New Frontiers in Smoking Cessation to Support Wellness among People with Mental Health Problems
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Smoking cessation may be the most significant modifiable risk factor intervention to decrease mortality among people with mental health problems. People with mental health problems are among those with the highest smoking prevalence. In fact:
- Seventy-five percent of individuals with either mental health problems or addictions smoke cigarettes as compared to 23 percent of the general population. 1
- Americans with mental health problems represent an estimated 44.3 percent of the U.S. tobacco market. 2
- Half of all deaths from smoking occur among patients with mental illnesses or substance use disorders. 3
Smoking cessation is part of a decision to make more positive life choices. Individuals with mental health problems have a right to accurate information regarding tobacco use and options for cessation services and support.
There are a number of traditional smoking cessation models for persons with mental health problems that generally combine nicotine replacement therapy (NRT) or other medications with cognitive-behavioral therapy, which focuses on changing the way people think about aspects of their lives. Smoking cessation, however, also requires accurate information, support, self-discipline, motivation, and a determination to live a healthier lifestyle.
There are real and perceived barriers to providing smoking cessation options in mental health and substance abuse treatment settings. Many clinicians do not view tobacco cessation as a part of their scope of practice or feel that tobacco cessation could be detrimental to the treatment plan. Cessation interventions do add to the competing demands providers face, but providers typically already have the skills necessary to utilize low-burden strategies that can significantly assist patients to reduce and quit using.
Some barriers to quitting are particularly challenging for people with mental health problems and these will be discussed as part of the training teleconference. Barriers include:
- nicotine addiction
- socially reinforced habits
- expectation of failure
- lack of motivation
- lack of hope
- lack of support to quit
- fear of weight gain
- fear of side effects of withdrawal
- difficulty coping with the anticipated increase in tension and anxiety
- loss of pleasure
- loss of social reinforcements for smoking
This training teleconference will give participants the opportunity to hear from some of the people on the leading edge of tobacco cessation for people with mental health problems. Speakers will include representatives of the University of Colorado Denver (UCD) Department of Psychiatry; New York Department of Health and Mental Hygiene's Smoking Cessation Detailing Campaign; and CHOICES (Consumers Helping Others Improve their Condition by Ending Smoking), a consumer-driven peer outreach program.
Goal: Increase awareness of the latest and most effective tobacco cessation tools, initiatives, and services specifically designed for mental health consumers and those working in mental health settings.
This training will provide an overview of:
- the magnitude of tobacco use among persons with mental health problems and the related morbidity and mortality;
- the effectiveness of a variety of smoking cessation interventions designed to replace tobacco use with tools for living well, including a New York City effort targeting mental health providers and consumers; and
- a peer outreach tobacco cessation program that empowers people with mental health problems to make informed choices that enhance social inclusion, wellness, and mental health recovery.
- Consumers, survivors, current and past recipients of mental health services, peers, family members, and mental health organizations
- Mental health providers
- Primary care providers
Chad Morris, Ph.D., is an associate professor at the University of Colorado Denver Department of Psychiatry and director of the Behavioral Health & Wellness Program. He is pursuing research on community-based care models with an emphasis on integrated systems, as well as tobacco cessation and obesity interventions for persons with mental health problems and substance abuse disorders. He is the principal investigator of multiple studies and clinical trials exploring the effectiveness of psychosocial and pharmacologic tobacco cessation strategies for both youth and adults. Dr. Morris has been a consultant to the Colorado Division of Behavioral Health for more than 10 years, and manages the state's SAMHSA Projects for Assistance in Transition from Homelessness (PATH) and New Freedom Initiative (Olmstead) grants. He is the director of the UCD Administration and Evaluation Postdoctoral Fellowship, past-president of the Colorado Psychological Association, and a licensed psychologist.
Marlene M. Reil, Ph.D., C.A.S.A.C., has developed and implemented projects to address the mortality and morbidity disparities among people with mental health problems. Along with her colleagues in the New York Department of Health and Mental Hygiene, Office of Consumer Affairs, Dr. Reil recently created and implemented the "Mind Your Health" peer health-and-wellness coach training program. While in the Office of Health Integration, Dr. Reil contributed to the development of the Smoking Cessation Action Kit and Detailing Campaign, a public health campaign that provided smoking cessation tools and resources to more than 400 behavioral health provider agencies in New York City. She has presented at various conferences, mental health consumer events, grand rounds, and trainings on smoking cessation and co-occurring mental health and substance-use disorders. She is also a psychotherapist and addictions counselor at the Metropolitan Center for Mental Health in New York City.
Marie D. Verna supports a variety of programs at the University of Medicine and Dentistry of New Jersey Behavioral Research and Training Institute. She was diagnosed in 1983 with bipolar disorder and since 1997 has devoted her professional career to improving the lives of people with mental health problems through education and advocacy. She is a founder of CHOICES, a consumer-to-consumer tobacco cessation education program that received Mental Health America's Innovation and Creativity in Programming Award.
Previously, Marie was the Director of Advocacy at the Mental Health Association in New Jersey, and she has served on the Governor's Human Services Transition Advisory Group on Behavioral Health; Mental Health Task Force, Subcommittees on State Government and Treatment, Wellness, and Recovery; and many statewide coalitions. She is the recipient of the New Jersey Association of State Mental Health Agencies' Advocacy Award. Marie also served as the Director of the National Mental Health Consumers' Self-Help Clearinghouse, a technical assistance center for mental health consumers.