August 2010: Changes to the Clinical Tobacco Intervention (CTI) Program

Please note that the CTI program has been scaled back due to government funding cuts. Information about specific dental or pharmacy related programs should be addressed to the Ontario Dental Association (416-922-3900 or info@oda.ca) or the Ontario Pharmacists Association (416-441-0788 or mail@opatoday.com). Please note that OMA-related links are valid and physicians can still order CTI materials online.

What is Clinical Tobacco Intervention (CTI)?

The CTI Program was designed as a cooperative effort between the Ontario Medical Association (OMA), the Ontario Pharmacists’ Association (OPA) and the Ontario Dental Association (ODA). CTI provided a systematic approach to help medical, dental, and pharmacy professionals assist their patients to stop using tobacco products. Although support is still being offered to members of the partner organizations, the CTI partnership itself is on hold and workshops are no longer being offered. Online learning may still be offered by your respective association.

The CTI method and process is still valid and provides an evidence-based approach to enhance the tobacco cessation interventions of health care practitioners, namely physicians, dentists, pharmacists, and their support staff, through the dissemination of education kits and continuing education programs.

Each association continues to work to increase the awareness, role, and quality of CTI program delivery to their members.

How does CTI work?

Through education and promotion, CTI provides health care practitioners with tools to identify tobacco users and assist patients in their attempts to quit.

What are the principles of CTI?

ASK - patients about smoking status.
ADVISE - patients about the health risks of tobacco use and the benefits of quitting.
ASSESS - patients’ readiness to quit.
ASSIST - patients that are ready to quit.
ARRANGE - follow up.

These principles can be applied through comprehensive intervention or minimal contact intervention, which is a brief two-to-three minute intervention also applying the above principles of CTI to a patient who smokes.

Why is CTI important?

In Canada, approximately 37,000 deaths per year are attributable to smoking. Smoking remains the number one preventable cause of death and disease in Canada. It is estimated that smoking prematurely kills three times more Canadians than car accidents, suicides, drug abuse, murder and AIDS combined. In 1991, smoking-related deaths accounted for about 62% of the overall increase in deaths from 1989.

In 1991, smoking accounted for an estimated $2.5 billion in health care costs, $1.5 billion for residential care costs, $2 billion from workers’ absenteeism and $10.5 billion in lost future earnings, totaling $16.5 billion. Research indicates that health care professionals can play a significant role in patients’ smoking cessation efforts and that patients themselves are receptive to such advice and assistance.

History of CTI

The Clinical Tobacco Intervention Program began in 1996 at the Ontario Medical Association (OMA), in collaboration with the Canadian Medical Association and two other provincial medical associations.

In 1999, the OMA joined with the OPA and ODA and submitted the proposal “Mobilizing Ontario Health Care Professionals for Clinical Tobacco Intervention” that received funding from the Government of Ontario.



Funding for this program has been provided, in part, by the Government of Ontario.