Tools for Providers

QuitWorks-RI provides tools to prompt staff to ask every patient about tobacco use. All tools are for use by any provider in any clinical setting.

Patient Enrollment Forms

QuitWorks-RI provides customized enrollment forms to hospitals and health centers. Read more...
QuitWorks-RI Vital Sign Stamp and Stickers

Vital Sign Stamp & Stickers

The QuitWorks-RI can provide a self-inking vital sign stamp and a roll of vital signs stickers as a way to identify tobacco users.

Download the order form: (PDF, 43 KB)

Tobacco Use Questionnaire

This simple questionnaire provides needed information on tobacco use and on whether the patient is thinking about quitting. It is administered when the patient checks in.

Download the Tobacco Use Questionaire (PDF, 26 KB)

Pharmacotherapy Dosing Guide

This guide walks you through the easy steps to identify which of your patients should use pharmacotherapy, what types are appropriate and the medical contraindications.

Download: Pharmacotherapy Dosing Guide (PDF, 81 KB)

Pocket Guide

This is a quick guide to pharmacotherapy in tobacco treatment. It also lists the 5As to tobacco intervention.

Download the Pocket Guide (PDF, 58 KB)
QuitWorks Poster

QuitWorks Poster

This poster reads: "TWO DAYS: That's all it takes for your taste buds to get better, once you quit smoking. You know quitting is better for you. Now there's a better way to do it: QuitWorks. Ask your doctor today how the program can work for you or call 1-800-TRY-TO-STOP."

Download the order form: (PDF, 43 KB)
QuitWorks Button

QuitWorks Button

"Ask me about QuitWorks if you want to quit smoking" buttons can be worn anywhere to help prompt your patients to inquire about QuitWorks.

Download the order form: (PDF, 43 KB)


NOTE: Adobe Acrobat Reader is required to view or print these documents. It can be downloaded for free from www.adobe.com.