CEASE: Quick Tip Sheet
#1 ASK: Does anyone who smoke cigarettes live with or care for your child?
Systematically screen all parents/caregivers
#2 ASSIST with nicotine replacement
Provide brief motivational interviewing; see this link for resources, then, offer NRT (check with liability coverage to ensure coverage for prescribing to adults)
SCREEN For Contraindications
- Heart Attack in the past 2 weeks
- Prior Skin reactions (for patch)
- Pregnancy/Lactation (use gum only)
Talk about Signs of TOO MUCH nicotine
- Nausea, diarrhea, vomiting
- Rapid heartbeat, dizziness, cold sweats
- Blurry vision, headaches, drooling
Prescribe Patch AND Gum TOGETHER
Use the preprinted NRT prescription
First 5 CA provides FREE NRT to smokers living with kids aged 0-5. If the caregiver does not have insurance, encourage them to call the Smokers’ Helpline (see #3) and enroll in counseling so they can get their NRT!
Patches (7mg, 14mg, 21mg) Change q 24 hours; place on hairless skin; rotate site daily.
If smoke ½ pack per day or more, start at 21mg patches.
If smoke LESS THAN ½ pack, start at 14mg patches.
- Use 21mg patch for 6 weeks then decrease to 14mg for 2 weeks then 7mg for 2 weeks
- If starting at 14mg patch, use for 6 weeks then use 7mg for 2 weeks then STOP.
Prescribing Gum OR Lozenge (4mg or 2mg). Use for CRAVINGS during day
Use 4mg if smoker has first cigarette within 30 minutes of waking; otherwise use 2mg gum.
To save money, smoker can get 4mg gum and split it in half.
- Use gum at start of craving
- “Chew and Park”. Chew gum for a few bites until you feel a tingling and then “park” it in your cheek until tingling disappears. Then chew again and park. A piece of gum lasts about 30 minutes
- Use gum every 1-2 hours for six weeks and gradually wean over time
- Avoid swallowing gum or saliva while chewing, as nicotine can upset stomach
#3 Refer to the California Smokers Helpline by clicking here!
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