The Nicotine Thing: What Consumers Want You

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Spectrum Community Mental Health

Smoking 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 MD

Douglas 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

Contact Information

• Sally Sales ssales@resource-mn.org

(612) 752-8302

 Beth Kuettner bkuettner@resource-mn.org

(612) 752-8320

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