Transcript Slide 1

Clubhouse of Suffolk: A Model Intervention
for
Tobacco Dependence in
Individuals with Serious Mental Illness
Tara Fredericks, LMSW
Objectives
•Discuss programmatic and non-programmatic strategies
for addressing tobacco use in mental health settings
•Recognize consumers’ desire and ability to reduce or
cease cigarette consumption.
•Identify resources to support effective tobacco
dependence treatment
Disclosure Statement
I have no real or perceived vested interests that relate
to this presentation nor do I have any relationships
with pharmaceutical companies, and/or other
corporations whose products or services are related to
pertinent therapeutic areas.
A Model Intervention
In 2003 Clubhouse of Suffolk, Inc. was
awarded a grant to develop
tobacco dependence intervention
strategies for individuals with mental illness.
Have
Readiness
Need
Motivation
Knowledge
Leadership
Support
Awareness
Direction
Clubhouse of Suffolk, Inc. Tobacco Model
Integration
“that’s where we already go…”
Relationships
Access
Language
Expertise
Culture
Services
• Tobacco Awareness: “Why I Smoke”
• Individual Readiness Development and Personal
Quit Planning
• Cessation and Relapse Prevention Groups
• Peer Support Groups
Tobacco Awareness
Community Changes
• Staff Development and Training
• Policy: Phase 1
• Marketing/Awareness
• “Talking About Tobacco”
Outcomes
• Other Members Quit
• Support and Outreach
• Replication
Results
The program was successfully
implemented in Clubhouse of Suffolk with
over 60 members participating in the
Tobacco Awareness groups,
approximately 20 more attending the peer
groups and numerous members taking
advantage of individual treatment planning
to help them quit.
Results
• Of the members who participated in the Tobacco
Awareness groups 36% made a serious quit
attempt and nearly 24% maintained their quit
time for at least 3 months.
• We also saw a significant decrease in the
number of cigarettes smoked per day among
those who made a quit attempt as well as those
who did not.
Change in Number of Cigarettes Smoked
20
10
0
-10
-20
-30
NRT Use
No NRT Use
Chang in Cigarettes Smoked Per Day
20
10
0
-10
-20
-30
0
5
10
Males
15
20
Females
Number of Sessions Attended
25
62%
2%
10%
Quit A t t emp t wit h N R T U se
N R T use wit h no Quit A t t emp t
26%
Quit A t t emp t wit h no N R T U se
N o Quit A t t emp t and no N R T U se
Program Replication (UIBH)
• A total of 111 consumers engaged in group services within 6
program sites.
• 56% made either a quit attempt or a reduction to quit.
• 39% of consumers engaged in group services made a quit attempt.
– 30% of consumers who made a quit attempt used tobacco treatment
medication(s)
• 17% of consumers engaged in group services reduced their
cigarettes per day consumption.
• 30% of consumers engaged in group services utilized tobacco
treatment medications.
• 43% of consumers attended more than one group, 13% attended 3
or more groups.
• 24% of consumers who attended more than one group who did not
make a quit attempt reported a positive change in level of readiness
to quit
Observations
Observations
There is a lack of awareness and knowledge
regarding tobacco dependence in this
population among professionals and
service providers.
Staff
< 10% have ever made a referral to NYS
Smokers’ Quitline.
56% believe that Nicotine causes cancer.
Observations
Time and effort must be spent addressing
attitudes and beliefs regarding tobacco
use within an agency for intervention
strategies to be completely successful.
Staff
98% believe that quitting smoking is extremely or very
important to an individual’s medical health,
only 88% believe it is as important to mental health.
53% believe that the consumers they serve will not be
able to quit regardless of support and services
provided.
Observations
There is a significant need for tobacco
dependence treatment to be available at
multiple levels within the mental health
treatment setting.
Staff
50% believe that more consumers would want to quit if
they had Information
67% believe more would want to quit if they had support.
The Healthy Body Healthy Mind Model
You Can Do This
Advertise
Take the materials that we discussed today or
order a poster from the NYS Smokers’ Quitline
(www.nysmokefree.com) and hang it in a
prominent place in your agency, where everyone
can see.
Talk
Before the end of each day have at least
one conversation with one consumer
about tobacco. You can talk about how
smoking impacts their health, housing,
finances, job or recovery.
Share
Use the information you learned here today,
or any of the resources that we’ve told you
about, and present them to the other staff in
your agency.
Example: Show the video
Smoke Alarm
at your next staff meeting.
(www.clubhouseofsuffolk.org)
Steps to Success
1. Evaluation of Agency (knowledge,
attitudes and stage of readiness for
change)
2. Staff Training
3. Consciousness raising activities
(wellness initiative)
4. Implementation of Services
5. Re-Evaluation and policy change