will be assessed (see figure below, left).
The Tobacco Cessation
Attitude & Belief Survey
is used to identify change
in participants’ attitudes
and beliefs regarding
tobacco use, the campuswide ban, and the benefit
of utilizing pharmacists in
quitting. Patient
motivation and belief in
success is also addressed.
It is given at the initial visit
and weeks 8 and 12 of the
program.
 Enrollment is ongoing. Since implementation in August: 5
patients have enrolled; 4 have begun treatment
Cessation Aid Treatment Primary
Patient Tobacco Form
(+ Counseling) Status Endpoint
1
Chewing tobacco NRT patch
Ongoing N/A
 Information on medication side effects and nicotine withdrawal will be selfreported and assessed via Likert scale at each follow-up visit through the end of
treatment (see figure above, right).
 For the NRT group, blood pressure will be collected at minimum at the initial visit,
week 4 follow-up visit, and week 8 follow-up visit.
 Pharmacologic therapy is offered as adjunct to counseling. Options available from
ONU HealthWise are NRT gum, lozenge, and patch. More than one option can be
used together. Route is determined by the ONU HealthWise practitioner and the
patient. Duration of therapy and dosing titration follow FDA recommendations and
current standard of care, and will be individualized based on patient specific
factors. If NRT is contraindicated, unsuccessful, or undesired, patients are referred
to a primary care provider with recommendations for bupropion SR or varenicline.
 The study will provide both descriptive and inferential statistics regarding the
primary and secondary outcomes.
 This study was approved by ONU’s Institutional Review Board.
2
Cigarettes
NRT patch
Complete Achieved
3
Cigarettes
NRT patch
Complete Achieved
4
Cigarettes
NRT patch
Complete Achieved
**N/A if: treatment ongoing, or < 14 days since completion
 Results are pending and will be submitted for publication.
1. Jamal A, Homa DM, O’Connor E, et al. Current cigarette smoking among adults—United States, 2005–2014. MMWR. 2015; 64(44):1233–40.
2. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: 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, 2014.
3. Americans for Nonsmokers’ Rights (ANR) [Internet]. Berkeley (CA): Americans for Nonsmokers’ Rights Foundation; c2015. Colleges and
Universities; [updated 2015 Oct 2; cited 2015 Nov 17]; [about 1 screen]. Available from: http://no-smoke.org/goingsmokefree.php?id=447
4. Costello MJ, Sproule B, Victor JC, et al. Effectiveness of pharmacist counseling combined with nicotine replacement therapy: a pragmatic
randomized trial with 6,987 smokers. Cancer Cause Control. 2011; 22:167–80.
5. Dent LA, Scott JG, Lewis E. Pharmacist-managed tobacco cessation program in Veterans Health Administration community-based outpatient
clinic. J Am Pharm Assoc. 2004; 44:700–15.
6. Wahl KR, et al. Promoting pharmacy-based referrals to the tobacco quitline: a pilot study of academic detailing administered by pharmacy
students. J. Pharm. Pract. 2015; 28(2) 162-65.
Authors of this project have nothing to disclose.