Skills and knowledge in this unit are provided to support implementation of common population based smoking cessation strategies such as participation in health promotion campaigns, including the preparation of campaign resources such as pamphlets and participation in health education and health screening activities

ELEMENT

PERFORMANCE CRITERIA

1. Assess needs of clients who are nicotine dependent

1.1 Elicit client's history particularly relevant to smoking, in accordance with organisation guidelines and ethical considerations

1.2 Assess nicotine dependence using a validated method

1.3 Determine smoking cessation treatment based on assessment of an individual's level of nicotine dependence, stage of change and client history

1.4 Professionally and accurately maintain client records

1.5 Maintain client confidentiality

2. Implement interventions

2.1 Match intervention to client's personal circumstances including relevant health issues, level of dependence and behavioural triggers

2.2 Conduct brief intervention with client according to client needs

2.3 Use motivational interviewing techniques to increase client's motivation to quit

2.4 Provide intensive counselling as per individual need

2.5 Refer clients to other health professional or agency as appropriate

3. Assist clients in accessing pharmacotherapies for smoking cessation

3.1 Provide client with information about pharmacotherapies, their benefits and contraindications

3.2 Determine suitability of pharmacotherapies for client

3.3 Provide referral to a medical practitioner for pharmacotherapies as appropriate

3.4 Determine options for optimal combination of smoking cessation therapies with client if appropriate

4. Monitor client's progress

4.1 Arrange and conduct client follow up

4.2 Assess client's progress against goals set and interventions conducted and then provide feedback

4.3 Assess risk of relapse

4.4 Provide behavioural interventions and/or pharmacological advice

4.5 Refer clients to other health professional or agency as appropriate

5. Ensure high standards of professionalism and continuing professional development

5.1 Demonstrate professional standard of conduct at all times

5.2 Maintain knowledge of evidence base relating to smoking cessation therapies

5.3 Undertake qualitative and quantitative assessment of work

5.4 Appraise developments in smoking cessation practices and apply to improve own practice

5.5 Maintain ongoing personal professional development and training in smoking cessation

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

Brief intervention techniques

Contraindications associated with use of NRT, including recent cardiac events, unstable angina and pregnancy

Evidence based key strategies for smoking cessation including the World Health Organisation: Evidence-based Recommendations on the Treatment of Tobacco Dependence and the Australian National Drug Strategy 'Smoking cessation interventionsReview of evidence and implications for best practice in healthcare settings'.

Evidence-based aspects of dosage and duration of use of nicotine replacement therapies (NRT)

Intensive counselling techniques suitable for smoking cessation interventions

Interaction of nicotine with various medications

Interaction of NRT with medications and other drugs, e.g. caffeine, alcohol, insulin

Internationally accepted definitions of nicotine dependence including the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders 4th Ed) and the WHO International Classification of Disease (ICD-10)

Motivational interviewing techniques

Physiological links between mental illness and nicotine dependence

Process of neuro-adaptation to nicotine

Processes of titration of nicotine dose and smoker compensation practices

Use of non prescription (such as NRT) and prescription-only (such as slow-release bupropion) pharmacotherapies

Essential skills:

It is critical that the candidate demonstrate the ability to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

Access and locate existing state/national/international print and electronic primary sources of evidence relating to assessment and treatment of nicotine dependence

Apply active listening including questioning

Apply negotiation skills

Apply problem solving skills

Assess the needs of clients who are nicotine dependent

Demonstrate effective communication and interpersonal skills

Establish rapport

Implement a range of smoking cessation interventions

Provide information on smoking and smoking cessation to the client

Provide referral to appropriate services

Undertake networking and liaison with other services and service providers

Work with a range of clients

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit:

The individual being assessed must provide evidence of specified essential knowledge as well as skills

Access and equity considerations:

All workers in the health industry should be aware of access and equity issues in relation to their own area of work

All workers should develop their ability to work in a culturally diverse environment

In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people

Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Context of and specific resources for assessment:

This unit may be assessed on the job or through simulation

Consistency in performance should consider the work environment, worker's role and responsibilities in the workplace

Access is required to equipment and resources normally used in the workplace

Method of assessment:

Assessment may include:

Observation

Interview and questioning

Simulation

Workplace documentation of practice

Portfolio

Testimonial

Related units:

This unit should be assessed after or in conjunction with related unit:

HLTPOP403C Provide information on smoking and smoking cessation

It is also recommended that this unit be undertaken in conjunction with:

HLTPOP402C Assess readiness for and effect behaviour change

This unit may also be assessed in conjunction with:

CHCCS403B Provide brief intervention

CHCGROUP403D Plan and conduct group activities

CHCTC302A Provide client-centred telephone counselling

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Historical, social, political and economic context includes:

The statutory framework within which work takes place in the health and community sector

The historical context of work e.g. changing knowledge about best practice in treating nicotine dependence; changing approaches to working with clients; changing social context of work e.g. changing government and societal views of tobacco use and approaches to working with clients

The political context e.g. government policies and initiatives affecting treatment for nicotine dependence

The economic context e.g. the current economic situation as it relates to and affects tobacco use and the subsequent impact on client needs

Client history relevant to smoking includes:

State of health

Behavioural factors

Level of nicotine dependence

Smoking cessation interventions may include:

Brief interventions:

The 'Five A's':

Ask (about smoking)

Advise (all smokers to quit)

Assess (level of dependence and readiness to quit)

Assist (provide advice and support)

Arrange (follow up)

Motivational interviewing techniques

Exploring 'readiness to quit' using the trans-theoretical model of behaviour change:

those not ready to quit

those thinking about quitting

those ready to quit

those who have already quit

those who have relapsed

Intensive counselling

May include phone or face to face interventions

May be individual or group interventions

Pharmacotherapy includes:

Nicotine replacement therapies (non-prescription)

Bupropion slow-release, 'Zyban' (prescription only)

A commitment to access and equity must be demonstrated by:

A non-discriminatory approach to all people using the service, their family and friends, the general public and co-workers ensuring the work undertaken takes account of and caters for differences including: cultural, physical, religious, economic, social, etc.

Validated methods for assessing nicotine dependence include:

Fagerstrom test for nicotine dependence

TTFC + CPD (time to first cigarette plus cigarettes per day)

CO monitor

Social, political and economic context of tobacco smoking may include reference to:

Aboriginal and Torres Strait Islander Complementary Action Plan 2003-2009

This unit contains Employability Skills