Tara Fredericks, LMSW

Clubhouse of Suffolk: A Model Intervention Clubhouse of Suffolk: A Model Intervention for for

Tobacco Dependence in Tobacco Dependence in Individuals with Serious Mental IllnessIndividuals with Serious Mental Illness

Tara Fredericks, LMSWTara 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.

ReadinessHave

Motivation

Leadership

Awareness

Need

Knowledge

Support

Direction

Clubhouse of Suffolk, Inc. Tobacco Model

IntegrationIntegration

““that’s where we already go…”that’s where we already go…”

Relationships

Access

Language

Expertise

Culture

ServicesServices

• Tobacco Awareness: “Why I Smoke”Tobacco Awareness: “Why I Smoke”

• Individual Readiness Development and Personal Individual Readiness Development and Personal Quit PlanningQuit Planning

• Cessation and Relapse Prevention GroupsCessation and Relapse Prevention Groups

• Peer Support GroupsPeer Support Groups

Tobacco AwarenessTobacco Awareness

Community ChangesCommunity Changes

• Staff Development and TrainingStaff Development and Training

• Policy: Phase 1Policy: Phase 1

• Marketing/AwarenessMarketing/Awareness

• ““Talking About Tobacco”Talking About Tobacco”

OutcomesOutcomes

• Other Members QuitOther Members Quit

• Support and OutreachSupport and Outreach

• ReplicationReplication

Results

The program was successfullyimplemented in Clubhouse of Suffolk with

over 60 members participating in theTobacco Awareness groups,

approximately 20 more attending the peergroups and numerous members taking

advantage of individual treatment planningto 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.

-30

-20

-10

0

10

20

NRT Use No NRT Use

Ch

ang

e in

Nu

mb

er

of

Cig

aret

tes

Sm

oke

d

-30

-20

-10

0

10

20

0 5 10 15 20 25

Males Females

Number of Sessions Attended

Ch

ang

in

Cig

aret

tes

Sm

oke

d

Per

Day

26%

62%

10%

2%

Quit Attempt with NRT Use Quit Attempt with no NRT UseNRT use with no Quit Attempt No Quit Attempt and no NRT Use

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 veryimportant 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 beable to quit regardless of support and servicesprovided.

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 ifthey 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