Public Health Toolkit: Best Practices

Best Practice

Family Counseling Services provides mental health and chemical dependency counseling to residents in Cortland, Madison, Broome and surrounding counties. In 2014, with the support of the Central New York Regional Center for Tobacco Health Systems at St. Joseph's Health in Liverpool, a Health Systems for a Tobacco-Free New York grantee, Family Counseling Services identified a need for enhanced tobacco dependent treatment protocols. At that time, there was no system to consistently address tobacco use and nicotine addiction.The CNY Regional Center worked with Family Counseling Services to develop a comprehensive tobacco dependence treatment protocol based on the Public Health Service Clinical Practice Guidelines for Treating Tobacco Use and Dependence.

Family Counseling Services now has comprehensive tobacco dependence treatment protocols embedded into their Standard of Care Workflow that promotes evidence-based treatment which includes:

  • The 5A's for tobacco dependence, a model that presents the five major steps in providing a brief intervention. At every visit patients areasked about their tobacco use, advised to quit, assessed in their willingness to make a quit attempt, assistedby their health care provider to make a quit attempt, and arranged with a follow-up to prevent relapse.
  • Identifying tobacco treatment champion(s) at their clinic sites. In addition, providing training and support to the champion(s) on evidence-based methods for treating tobacco dependence and nicotine addiction.
  • Ensuring that current staff and new hires are educated about and understand the evidence-based tobacco treatment and understand the proper use within the electronic medical record.
  • Providing performance measures to ensure that the tobacco dependence and nicotine addiction interventions are being completed per the organizational standard of care guidelines. Quality assurance assessments are conducted through health record audits and staffs are routinely updated on performance measure outcomes.
  • Providing support to clients to ensure they have an understanding of their health insurance plan benefits for tobacco cessation counseling and medications.

The benefits of this comprehensive intervention are evident with their clients, as seen in testimonials of Family Counseling Services staff members:

  1. One of my clients, who is seeking support for a mental health condition, has been attempting to quit smoking for many years. Since coming to FCS and engaging in tobacco treatment, his smoking has decreased. He has begun to recognize he has an "emotional connection" with tobacco along with a physical addiction. He has begun to identify how smoking has impacted his anxiety. While anxious, he attempts to smoke to "calm down". This decreases his lung functioning, which heightens his anxiety. He has begun to recognize that smoking has not really assisted with his anxiety but actually heightens it and is attempting to engage in healthier coping skill use.
  2. My client, who is seeking support for addiction, has quit smoking and resumed smoking on/off for years.The smoking calculator that describes the costs has really made an impact on her. She has even shared it in our waiting room! I've also given her copies to give her family and friends.Now when she reports her sobriety in groups, she also reports her efforts to stop smoking. I like how the quit plans mimic what we teach in recovery, and the peer pressure/support seems a big part of her success.

Lessons Learned:

  • Family Counseling Services began the process with a paper-based intervention to treat tobacco dependence and nicotine addiction. Over the course of the past two years, they took the time needed for their organization to ensure that this intervention tool was suitable for their clients. Once they felt confident, they embedded the intervention tool into their electronic medical record system.
  • The 5A's for treating tobacco dependence and nicotine addiction is an easy tool for staff members of all levels. This tool can be utilized in an individual manner based on clients need and wants.
  • Regular audits are being conducted to ensure that the intervention is being utilized by staff.
  • Providing support and on-going education to staff about the best practices for treating tobacco dependence and nicotine addiction is critical.

Share Your Best Practices

Across New York State, health professionals are making great strides in improving public health through a wide range of initiatives such as reducing sodium consumption in schools, prompting municipal officials to move toward "walkable" communities and even convincing store owners to remove tobacco advertising. The New York State Department of Health would like to share and highlight your successes, best practices and lessons learned. Public health efforts come in all sizes and shapes – a one-time only poster or promotional giveaway or a multifaceted campaign. Some are more effective than others, but all of them teach us something about reaching audiences and changing behavior. Help others benefit from your experiences, large or small by sharing them with us to highlight on this page.

Examples of best practices

  • Campaign that motivated the community and community leaders to take action
  • Outreach to a hard to reach audience
  • Innovative use of social media or other emerging technology
  • Low or no-budget effort that succeeded beyond expectations
  • A slogan, logo or other branding that effectively communicated with and motivated an audience

Examples of lessons learned

  • Our target audience responded differently than we anticipated because…
  • With a few more dollars we could have….
  • If we had it to do over again, we would….
  • The tools we used or direction we chose were less effective than they should have been because…
  • We were pleasantly surprised to learn…

If you have a story to tell that others could benefit learning about, please share your knowledge with us by filling in the fields within this PDF and email it to us at Each submission will be followed up on and considered for a chance to be highlighted on this page.