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Nori de la Peña Michael Leon-Guerrero Public Health - Seattle & King County Tobacco Prevention Program (206) 296-7613 Brief Tobacco Intervention Skills (BTIS) training Summer 2010 DESC training [email_address] Framing the issue, understanding the addiction and implementing an effective intervention program HealthPoint  August 10 th , 2010
 
 
 
 
 
 
 
 
 
Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Smoking Statistics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Doctors advise adolescents about tobacco <2% of visits Medical Bias in Considering Tobacco a &quot;Drug of Abuse&quot;
Tobacco smoke: ,[object Object],[object Object],[object Object],[object Object],[object Object]
A Toxic Waste Dump ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.tobacco.org
An Unfair Share of Mortality Number of Deaths (thousands) Source: CDC AIDS  Alcohol  Motor  Homicide  Drug  Suicide  Smoking Vehicle  Induced Est. 200,000 per year for mentally ill and SA
The Double Whammy! ,[object Object],[object Object],[object Object]
 
SUCCESS = ,[object Object],[object Object],[object Object]
 
 
Mental Health and Nicotine 44% of all cigarettes bought & consumed in the US are by individuals living with mental illness.
MI and Nicotine ,[object Object],[object Object],[object Object]
Unfair  Share  of the Burden ,[object Object]
Be Aware That: ,[object Object],[object Object],[object Object],[object Object]
Alternative tobacco
 
 
Your Role ,[object Object],[object Object]
WHY don’t they just QUIT?
Why Don’t They Just Quit? + No Cessation Help
 
 
 
 
 
 
The intervention: 2A’s & R Site Champ
ASK ,[object Object]
ADVISE ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],REFER
Washington State Quitline – OVER 18 ,[object Object],[object Object],[object Object]
Medicaid eligible: ,[object Object],[object Object],[object Object],[object Object]
Is the Quitline a Good Fit? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“ Ask” Identify Tobacco Use /exposure to smoke  Document chart “ Advise” To Quit “ Assess” willingness to quit “ Assist” with quitting “ Arrange” Follow-up Quitline 1-800-QUITNOW 1-877-2NO FUME Local Resources DESC champ (Provided by Sophie Balk, MD,  Albert Einstein College of Medicine) Referrals The 5 A’s
ASSESS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
ASSIST ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ARRANGE ,[object Object],[object Object],[object Object],[object Object]
Benefits of Quitting 10 Years Risk of HD/Stroke almost the same as a non-smoker 5 Years Lung Cancer Death Rate Decreases by 50% 2Weeks-3 Months Circulation Lung Function 48 Hours Taste/Smell Nerve Endings 8 Hours 02 Levels 20 Minutes BP   Body Temp  
The 5R’s: Not Ready to Quit REPITITION – Repeat motivational intervention ROADBLOCKS – client identifies barriers REWARDS – client identifies benefits of quitting RISKS – client identifies risks of smoking RELEVANCE – Specific and personal reasons The 5 R’s
Motivational Interviewing Is ,[object Object],[object Object],[object Object],[object Object],[object Object]
Motivation Enhancing Skills OARS - toolkit for SUCCESS! ,[object Object],[object Object],[object Object],[object Object]
Nicotine Replacement Therapy in biologically addicted adults ,[object Object],[object Object],[object Object],[object Object]
What NRT Does  Not  Do ,[object Object],[object Object],[object Object],[object Object]
Patch Counseling ,[object Object],[object Object],[object Object],[object Object]
Patch Side Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Smoking and NRT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Quitting the Three Link Chain NRT?? Behavioral Counseling Posters Groups Activities + Cessation Help @ DESC
[object Object],[object Object],[object Object]
Relapse Is Common ,[object Object],[object Object],[object Object],[object Object],[object Object]
Policies ,[object Object],[object Object],[object Object]
 
Public Health Contact ,[object Object],[object Object],[object Object],[object Object]
Selected References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Health pointfw 081010

  • 1. Nori de la Peña Michael Leon-Guerrero Public Health - Seattle & King County Tobacco Prevention Program (206) 296-7613 Brief Tobacco Intervention Skills (BTIS) training Summer 2010 DESC training [email_address] Framing the issue, understanding the addiction and implementing an effective intervention program HealthPoint August 10 th , 2010
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  • 13. Doctors advise adolescents about tobacco <2% of visits Medical Bias in Considering Tobacco a &quot;Drug of Abuse&quot;
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  • 16. An Unfair Share of Mortality Number of Deaths (thousands) Source: CDC AIDS Alcohol Motor Homicide Drug Suicide Smoking Vehicle Induced Est. 200,000 per year for mentally ill and SA
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  • 22. Mental Health and Nicotine 44% of all cigarettes bought & consumed in the US are by individuals living with mental illness.
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  • 30. WHY don’t they just QUIT?
  • 31. Why Don’t They Just Quit? + No Cessation Help
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  • 38. The intervention: 2A’s & R Site Champ
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  • 45. “ Ask” Identify Tobacco Use /exposure to smoke Document chart “ Advise” To Quit “ Assess” willingness to quit “ Assist” with quitting “ Arrange” Follow-up Quitline 1-800-QUITNOW 1-877-2NO FUME Local Resources DESC champ (Provided by Sophie Balk, MD, Albert Einstein College of Medicine) Referrals The 5 A’s
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  • 50. Benefits of Quitting 10 Years Risk of HD/Stroke almost the same as a non-smoker 5 Years Lung Cancer Death Rate Decreases by 50% 2Weeks-3 Months Circulation Lung Function 48 Hours Taste/Smell Nerve Endings 8 Hours 02 Levels 20 Minutes BP  Body Temp 
  • 51. The 5R’s: Not Ready to Quit REPITITION – Repeat motivational intervention ROADBLOCKS – client identifies barriers REWARDS – client identifies benefits of quitting RISKS – client identifies risks of smoking RELEVANCE – Specific and personal reasons The 5 R’s
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  • 59. Quitting the Three Link Chain NRT?? Behavioral Counseling Posters Groups Activities + Cessation Help @ DESC
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Editor's Notes

  1. Message – smoking is a larger issue for homeless population than for average population
  2. What causes people to contract a tobacco-related disease? Chemicals and additives in tobacco cause much of the problems. Write down four chemicals you think are in tobacco. In reality there are about 4000 chemicals in tobacco. 250 are toxic. Over 60 are cancer-causing. (cdc.org Surgeon General’s 2006 Report)
  3. Cite more specifically
  4. Insert video link
  5. Circles not equal size for all people
  6. Advising will not harm relationship with client, studies show satisfaction improves in other treatment settings the more a staff counsels on quitting
  7. Not a yes/no question
  8. Do not need to be done in order