Handouts

The following handouts and templates can be used to help LTC Home staff, residents, and their families and friends make the transition to a smoke-free environment. 

These handouts can be printed and distributed as needed, and some can be modified and tailored to your LTC Home’s particular circumstances.
 
Staff and Physician Handouts
• Fire Risk & Safe Smoking (available in Word and PDF)
• Second-Hand Smoke (available in Word and PDF)
• NRT Summary Sheet
• Signs/Symptoms of Nicotine Withdrawal or Overdose
• NRT Decision Tree
• Tips for Communication (available in Word and PDF)
• Safe Smoking Assessment Form (available in Word and PDF)
• Resident and Client Smoking Agreement
• SFO Act & LTC Homes Newsletter (available in Word and PDF)

Resident, Family, and Friends Handouts 
• Fire Risk & Safe Smoking (available in Word and PDF)
• NRT Info sheet (available in Word and PDF)
• Why Quit Smoking? (available in Word and PDF
• Second-Hand Smoke (available in Word and PDF
• Tips for Helping Your Friend Quit Smoking

Posters – “Welcome to our Smoke-Free Home”
• Poster for homes with smoking allowed on property (available in Word and PDF)
• Poster for homes with non-smoking property (available in Word and PDF)

Letter
• To Management (implementing the new smoke-free policy in the LTC Home)
• To Unit Managers (closure of designated smoking rooms)
• To Resident's Family (safe smoking assessment results)
• To LTC Home Stakehlders (the new smoke-free policy in the LTC Home for facilities without a CSA)
• To LTC Home Stakeholders (the new smoke-free policy in the LTC Home for facilities with a CSA)

Please note: You will need Adobe Acrobat Reader to read some of these files. For a free copy of Adobe Acrobat Reader, click here.