One of the critical expanded authorities that came from SB 493 was the ability for all licensed pharmacists in the State to provide and offer nicotine replacement products for smoking cessation. Prior to SB 493, providing nicotine replacement therapy was limited to pharmacists who worked in either an inpatient setting or an integrated system.
Pharmacists who provide nicotine replacement therapy are not just selling the nicotine replacement products themselves, but they are also assisting patients with tobacco cessation using patient specific interventions, including referring patients to quitlines, such as the California Smokers’ Helpline, and other resources that are available within the community. Before a pharmacist even offers nicotine replacement therapy, they will evaluate their patients for any specific factors including precautions or contraindications for medication therapy. In addition, extensive counseling is done by the pharmacist with their patient on the appropriate use of smoking cessation medications such as dosing amounts, how to administer the product, and any possible adverse effects.
SB 493 opened the doors for retail and community pharmacists to be able to transform their business model by offering more preventative healthcare services, like nicotine replacement therapy. Most importantly, pharmacists have an opportunity to be leaders in the fight against nicotine addiction by decreasing the use of tobacco products and promoting smoking cessation especially since they interface with patients frequently throughout the day.
The health benefits for patients who participate in a smoking cessation program are incredible considering the damaging effects of nicotine addiction. Smoking tobacco products increases the chance of lung cancer, chronic obstructive pulmonary disease, coronary heart disease, stroke, and peripheral vascular disease among others.
Patients are particularly at an advantage of receiving nicotine replacement therapy from their community pharmacist because the service can be provided more accessibly, rather than having to make an appointment to see their primary care physician which can take several weeks. Patients who want to quit smoking and begin a smoking cessation program with their local pharmacist will see major improvements in their health and will significantly reduce the risk of premature death.
The California Pharmacists Association was instrumental in advocating for SB 493 (Hernandez) and were sponsors of the legislation. CPhA’s CEO, Jon Roth recalls that the timing of this legislation was impeccable. “SB 493 was looked upon by the pharmacy profession as the perfect storm. For years, pharmacists had been overlooked as healthcare providers who could play a significant role in improving health outcomes and reducing overall healthcare spending through their expertise in medication management. After the Affordable Care Act had passed, California’s Medi-Cal program grew to over 13 million beneficiaries, which is about a third of the state’s population. Physicians became overwhelmed and we saw that many were no longer accepting Medi-Cal patients. So the need for pharmacists to bridge this gap in care was not only imperative, but it just made sense.”
Once the bill was signed into law, the California Board of Pharmacy and the Medical Board of California were responsible for developing protocols for pharmacists to follow when providing the authorized services outlined in SB 493 and determining the appropriate training requirements.
The entire protocol and training requirements for pharmacists to furnish nicotine replacement products is available here and summarized as follows:
Purdue College of Pharmacy has a 2.5 hour, home study course that fulfills the training requirement needed before initiating smoking cessation treatment. The course - Behavioral Counseling & Pharmacotherapy - has been approved by the Board of Pharmacy and can be accessed by visiting Rxforchange: https://rxforchange.ucsf.edu/continuing_education.php
Participants who complete the online program and successfully pass the post-test will receive 2.5 hours of Continuing Pharmacy Education Credit.
In addition, pharmacists can utilize the latest fact sheet provided by the California Smokers Helpline on furnishing nicotine replacement therapy for smoking cessation.