Dane County
Tobacco Integration Project
A joint venture sponsored by the Dane
County Chemical Dependency
Consortium and the Wisconsin Nicotine
Treatment Integration Project
Funded with a $10,000 WINTIP Grant
Wisconsin Nicotine Treatment
Integration Project = WiNTiP
 Saving lives by integrating evidence-based
nicotine dependence treatment in Wisconsin's
AODA and mental health services
 Buy-in + Training + Resources = Implementation
 Wisconsin's first coalition of tobacco, AODA,
mental health and the 2 government agencies
responsible for them
 In 2013 funding 9 projects for tobacco
integration innovation with $60,000 in grants
Why Are We Doing This?
General Public
Cold, Hard Facts
 From a third to half of smokers
and other tobacco users will die
from using tobacco products as
these products are intended
Cold, Hard Facts
Those admitted for AODA treatment have
the highest prevalence of nicotine
St Clare Center study – 86%
New York State addiction admissions –
Range – 78% to 92%
Cold, Hard Facts
 Those with substance use and mental
health disorders that are also nicotine
dependent are getting sick and dying
at from twice to more than 4 times the
rate in the general population
 They lose from 10 – 25 years Of life
Death By Tobacco
In Dane County
 357 Tobacco Death Every Year
 1,428 Innocent Family Victims Suffering grief
and lost income
 156 have AODA and Mental Health disorders
 624 Innocent Family Victims
There are 12 Substance Use
Disorders in the DSM-IVR
Eleven are eligible for the full
range of AODA services
One is not eligible
Nicotine Dependence – 305.1
This is by far our most lethal
addiction producing tobacco
caused and related diseases that
result in 440,000 American
tobacco deaths a year
Now for some good news
 30 + AODA treatment providers including drug
court, outpatient, residential, inpatient and other
 More than 200 weekly community support
 4 - 12-Step program club-houses
 Dane County Chemical Dependency Consortium
AODA Clinicians Can Do It
 Already trained to treat substance use disorders
 Know how to develop abstinence and harm
reduction treatment and recovery plans
 Understand medication management practices
 Skilled in motivational interviewing and cognitive,
behavioral and other therapies
 Experienced with 12-Step and other recovery
Dane County Tobacco
Integration Project
Created to begin the process of
integrating evidence-based
nicotine dependence treatment
in Dane County's 100% tobaccofree AODA treatment services
What Is a Tobacco-Free
AODA Program
A 100% tobacco-free
AODA treatment program
has two basic components
A tobacco-free facility and grounds are
100% tobacco free from all tobacco
products. No possession or use of tobacco
products is permitted. The tobacco-free
policy applies to all staff, patients/clients,
volunteers, visitors and guests and requires
a sign-off agreement to accept the
tobacco-free policy as a condition of
A tobacco-free program assesses and treats
nicotine dependence as a substance use
disorder of equal importance as alcohol
dependence and other substance use
disorders typically treated in Dane County
AODA services. Evidence-based nicotine
dependence treatment is included in
patient’s treatment and recovery plans. This
includes, assessment, referrals, education,
treatment and continuing recovery plans as
recorded in progress notes and records.
"We Support
DCTIP Ambassador Programs
Committed to Become
100% Tobacco Free Programs
 Connections Counseling
 Open Door for Change
 OceanHawk Counseling Alternatives
 ARC Community Services
 (VA Hospital-Addictive Disorder Program)
Connections Counseling
Together We Recover
5005 University Avenue, Suite 100, Madison, WI 53705
Phone: (608) 233-2100 Fax: (608) 233-2101
Connections Counseling…
Certified outpatient substance abuse and mental
health clinic successfully operating since 2003
Skilled and dedicated staff provide comprehensive
services for young people, families and adults, using
evidence-based practices
Our belief of “together we recover” is evident
throughout our philosophy, practice
and staff
Dane County Tobacco Integration Project
Connections Counseling is one of 4 Ambassador
programs in Dane County.
We are beginning the journey to tobacco-free
facilities and programs.
Our aim to support all of our clients in recovery
from nicotine addiction
Our journey so far….
Held Part 1 of 2 TIP orientations for our staff, to both assess and
build knowledge, skills and readiness; Part 2 scheduled midsummer
Slated a staff “readiness” discussion for early summer
Display “We Support Tobacco Free Recovery” posters
Expect to hold a skills training for staff in late summer or early fall
Plan for staff to attend Mayo Clinic’s Nicotine
Dependence Center (NDC) Tobacco Treatment
Specialist Certification Program this fall
Presented by Candace Peterson, PhD
Director of Operations
Connections Counseling
5005 University Avenue, Suite 100
Madison, WI 53705
Phone: (608) 233-2100
Fax: (608) 233-2101
[email protected]
Dane County
Tobacco Treatment
Integration Pilot
OPEN DOOR Center for Change, LLC
6502 Grand Teton Plaza, Suite 206
Madison, WI 53719
A bit about us..
