spectrum community mental health smoking cessation: just do it!! sally sales ma, program...
TRANSCRIPT
Spectrum Community Mental HealthSmoking Cessation: Just Do It!!
• Sally Sales MA, Program Coordinator, Northwest Community Support Program
• Beth Kuettner LPCC, Clinical Supervisor, Northwest Community Support Program
The Stories We Hear
With a growing emphasis of health and wellness at the Community Support Programs, many members who are smokers were sharing their concerns about being able to quit smoking.
“A lot of people our age grew up smoking.”
“I smoke more at home – I hibernate.”
“If you have anxiety you can’t go to groups.”
“My mental health care worker suggested I delay
quitting smoking.”
Community Based Participatory Research
University of Minnesota Program in Health Disparities
Research (PHDR)http://www.med.umn.edu/ccr/
hdresearch/
PHDR addresses health inequities among minority and other under-served populations by fostering multidisciplinary research in collaboration with
community members and academic partners
Engaging Consumers
Hiring a Community Program Assistant A Certified Peer Support Specialist was hired to
conduct interviews and focus groups.
Convening a Community Advisory Committee Comprised of consumers who are former or
current smokers
Interviews and focus groups with CSP members, both current and former smokers
What We Asked
Why do you smoke? Where do you smoke? Triggers? Utilities? Social Pressure?
Relationship of smoking and your MH?Your supports for quitting?
Imagine a stop smoking program that would work for you……
What We Learned
CSP members have a high level of general knowledge and awareness about
smoking.
Awareness of Triggers and Utilities.
Awareness of Negative Physical Consequences of Smoking.
The Power of Addiction.
What We Learned
Awareness of Triggers: social setting & stress.
“When…your friend or whoever you hang out with is a smoker, the urge to want to smoke is going to be really high because they’re smoking.”
“In instances where I feel I don’t have any control or power about what’s going on around me; If I’m upset about something I can’t change, then I’ll crave a cigarette.”
“The reason I started [again] was having the stress of getting divorced and…getting my own place and being on my own.”
What We Learned
Awareness of Utilities: pleasure, relaxation and distraction from pain.
“I wasn’t smoking…because other people smoked. I was smoking because I liked it. I just loved to do it.”
“Tastes good, feels good.”
“There is a relaxation from inhaling cigarette smoke.”
“I go through a lot of pain during the day; that’s part of the reason I smoke so much.”
What We Learned
Awareness of Negative Physical Consequences
“I think back on how much better I used to feel. I slept better…food tasted better, I could smell better.”
“Sometimes I’ll smoke so much you can feel it the next day, like your lungs hurt.”
“I noticed when I did stop smoking when I was pregnant, I could breathe a lot easier.”
What We Learned
The Power of Addiction
“The nicotine thing…it’s cunning and baffling.”
“My fear is the physical withdrawal. I shake. I get hot and cold sweats. I’m very moody.”
“You don’t mean to go back to it. I’ll just have one cigarette…and it just leads right back up.”
What We Learned
CSP members want to quit… but show a lack of confidence.
“The fear part and confidence is what really…Can I go through life with all the urges and make it?”
“It’s almost like a leap of faith to leave it all behind.”
“Some people’s medications make it harder for them to quit than others.”
“I’m too worried about getting more depressed, and that’s a real fear of mine because of some of my symptoms.”
What We Learned
CSP members want to have choice:a VARIETY of available treatments
• No single program or approach was supported
• People wanted a flexible menu of choices
“What may work for you may not work for me. What works for me may not work for you.”
What we learned
Interest in Nicotine Replacement
Therapies (NRT)
“The CSP should see if…administration could possibly get [NRT] free to offer to CSP clients
to quit smoking”
What We Learned
Although there was a positive attitude about Nicotine Replacement Therapy [NRT] by
many, a few individuals experienced negative side effects.
“I tried [NRT] and got nasty. I wanted to, for no reason at all, haul off and punch someone. It scared
me. It was like, I better smoke.”
“[NRT] worked for about a month or so, but then you get suicidal thoughts and you’re pretty much up a
creek.”
What we learned
Interest in Coaching, Counseling and/or Support Groups
• Support from peer counselors and/or former smokers…“someone who’s quit”.
“I think having a peer, like a sponsor, might be helpful, too.”
What we learned
Interest in Alternative Therapies• Massage
• Acupuncture• Hypnosis
• Mindfulness & Stress Management
“If you can get people to sit back and relax and be quiet long enough to…take a look inside
themselves, cleansing themselves, and try to do that.”
What we learned
Importance of Individual Effort“Even though I did it on my own, I had a program. I made a decision to have one
cigarette an hour and then quit that way.”Importance of adopting positive
alternative behaviors“If you have something to do that consumes
your energy and you mind you can get through several hours and thinking I don’t have to have
a cigarette now.”
How is it going so far?
April 2013 at Northwest CSP
“Learning About Healthy Living: Tobacco & You”
Jill Williams MDDouglas Ziedonis MD MPH; Nancy Speelman CSW, CADC, CMS; Betty Vreeland MSN, APRN, NPC, BC; Michelle R Zechner LSW, Raquel Rahim APRN, Erin
L O’Hea, PhD
How is it going so far?
• Weekly group meeting at CSP
• Facilitated by team of 3 staff: LPCC, LPCC working toward LADC, RN (2 are former smokers)
• Early on decided to make it an open “drop-in” group
• Initial “Consumer Self-Report Tobacco Assessment”
• Weekly CO levels & self-report of cigarettes smoked per day
How is it going so far?
What the class has looked like…• 17 participants total
• Average of 4-6 at each group
• Education + open discussion
• Peer support
How is it going so far?
Early Observations About What’s Worked
• Education
• Accountability
• Peer Support
• Ideas/Motivation/Confidence
