Resources
The MaineHealth Center for Tobacco Independence provides a variety of tools for providers on addressing tobacco use and treatment.Clinical Provider Toolkit
The following resources are free for providers to use; they are the same documents we provide at our outreach visits and trainings. Please visit our Patient Tools section for targeted resources for clients and patients.
- CAGE AID
- Smokeless Fagerstrom Nicotine Dependence Scale
- Fagerstrom Nicotine Dependence Scale
- The 5As Flowchart
- Questionnaire Long Form
- Tobacco Diagnosis Coding
- Medication Dosing Guidelines
- Tobacco Treatment Flow
- Maine Tobacco Helpline Fact Sheet
- Tobacco Treatment Note Outpatient
- Open-ended Questions
- Tobacco Treatment Plans Behavioral Health
- Provider Patient Online Resources
- Tobacco Use Assessment Short Form
- Tobacco Treatment Services Guide
Behavioral Health IMAT Pilot Project and Toolkit
About the Pilot Project: Tobacco use disorder is often overlooked by behavioral health clinicians. A proposed solution is to integrate treatment for tobacco use disorder into the treatment for co-occurring addictions and/or mental health conditions for which people who use tobacco are already enrolled. In addition to the practicality of bringing tobacco treatment to the client in their existing treatment setting, it also makes sense therapeutically given the intimate relationship between tobacco use and other behavioral health disorders. Over the course of a 7-month pilot program, which was a collaboration between the Center for Tobacco Independence (CTI) and the MBH Biddeford Integrated Medication Assisted Treatment (IMAT) program for treating opioid use disorder, strategies to integrate tobacco treatment were implemented.
- Report on a Pilot Project: Register for the January 23, 2018 Webinar
The following resources, utilized with the Behavioral Health Pilot Project, are available for download and use by providers and include materials for both providers and clients. Additional resources can be found under the Clinical Provider Toolkit and Patient Tools section.
- Toolkit Index
- Assessment:
- Maine Tobacco HelpLine:
- Motivation Documents:
- Medication Documents:
- Medication Dosing Guidelines
- Cost of Tobacco Treatment Medications vs. Cigarettes
- Over-the-Counter Nicotine Replacement Therapy (NRT)
- Prescription NRT
- Other Prescription Medication (not containing nicotine)
- Treatment Planning and Strategies:
- Back Talk
- Carbon Monoxide Monitor
- Cigarette Log
- Pack Tracks
- Keeping Track
- When Do I Use Tobacco
- Components of a Simple Quit Plan
- Daily Coping Inventory Worksheet
- Dear Family and Friends Letter
- Diagnostic Codes
- Drug Interactions with Tobacco Smoke
- Electronic Nicotine Delivery Systems (ENDS)
- H.A.L.T.
- Helpful Tips for Quitting Tobacco
- I Quit Smoking and Now I Feel
- My Medication Plan
- My Weekly Strategies and Goals
- Possible Nicotine Withdrawal Symptoms
- Quitting Tobacco and Weight Gain
- Sample Group Schedule
- Sample Tobacco Treatment Plans
- Sample Tobacco Treatment Goals (Long List)
- The 4 D’s
- The Three-Legged Stool
- Tips for Getting through the Day Worksheet
- Tobacco Diagnostic Codes
- Tobacco Treatment Group – Flowsheet
- When You Quit Smoking
- Withdrawal Symptoms
- You Can Quit Smoking Worksheet
- Three Topics
- Presentation for Clients: Thinking About Quitting Tobacco