Living Tobacco Free is a Partners Wellness Program designed to encourage, support, and equip tobacco users in their efforts to quit, and to link them to treatment providers and community, and create awareness across communities in their efforts to quit tobacco use. This is in alignment with the Department of Health and Human Services (NCDHHS) approach to tobacco reduction statewide. For more information, see the program overview at the bottom of this page.

Partners is offering training, events, and resources to help support providers in their implementation of the NC Tobacco-Free Policy requirement that goes into effect for NC Standard and Tailored Plan providers on July 1, 2024 (click link below to review requirement).

https://medicaid.ncdhhs.gov/blog/2024/03/21/tobacco-related-policy-requirements-go-effect-july-1-2024

Visit this page often to stay updated on all things Tobacco-Free at Partners!

Important Resources and Links

Change for Life: Tobacco-Free Recovery: McLeod Center

CDC: Tips From Former Smokers - Rebecca M.: Vicious Cycle

Provider Trainings for Tobacco Use Treatment and Tobacco-Free Policies

Below is a list of trainings. There are recorded trainings that you are free to use on demand, upcoming FREE live trainings, and nationally accredited tobacco use treatment specialist trainings and scholarships. As always, your regional tobacco control staff are also available to provide or set up trainings for provider agencies.

Recorded Trainings:

Providing a Tobacco Free Culture of Care (3 hrs)
https://drive.google.com/file/d/1-xd6LMLk_H-9xBfdSbrmDTVFx6tKbHMT/view?usp=sharing

Taking Psychosocial Rehabilitation Services Tobacco-Free: A Success Story from Maryland (1 hr)  https://drive.google.com/file/d/1jx0fxP1vmxhDEk4_StT3ET3TDCBZz4w5/view?usp=sharing

Partners Living Tobacco Free Provider Kickoff Event recorded Tuesday 10/18/22  (2 hrs)
https://youtu.be/gbKm61Xd_Bo?t=55

Includes great lineup of speakers and topics designed to help providers prepare to implement State guidelines around tobacco free campuses and incorporate evidence-based tobacco cessation treatment by April 1, 2023. Many providers may know Joyce Swetlick at DHHS, Stephanie Gans, Carlene Crawford, and others on the Tobacco Prevention and Control team. Watch their presentations on the topics listed below and learn about Partners Living Tobacco Free Wellness Program.

  • Overview- Partners Living Tobacco Free Wellness Initiative- Supporting providers through the process
  • The Why/Buy In
  • Roadmap for providers
  • 1-2 provider testimonials
  • The Quitline experience
  • Incorporating Evidence-Based Treatment into your program (Screening, Brief interventions, Billing)
  • Changes in the environment (signs, conversion of smoking areas to wellness, …)
  • Wrap-up and Q&A

Other Training Opportunities:

BreatheEasyNC has several upcoming trainings, click the link below:
https://breatheeasync.org/tobacco-use-treatment-integration-training/#Training_Staff

Media Kit Materials

Brochures, handouts, graphics, etc. for providers to use in practice.

Partners Health Management Living Tobacco Free Wellness Program Overview

Living Tobacco Free is a Partners Health Management prevention and population health program designed to prevent, reduce and stop tobacco use in all forms. This plan aims to address member and recipient tobacco-related health concerns through education, support, treatment, resources and access to QuitlineNC. Living Tobacco Free is a program that can support tobacco users, treating providers and communities in their efforts to quit.

Living Tobacco Free will target members and recipients who use tobacco across our service area. Partners recognizes that tobacco use contributes to chronic conditions. For that reason, we have chosen Living Tobacco Free as one of our initiatives to improve health. Tobacco use causes disease and illness in nearly every organ in the body. Despite significant progress, tobacco use remains the leading preventable cause of death and disease in the United States and North Carolina. Tobacco cessation can save lives and improve overall health.

The goals of Living Tobacco Free include:

  • Wellness and PreventionReduction of tobacco in all forms, including cigarettes, chewing tobacco and vaping pens with specific targets for members/recipients with behavioral health (BH), intellectual and/or developmental disabilities (I/DD) and traumatic brain injury (TBI).
  • Wellness and Recovery ManagementManage and reduce risk of members’ tobacco-related health conditions through the use and completion of the QuitlineNC program.
  • Safety Across SettingsPromote tobacco free campuses at contracted facilities, in alignment with the Department of Health and Human Services (NCDHHS) approach to tobacco reduction.
  • Manage multiple chronic conditions – Increase the percentage of members who receive medical assistance with smoking and tobacco use cessation (National Committee for Quality Assurance [NCQA] Healthcare Effectiveness Data and Information Set [HEDIS] measure) using three components:
    • Advising smokers and tobacco users to quit
    • Discussing cessation medications
    • Discussing cessation strategies

Tobacco-Related Policy Requirements go into Effect on July 1, 2024

Tobacco-related policy requirements will be effective July 1, 2024, for NC Medicaid Managed Care Standard Plans, Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plans, and Local Management Entity/Managed Care Organizations (LME/MCOs) contracted medical, behavioral health, I/DD and traumatic brain injury (TBI) service providers. These requirements apply to both Medicaid and State-funded service providers. The Department will work with health plans and LME/MCOs to include these requirements, as appropriate, in advance of July 1, 2024.

