Alameda County Information

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!

AAP CEASE Web referral form Spanish gray logo Word Document V1
Jun 23, 2016, 7:23 PM
Contra Costa Coverage.doc  Word Document V1  Jun 23, 2016, 7:23 PM