SHIP stories
The Statewide Health Improvement Program
(SHIP) works to improve health through better
nutrition, increased physical activity and
decreased commercial tobacco use and exposure.
SHIP succeeds by supporting individuals seeking
to make healthy choices. Across the state, health
care is a key area in which SHIP works to
improve health.
Tobacco to be respected, not
abused at Leech Lake
Given the high rate of tobacco use among American
Indians, making improvements in how clinics work
with their patients who smoke could have a profound
effect on the health and wellbeing of generations of
tribal people. Many people want to quit and want to
be better role models for their children. Tobacco in
native culture is a sacred medicine, and they want their
children to understand and respect that teaching.
The White Earth Community has successfully
implemented a referral system for commercial tobacco
users. Leech Lake’s SHIP, in partnership with the Mayo
Clinic, Indian Health Services Clinic, and White Earth
Tobacco Coalition, held two trainings for clinic staff
from all departments (including nursing, pharmacy,
and optometry). Now clinicians ask the 5As at each
visit: Ask (identify and document tobacco use status
for every patient at every visit), Advise (urge every
tobacco user to quit), Assess (is the tobacco user willing
to make a quit attempt at this time?), Assist (for the
patient willing to make a quit attempt, use counseling
www.health.state.mn.us/divs/oshii
and pharmacotherapy to help him or her quit), and
Arrange (schedule follow up contact, in person or by
telephone, preferably within the first week after the
quit date). Patients are then referred to appropriate
cessation services. Follow up phone calls are done by
the SHIP coordinator and the tobacco coordinator.
The evaluation of this approach has been promising.
There has been a quit rate of 30 percent for
commercial tobacco users in one year. In comparison,
previous years’ data show a quit rate of 7 percent.
Those who were impacted have said they are happy
to have access to this valuable service as they believe
they would not have been able to quit without it.
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SHIP is working to make the healthy choice the easy
choice in Minnesota. Find out how at
www.health.state.mn.us/ship