Secondhand smoke is a well-documented danger to health. No one should be exposed to secondhand smoke when they access care or on the job. Research shows that most people who use tobacco want to quit. An environment free from triggers, as well as access to evidence-based treatment, is necessary to support service recipients whose goal is to become tobacco free. Among people who try to become tobacco free, only a small minority receive such assistance. Additionally, people with behavioral health disorders die disproportionately from tobacco-related illness.

Starting July 1, 2024, Standard Plans, Tailored Plans and LME/MCOs will require contracted providers, with exceptions noted below, to implement a tobacco-free policy covering any portion of the property on which the provider operates that is under its control as owner or lessee, including buildings, grounds and vehicles.

A tobacco-free policy includes prohibition on smoking combustible tobacco products and use of non-combustible tobacco products, such as electronic, heated and smokeless tobacco products and nicotine products not approved by the U.S. Food and Drug Administration (FDA) as tobacco use treatment medications. A tobacco-free policy also includes prohibition on contracted providers purchasing, accepting as donations or distributing tobacco products to individuals they serve.

This tobacco-free policy requirement does not apply to:

  • retail pharmacies
  • properties where no direct clinical services are provided
  • non-emergency medical transport
  • alternative family living settings
  • manufacturing sites that employ people who receive adult developmental vocational program services
  • manufacturing sites that employ adults who receive other group day services.

Partial Requirement for these settings:
Starting July 1, 2024, the following partial tobacco-free policy shall be required in Intermediate care facilities for adults with intellectual disabilities (ICF-IID) and adult I/DD residential services subject to the Home and Community Based Final Rule and in adult care homes, family care homes, residential hospices, skilled nursing facilities and long-term nursing facilities:

Use of tobacco products is prohibited indoors when the building or home in which the provider operates is under the provider’s control as owner or lessee.
Outdoor areas of the property under the provider’s control as owner or lessee must:

  1. Ensure access to common outdoor space(s) free from exposure to tobacco use; and
  2. Prohibit staff/employees from using tobacco products anywhere on the property.

Providers subject to the above-referenced partial tobacco-free policy requirement retain the option to implement a 100% tobacco-free campus policy for the safety of clients and staff.

Provider Monitoring
Starting July 1, 2024, provider monitoring for the tobacco-free policy requirement will occur through a grievance/complaint process. Technical assistance by the NC Division of Public Health’s (DPH) Tobacco Prevention and Control Branch will be used to address grievances/complaints related to exposure to tobacco use on contracted provider property subject to the tobacco-free policy requirement.

The purpose of the policy requirement and grievance/complaint process is both to protect people from secondhand smoke/aerosol and to facilitate evidence-based tobacco use treatment in any setting a beneficiary seeks it. In maintaining adherence to a tobacco-free policy, providers should take a trauma-informed, non-punitive approach toward addressing tobacco-use on campus.

The response to non-adherence to the policy by clients is compassion and collaboration to find ways that work for the client to adhere to the policy on campus, including assessing a client’s need for tobacco use treatment and ensuring the client is provided necessary treatment services and supports. It is the responsibility of providers to offer clients the tools they need to be successful in avoiding using tobacco on campus.

Mirroring this collaborative approach, the grievance/complaint process used by NCDHHS and its health plan vendors, including LME/MCOs, for provider monitoring is an opportunity for technical assistance regarding both maintaining a tobacco-free campus and ensuring that clients continue to access necessary healthcare services while receiving the evidence-based tobacco use treatment interventions necessary to be successful in adhering to a policy.

Supporting Policy Change
To support this policy change, the DPH Tobacco Prevention and Control Branch partners with the Division of Mental Health/Developmental Disabilities/ Substance Abuse Services and the Division of Health Benefits to coordinate Breathe Easy NC: Becoming Tobacco Free.

Breathe Easy NC: Becoming Tobacco Free is a statewide initiative to support people with behavioral health conditions and IDD/TBI in becoming tobacco free, by working with service providers to integrate tobacco use treatment and make campuses tobacco free.

Standard Plan, Tailored Plan and LME/MCO contracted service providers should make use of this resource to ensure they have a transparent, well-organized and evidence-based tobacco-free policy and tobacco use treatment implementation process.

Making an organization’s campus tobacco-free is a process that should involve all organization stakeholders: service recipients or clients, leadership and staff. Implementing a tobacco-free policy can take three to six months, occasionally longer.

Providers should integrate tobacco use treatment or referrals to tobacco use treatment resources, such as QuitlineNC, prior to policy implementation.

Providers can visit BreatheEasyNC.org for technical assistance and training on tobacco-free policy implementation and evidence-based tobacco use treatment or contact their county’s regional or local tobacco control staff directly. They can assist with every step of this process.

If you have any questions, check out these Frequently Asked Questions (FAQ) webpages from Breathe Easy NC:

For more information, contact Joyce Swetlick at Joyce.Swetlick@dhhs.nc.gov.

Updated: April 29, 2024