UC Davis Health tobacco researcher and physician Elisa Tong is leading a statewide effort to help safety-net health care systems guide their patients who use tobacco products to resources to help them quit.
Launched this fall, the 5-year statewide project, dubbed CA Quits, is a $6 million award from the California Tobacco Control Program. CA Quits builds on UC Quits, another project led by Tong that enabled all five UC Health systems to build and share modifications for tobacco assessment and treatment into the electronic medical record and workflows. Since its launch, UC Quits has referred nearly 12,000 patients, including almost 2,400 from UC Davis, to the free California Smokers’ Helpline which provides help that can double the chances of a smoker quitting.
“One of the best aspects of UC Quits has been sharing across institutions how we can better help our patients who use or are exposed to tobacco,” said Tong. “It’s a natural step for us to grow into CA Quits and extend this learning collaborative approach with other health systems across the state.”
CA Quits aims to reduce the burden of tobacco use in California, where more than three million people still smoke, or 11 percent of the population. This rate is higher among California’s safety-net, in which one in three Californians are covered by Medi-Cal, the state’s Medicaid program, and 17 percent of adult Medi-Cal members smoke. The project has two objectives; the first is to assist safety-net health care systems and the second is to engage related health partners including Medi-Cal managed care plans and county public health programs. CA Quits is an important project in the state’s overarching strategy to reduce tobacco use in California to zero by 2035.
The first objective tackles higher rates of tobacco use in populations served by targeted health systems, such as safety-net hospital clinics, Federally Qualified Health Centers, and other ambulatory healthcare systems including Indian Health Service, Planned Parenthood and Family Planning, Access, Care, and Treatment (Family PACT) clinics. Many of the patients served by these providers are poor, uninsured or covered by Medi-Cal.
Tong’s team plans to build the capacity of these systems through collaborative educational opportunities, technical assistance, training, information technology and other support so that evidence-based tobacco cessation approaches are integrated into their care models. The 5-year-goal is to have at least 30 safety-net systems with an integrated process to identify and refer patients to cessation support including the free California Smokers’ Helpline. This project also aims to help these health care systems improve their quality metrics linked to tobacco assessment and counseling.
The second objective targets people covered by Medi-Cal insurance, 80 percent of which are covered by 26 Medi-Cal managed care plans. This project aims to help Medi-Cal managed care plans meet evidence-based guidelines for tobacco treatment, from clarifying coverage of cessation medications to promoting the California Smokers’ Helpline to identified members who smoke. CA Quits will also facilitate collaborations with local public agencies such as county health departments to help connect local resources.
“The vision for CA Quits is to start building an integrated health system support for tobacco treatment that triangulates providers, plans and public health partners including the free California Smokers’ Helpline,” Tong said. “We know that support for a person trying to quit tobacco doesn’t have to be just the provider’s job, but that a whole team can work together to help support at a community or population level.”
Other UC Davis faculty members on the CA Quits team are Ulfat Shaikh in the Department of Pediatrics, Bimla Schwarz in the Department of Internal Medicine and Patrick Romano in the departments of Internal Medicine and Pediatrics. Angela (Jackie) Kaslow is the project operations director working with the CA Quits outreach staff.