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
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