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The third class of recipients of the AAFP Tobacco and Nicotine Prevention and Control Chapter/Family Medicine Residency Program Mini-grants -- like their predecessors -- created novel approaches to controlling tobacco use at the state and local levels.

The Academy awarded $10,000 each to the five 2016-17 mini-grant recipients whose innovative programs addressed tobacco and nicotine prevention and control by focusing on clinical practice, social factors or public policy.

Supported in part by a grant from the AAFP Foundation, this will be the mini-grants program's final year; after careful consideration, the AAFP has decided to reallocate this funding to support its new Center for Diversity and Health Equity.

"We were very happy with the mini-grant funding model and hope to use that model in the future with other projects and programs, where appropriate," said Ashley Poole, global population health specialist in the AAFP Health of the Public and Science Division.

The Kansas AFP partnered with Tobacco Free Wichita(118 KB PDF) to test strategies for engaging physicians and other health care professionals in health messaging and advocacy on tobacco control initiatives. Specifically, the groups developed traditional media and social media training opportunities for physicians seeking to become tobacco-control advocates.

The partners offered a half-day training session with a local media firm on conducting quality media interviews. Each participant recorded an on-camera interview addressing tobacco issues and received feedback from the media firm representative.

According to the chapter, this training helped potential tobacco-control advocates communicate their stances and ideas about the importance of tobacco control more clearly and gave them insight on what journalists look for when reporting stories.

The Kansas AFP also provided training with a local oncology nurse and social media expert on using social media networks to expand reach and impact. These trainings were provided both in-person and virtually, and covered the basics of using Facebook and Twitter.

After completing the training, some participants used their established social media networks to promote Tobacco Free Wichita's social media accounts, which increased that group's following by 500 percent.

Tobacco Free Wichita also developed a hashtag -- #KSHealth -- to use when sharing health-related news statewide. The hashtag is now being widely used by organizations across the state.

As fortune would have it, the New Jersey and Delaware AFPs(271 KB PDF) had just teamed up to launch a quality improvement education project(www.njafp.org) in which they sought to address the ABCS of treating type 2 diabetes (A1c, blood pressure, cholesterol and smoking). So, when the AAFP's tobacco mini-grants came available, it made sense for the two groups to add a special focus on tobacco cessation to complement their broader project.

Here's how the groups explained it in their mini-grant project report: "We supplemented our curriculum with additional tobacco cessation education and added a partnership with the local American Lung Association (ALA) to provide additional resources. We reinforced that learning with data collection on cessation-related practice changes and tobacco counseling data from the practice (electronic health record systems)."

The groups trained practices to use a brief, evidence-based intervention and linked them to cessation resources such as the ALA's Lung HelpLine & Tobacco QuitLine, 1-800-LUNGUSA. A trainer from the ALA conducted the intervention training, which used the Ask, Advise and Refer model. Encouragingly, 95 percent of training participants said they intended to implement a new cessation strategy in their practices.

In April 2016, the Minnesota AFP House of Delegates passed a resolution asking the chapter to organize support for legislation in local cities and counties to ban nicotine sales to those younger than 21. The tobacco mini-grant the Minnesota AFP received enabled it to help lead the state's Tobacco 21 initiative(tobacco21.org).

Among the many activities the chapter listed in its project report(107 KB PDF) was recruiting members to act as Tobacco 21 champions, who used grassroots advocacy efforts to reach out to local legislators and media outlets and presented educational programs throughout the state.

The chapter also partnered with the Twin Cities Medical Society and other local public health organizations to host an education program for health care professionals to discuss both e-cigarettes and the Tobacco 21 initiative.

And when the community of Edina showed interest in Tobacco 21, the Minnesota AFP encouraged members living or practicing in the area to engage government officials and urge them to pass the legislation.

Those efforts paid off when on May 2, Edina became the first city in Minnesota to pass Tobacco 21 legislation.

Aultman Family Medicine Residency Outpatient Clinic in Canton, Ohio, caters to urban poor, Medicaid and Medicare patients, as well as some patients who are uninsured and some who have commercial insurance.

Before receiving the tobacco mini-grant, 22 percent of patients treated were smokers, and most of them had co-existing mental illness such as anxiety, depression or bipolar disorder. Additional comorbidities included heart disease, stroke, cancer and chronic obstructive pulmonary disease. Not surprisingly, hospitalizations and readmissions were higher among these patients.

To complement Aultman Hospital's in-house tobacco cessation program, Aultman Give It Up!, which is run by certified treatment specialists and includes six weeks of multi-session tobacco cessation classes, the group created the AultQuit app(1 MB PDF). Program participants use the app to receive messages during their classes with tips for quitting and reminders about classes. The app also allows for better data collection and retrieval and has greatly streamlined the program's sign-up process.

The mini-grant has also permitted the Give It Up! program to incentivize potential participants with prizes and to enhance the mental health aspects of the existing classes, particularly the cognitive behavioral therapy and mindfulness components.

Related AAFP News Coverage CDC MMWR Teen Tobacco Use Dropped Significantly From 2015 to 2016 (6/22/2017)

Leader Voices Blog: Not Blowing Smoke: FPs Can Make a Difference on Tobacco(4/4/2017)

AAFP Tobacco Control Mini-grant Recipients Get Creative Again (7/13/2016)

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AAFP Awards Third Round of Tobacco Control Mini-grants - AAFP News