The Illinois Academy of Family Physicians is a professional membership society representing over 4,400 family physicians, family practice residents and medical students. Our mission is to promote excellence in the health and well-being of the people of Illinois though support and education of family physicians and the communities they serve.

As you know, 90 percent of today's adult smokers took up the habit before they turned 18. Here in Illinois, 34 percent of our high school students are current smokers. However, many teens smoke without their parents' knowledge and therefore don't get a parent's help to quit. Together, Illinois family physicians and pediatricians developed a program that is evidence-based, physician-friendly and can be easily shared and replicated around the country.

IAFP partnered with the Illinois Chapter of the American Academy of Pediatrics to create a program educating primary care providers to help a very specific and very difficult group of smokers quit… the teenagers we see in our offices. Family physicians treat patients of all ages who struggle with tobacco use, and we see too many patients die as a result of tobacco use. At the same time, pediatricians are treating children that are entering those teenage years. By working together, our partnership ensures that the teenagers who often slip through the cracks between childhood and adulthood receive the best opportunity to break a deadly addiction before the consequences of their tobacco use become irreversible.

The project, "Adolescent Tobacco Use – Prevention and Cessation: Strategies for Primary Care Providers," began on November 1, 2001, as the result of a grant awarded to the project's two co-sponsors, the Illinois Academy of Family Physicians (IAFP) and the Illinois Chapter of the American Academy of Pediatrics (ICAAP). The grant funding was provided by the Illinois Department of Public Health from money allocated by the State from the Illinois Master Settlement Agreement receipts for fiscal year 2002.

The goals of the project were to train primary care medical professionals to:

• proactively request information about their young patients' tobacco use,
• utilize several medical treatments and social interventions to increase cessation attempts among adolescent patients,
• and maintain their support of cessation strategies in subsequent patient visits.

A six-member expert panel of family physicians, pediatricians and other health professionals with extensive tobacco cessation expertise worked together to create the curriculum.

With the grant funding from IDPH, and the knowledge and consensus of the six-member Expert Panel, we were able to produce educational materials in the spring of 2002. Copies of these products are in this folder. With the IDPH funding we were also able to offer programs to train physicians across the state beginning in June 2002

Less than six months since we launched our completed Adolescent Tobacco Use – Prevention and Cessation program, 790 Illinois physicians have attended a live program, read the monograph or guideline, or listened to the audio program. 

Now for the bad news – IDPH planned to give us a grant to continue implementing, marketing and disseminating this program in fiscal year 2003, which began this past July. However, the state's current budget woes have taken that funding opportunity off the table. The high quality CME materials now sit in boxes at IAFP's Lisle office and at ICAAP's office downtown, since we no longer have funding to ship these materials.

We are forced to find creative, budget neutral opportunities to share our self study materials with primary care providers. As you can imagine, this is seriously reducing the number of physicians we can reach and the effectiveness we can have in helping teen smokers. We can't afford to wait for the states to take action.

In addition to the adolescent cessation program, family physicians in Illinois and across the country and overseas volunteer their time to "Tar Wars," teaching tobacco prevention in fourth and fifth grade classrooms at schools in their communities. The program is free to schools and the curriculum is free, provided by the American Academy of Family Physicians. However AAFP is in desperate need of a consistent funding stream to operate the program nationwide. The only cost for participants is the physicians' time and effort in taking tobacco prevention directly to the kids that we don't see in our practices. You can learn more about the Tar Wars program at www.tarwars.org.

Family physicians are doing what they can to fight the harm of tobacco use in their practices and the community, with little or no financial backing. These educational efforts to promote smoking prevention cessation are only part of is needed to achieve our goals of increased cessation services by family physicians to our patients who smoke. We strongly encourage HHS to provide grants that would create model curriculum materials for medical and dental schools, since tobacco control is most often left out of the standard curriculum in health professional education.

Family physicians also face other barriers in providing smoking cessation services that need attention. Reimbursement for providing cessation services must become as important as coverage for other chronic diseases such as diabetes. CPT codes should be created for nicotine dependence and its treatment.

Finally, population-based initiatives that promote cessation should be promoted strongly by HHS, particularly increased prices for tobacco products and policies that protect the public from the hazards of second-hand smoke. Both of these approaches have been shown to reduce smoking prevalence and enhance cessation, and need support at all levels of government.

The USPHS clinical practice guidelines suggests that physician intervention for tobacco cessation is at least as clinically useful and cost effective as screening for breast cancer or treating hypertension. Failure to adequately address smoking cessation will perpetuate the human and economic toll caused by tobacco use. It is time that society addressed tobacco use in a comprehensive way, as it's the only way we'll ever beat it.

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