SETTING UP A

SMOKING CESSATION CLINIC

Framework Convention on Tobacco Control

Alliance, Philippines (FCAP)
Definition of the Smoking Cessation Clinic

-it is a fixed place or location- whether a room or a building

where competent health workers attends and helps clients
in their attempt to quit the smoking addiction.

- it should be able to provide basic services such as

assessment of clients, plan of care, pharmacologic
treatment, stress management and counseling services.

- Counseling services maybe done individually or by group

sessions. Thus, setting up a smoking cessation clinic is
essential to be able to provide care for clients who want to
stop smoking.
Identify the staffing requirement of the
smoking cessation clinic
The smoking cessation clinic shall have an updated
organizational chart with clear job descriptions of roles and
responsibilities for each staff. It should have an effective
means of communication to ensure prompt, reliable
reporting and adequate dissemination of information.

-maintain the following records:

Staff Records
Client Records
Records of Referral Professionals and Institutions
Staff Record

The records of the staff in the cessation clinic should

include:

-Office Order to include the designation as TC Smoking

Cessation Coordinator/Staff Designated to Provide Smoking
Cessation Services

-List of Staff trained on smoking cessation supported by

Training Certificates, Hospital/Agency Orders regardless of
status as long as designated but with at least 1 plantilla
position
Client Records

The clinic shall maintain clients’ records on registration,

clinical notes of consultation and treatment given.

All client records should be accurate, sufficiently

detailed, legible, current, complete and confidential.
The clients’ records shall be organized for easy retrieval,
review and continuing therapy.

Client records shall be retained for no less than one (1)

year from the last session.
• Forms used by health facilities including smoking
status as part of patients records

- List of smokers enrolled in the clinic (walk-in, referral,

callers from quit line)
- Record on intervention given to
smokers/callers/referrals (Brief advise/counselling,
pharmacotherapy, etc)
- Record of current smoking status of smokers (quit,
reduced consumption, relapse, change in readiness to
quit, reprimanded, etc)
Number of LGU personnel classified according to their
smoking status (all employees not limited to the
Health Office)
-list of smokers
- -Record on intervention given to
smokers/callers/referrals (Brief advise/counselling,
pharmacotherapy, etc)
- Record of current smoking status of smokers (quit,
reduced consumption, relapse, change in readiness
to quit, reprimanded, etc)
Number of smokers classified as to action taken by the
office (reprimanded referred for cessation counselling,
fined, etc)
• List of violators
• Record of actions for every corresponding smoking
violation documented by the office
• No violations noted among smokers
• (If there are no violations from the LGU personnel,
asked for report signed by the head of office, MHO,
CHO/PHO or Mayor)
Clients Tracking Form
Number of patients in the health facility availing of
smoking cessation services under the Primary Care
Benefit 1(all employees not limited to the Health
Office)
-LGU implement the PCB1
List of availment of smoking
cessation services
PCB1
San Juan Municipality,
Southern Leyte
Support group/s created for smokers who quit

• List of support groups (Youth against smoking, I

love smokefree goup, Smoking Quitters Club)
• Minutes, photos and attendance of activities
Number of LGU requested for training on brief
advise/smoking cessation training

• Letter of request from LGU to DOH/Academe/CSO

• Budget for training alloted by the LGU (under the

WFP)

• Training conducted
Discuss policies and procedures for the
operations of the smoking cessation clinic

-non smoker providers

-absolute no smoking (Health facilities)
-copy of the ordinance/policy of the office
Presence of Smoking Cessation Clinic
- space/corner/office
- IEC Materials available, posters, flipcharts/algorithms
- hotline
- Logbook of callers
- Availability of equipment & supplies and medicines
used for smoking cessation (e.g. test for nicotine level,
nicotine patch, champix)
Facilities and
Equipments

-Every part of the smoking cessation

clinic shall be clean, tidy and in good
state of repair.

- adequate lighting and ventilation.

-ensure that comfort, privacy and safety
of the client are not compromised.
-sufficient space and supplies in the
clinic.

-The clinic’s instruments (ie.

Smokerlyser, spirometer) shall be
functional.

-The therapy room shall be

appropriately furnished with a desk,
telephone and where possible, a
comfortable lounge chair and audio/TV

-A suitable waiting area shall be

provided where appropriate.
Smoking Cessation
Corner
Sample Citation Ticket
Set-up monitoring and evaluation tools
Advocate/market the smoking cessation
clinic to the community

-Posters
-Leaflets
-Recorida?/Announcement every Monday (Flag
ceremony)
-Memos/letters to different government offices in the
locality
Set-up monitoring and evaluation tools