Ask, Assist & Refer: WIC Nutritionists Help Participants Quit Tobacco

Dates: 2012

State: New Hampshire

Client(s): NH Comprehensive Cancer Collaboration

Service: Training & Technical Assistance

Technical Expertise: Substance Use


In 2010, 25% of New Hampshire Women Infant Children (WIC) participants continued to smoke during their pregnancy compared to 14% nationally, yet studies show that a brief intervention (Ask, Assist and Refer) by healthcare providers can increase tobacco cessation.

JSI/New Hampshire received a grant from the New Hampshire Comprehensive Cancer Collaboration to help reduce smoking among participants in the WIC program at Southern New Hampshire Services (SNHS) and Rockingham Community Action (RCA) in accordance with the U.S. Public Health Services’ Clinical Practice Guideline on Treating Tobacco Use and Dependence by training WIC nutritionists to provide a brief intervention to their smoking WIC participants. Using this intervention in a WIC agency setting is ideal as the staff have frequent face-to-face interaction with their participants.

JSI/NH conducted two training workshops to increase the capacity of the WIC Nutritionist to effectively intervene with their clients who use tobacco products by providing office-based systems change and training of the 2 As and R intervention, a modified version of the 5 As model from the PHS Guidelines. For a successful implementation, JSI-NH worked with the Lead Nutritionist to tailor a systems change approach that identified processes, forms, policies by using the Plan-Do-Study-Act model to best meet the needs of SNHS/RCA.