Tobacco Cessation

Project name: Comprehensive Tobacco Cessation Services in North Dakota Pharmacies 

Principal Investigator: Brody Maack, PharmD, BCACP, CTTS 

Timeline: 2021-2023 

Funding: TBD 

Collaborators: Don Miller (Pharmacy Practice), Kelly Buettner-Schmidt (Nursing), CAP Center, ND Department of Health, ND Board of Pharmacy, University of California-San Francisco/Purdue University College of Pharmacy 

Purpose: Create a protocol for prescribing tobacco cessation medications by pharmacists in North Dakota to be approved by the ND Board of Pharmacy, and subsequently facilitate the implementation of tobacco cessation medication prescribing by North Dakota pharmacists, including training on prescribing tobacco cessation medications. 

What is already known on this topic? 

Several states have provided the opportunity for pharmacists to prescribe tobacco cessation medications, either per protocol or independently. North Dakota passed a law in 2021 that will allow pharmacists to prescribe tobacco cessation medications pursuant to a protocol developed and passed by the ND Board of Pharmacy. Additionally, there is evidence that implementation of the “Ask-Advise-Refer” system of identification and treatment of tobacco users in clinical settings can lead to higher tobacco abstinence rates, however evidence for this in pharmacy settings is lacking. Currently in North Dakota, it is not standard practice to have a system in place such as the Ask-Advise-Refer (AAR) system.  

What is the potential impact of this project on collaboration and advancement in pharmacy? 

After a tobacco cessation prescribing protocol is created and passed by the Board of Pharmacy, pharmacists will be able to prescribe these agents in virtually any practice setting. Using the CAP Center Core Principles, this project will aim to foster implementation of tobacco cessation medication prescribing, as well as the AAR system, across the state of North Dakota in outpatient practice settings, where it is currently not the standard of practice. This will serve to expand pharmacists’ scope of clinical services provided to patients across the state.  

What is the potential impact of this project on improving population health? 

Tobacco use and tobacco-related disease and death remains the leading cause of death in the United States. In North Dakota, 17% of adults report being cigarette smokers, which is above the national average of 14%, as of 2019. By removing barriers to receiving tobacco cessation care, and allowing patients easy access to their local pharmacist who can prescribe tobacco cessation medications and offer referral to counseling services (or provide that counseling themselves), there is potential to lower North Dakota’s tobacco burden, and thus greatly impact the health of our citizens. 

What ways will the results of this work be disseminated? 

Through research, the results of this project will be disseminated via conference presentations (i.e. poster and podium presentations) and journal publications. The project will begin as a pilot with regard to AAR systems implementation, and if successful, efforts will be made to expand to all ND pharmacists providing care in the outpatient setting. Additional grant funding will be sought to support that up-scaling. 

Top of page