TABLE 1.

The Addressing Tobacco Through Organizational Change 12 Step Approach

Acknowledge the challenge of addressing tobacco use. Establish a leadership group; secure the commitment of the organization to addressing tobacco use. Create a change plan and implementation timeline with measurable goals and objectives. Start with easy system changes that can be implemented. Conduct staff training and ongoing supervision. Provide treatment and recovery assistance for interested staff who are nicotine dependent. Require better assessments and documentation in charts of nicotine use, dependence, and prior tobacco dependence treatments, including previous quit attempts. Incorporate tobacco dependence treatment materials into patient education curriculum, including information about the new tobacco dependence group treatment and NRT. Provide NRT medications for nicotine dependence treatment. Integrate tobacco dependence treatment groups into the program. Develop onsite Nicotine Anonymous meetings. Establish communication with 12-Step recovery groups, professional colleagues, and referral sources about system changes. Develop written policies addressing tobacco use.