• Private practice, licensed under Chapter 35 but
provide dual-diagnosis treatment.
• Three partners (owners) and four employees.
• No admin staff. One staff dually-certified in
AODA/MH. The rest are MH certified only.
• Most have knowledge of and minimal training
in MET.
Starting point…
• Everyone on the staff except myself is a past
smoker. The most recent “quitter” was three
months ago.
• I was the only staff to have heard WINTIP
presentation or to have attended the kick off.
• YIKES!!!!!
• Get buy-in from the team that this was a
worthwhile endeavor for OPEN DOOR.
• Implement a plan for integrating screening tools
into intake and at least raising the question of
smoking cessation as a goal for people.
• Identify clients who were interested in quitting
and refer to QuitLine.
• Work toward having a certified staff member who
can treat nicotine dependence inhouse at OPEN
• All staff have agreed to the project in theory!!
• Signage displayed in our clinic.
• One staff member has met with Mac to discuss
treatment integration and will be attending
Intensive training by year end (applying for
scholarship, using stipend to offset cost of
• Three clients were identified as nicotine
dependent and all three were referred to the
Dane County Tobacco
Integration Project
OceanHawk Counseling Alternatives, LLC.
is committed to the kind of quality care
that respects and considers the whole
person. We attend to the ways in which
our clients' physical, spiritual, family and
relationship concerns affect their
emotional and mental well being.
OceanHawk Counseling Alternatives
provides a wide range of confidential
services to address a variety of personal
concerns. We serve individuals, couples,
and families of all ages and backgrounds
and is licensed by the State of Wisconsin.
Serving the Stoughton and Dane County
area since 2006.
Dane County Tobacco Integration Project
OceanHawk’s steps in implementing the
•Display “We Support Tobacco Free
Recovery” posters
•Completed a staff-readiness discussion at the
end of May
•Utilizing the Fagerstrom screening tool with
all new clients, as well existing clients who
identify as using tobacco products
Dane County Tobacco Integration Project
OceanHawk’s steps in implementing the
•Schedule a skills training for staff in late
•Plan for staff to attend Mayo Clinic’s Nicotine
Dependence Center (NDC) Tobacco
Treatment Specialist Certification Program
this fall
•Beginning in late fall OceanHawk will be
offering smoking cessation group sessions
•Potentially offering tobacco and nicotine
cessation products
Dane County Tobacco Integration Project
Our goal is to support our clients that
have mental health & substance abuse
disorders to become tobacco and
nicotine free.
We are working towards a tobaccofree clinic, which will include a nicotine
cessation program.
OceanHawk Counseling is one of four
Ambassador programs in Dane County.
Presented by
Jean Daute
Therapist & Clinical
OceanHawk Counseling
Alt. LLC
135 West Main Street,
Suite 207
Stoughton, WI 53589
[email protected]
608-873-7838 Ext. 1
ARC Community Services
ARC is a non-profit organization that
operates thirteen projects serving Dane and
Fond du Lac counties.
Each program serves women and their
children with innovative, gender-specific,
comprehensive wraparound care. All
programs are nearly100% grant-funded and
there is no cost to the participant.
The Problem
 Our new health educator was shocked at how
many of our clients were smoking-95%
 Upon further study she found that they were
smoking, on average, a half a pack a day.
Anecdotally, many of the clients reported
increased tobacco use upon entering treatment.
 From February 2012-December 2012, only 3
women enrolled in either the Quitline or Fresh
The Plan
Made Possible With WINTIP Grant
Paid to
•Incentivize women to enroll in the Quitline or First Breath
programs (gift cards)
•Create alternative break activities (crafts, Wii fit, nail polish)
•Foster development tobacco cessation culture (group quit
•All women will be screened/assessed for nicotine
•Pre-Treatment--Fagerstrom will be completed and
discussed in pre-treatment group
•Treatment—Add nicotine goals to treatment plan,
continue/increase groups on nicotine education, etc
The Results
Number Of Women Enrolled In Quitline/First Breath
Next Steps/Thoughts
• Continue to hold monthly meetings to check-in with
staff who are responsible for implementing the
• Keep brainstorming (staff AND clients) to generate
other ideas on how to further advance tobacco
How You Can Help
 Sign our Tobacco Integration Support
Resolution today as an agency or as an
 Consider becoming a DCTIP ambassador
 If you are an AODA provider, consider
applying for a $750 scholarship for Certified
Tobacco Treatment Specialist training at the
Mayo Nicotine Dependence Training
Contact Dane County
Tobacco Integration Project
David "Mac" Macmaster, CSAC, PTTS
(608) 393-1556
[email protected]
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