Although most tobacco users would like to quit, the majority do not receive professional assistance, and fewer than 5% who try to quit on their own are successful. The most effective approach for quitting combines pharmacotherapy with counseling, yet few clinicians routinely address tobacco use in practice. In recent years, only minor advancements have been made toward increasing the proportion of patients who receive professional assistance or use FDA-approved cessation medications, and novel approaches are needed to disrupt the status quo. One largely untapped yet highly accessible population of providers is pharmacists. In 2004, New Mexico implemented the first protocol granting pharmacists authority to prescribe smoking cessation medications, and eight additional states recently have signed similar legislation into law (with another 14 states in the process). While the passage of legislation is an essential first step, the second step – preparing the profession to act on these new prescriptive authorities – is equally important. The primary objective of this R25 application is to provide assistance to states attempting to advance pharmacy’s role in tobacco cessation. Through partnerships with key organizations, we will develop and disseminate training programs for all members of the pharmacy profession: pharmacists, pharmacy technicians, and pharmacist preceptors who host experiential training sites for pharmacy students. Program development and dissemination will be grounded in theory, building upon strong methodology established in our team’s prior work. More broadly, we will build bridges between the pharmacy profession, State Departments of Health, and tobacco quitlines, thereby providing patients with increased access to evidence-based methods for quitting. The specific aims of this R25 application are to: AIM 1. Develop a suite of live and enduring web-based tobacco cessation training programs for (a) pharmacy personnel, including pharmacists and technicians, and (b) pharmacist preceptors who host experiential training sites for pharmacy students. AIM 2. In a pilot Phase I (Years 01/02), conduct a series of 5 live training programs for Indiana pharmacists and launch web-based trainings for Indiana pharmacists and technicians. AIM 3. Revise materials, as appropriate, based on feedback from Phase I participants prior to a full-launch Phase II (Years 02–05), providing live and web-based trainings in states where pharmacists can prescribe smoking cessation medications. Overall, an estimated 5,680 pharmacists and 1,000 technicians will be trained. AIM 4. Apply a mixed methods evaluation approach to estimate the reach and impact of the training programs. This proposed educational initiative is both timely and needed—importantly, it capitalizes on heightened awareness due to recent legislative advances, and it builds upon our team’s decades of experience in training pharmacists, technicians, and students to assist their patients with the cessation of tobacco use.

NARRATIVE In recent years, numerous states have passed legislation granting pharmacists the authority to prescribe smoking cessation medications. While the passage of legislation is an essential first step, the second step – elevating the tobacco cessation counseling skills of pharmacists – is equally important. This project aims to partner with key organizations to develop and implement trainings for all members of the pharmacy profession: pharmacists, pharmacy technicians, and preceptors of pharmacy students (i.e., the nation’s future pharmacists), thereby enhancing the impact of this legislation in meeting its intended patient care outcomes.