People with mental illness and substance use disorders want to quit smoking and can quit successfully. And mental health professionals can help.
Until a few years ago, it was not common for people with mental illness or substance use disorders to be treated for their tobacco dependence. People with behavioral health conditions have only recently been identified by tobacco control and cessation professionals as a priority, even though their smoking rates are 2-4 times higher than in the general population (Lasser et al., 2000).
The 2006 Morbidity and Mortality in People with Serious Mental Illness report issued by the National Association of State Mental Health Program Directors, found that persons with serious mental illness die, on average, 25 years earlier and suffer increased medical co-morbidity. They often die from tobacco related diseases and are more likely to die from these diseases than from alcohol use.
The need to help this clientele quit tobacco is clear. Some strongly held myths have stood in the way of progress in this area. Fortunately, a growing body of research is debunking these myths, making way for new interventions.
The California Smokers’ Helpline has developed the following free resources to help you learn more about smokers with mental illness and substance use disorders and how to help them. Fact Sheet: Tobacco Cessation for Smokers with Mental Illness or Substance Use Disorders.
- Slide Presentation: Tobacco Cessation and Behavioral Health
- Online CE Training: Tobacco Cessation and Behavioral Health. Continuing education credits available to physicians, nurses, physician assistants, MFTs, LCSWs, and NAADAC certified counselors.
The California Smokers’ Helpline just made it easier for health professionals to refer their patients who smoke to the Helpline for free, evidence-based, tobacco cessation services in multiple languages.
Health professionals can now register online for the Helpline’s new web-based referral service. Once approved, it’s easy and convenient to refer patients who want to quit smoking with the Helpline’s online referral service – just select the provider name from the drop-down menu, enter the patient’s name, date of birth, phone number and preferred language, obtain patient consent, and save!
Studies have shown that smokers who use Helpline counseling are twice as likely to quit as those who don’t. Seventy percent of smokers visit a physician at least once a year and according to the U.S. Public Health Service Treating Tobacco Use and Dependence: Clinical Practice Guideline, 2008 Update, “Telephone quitline counseling is effective with diverse populations and has broad reach. Therefore, both clinicians and health care delivery systems should ensure patient access to quitlines and promote quitline use.”
“At Children's Hospital Oakland, we are big fans of the Helpline's new web-based referral system,” says Jyothi Marbin, MD, with the Department of Primary Care. “I have found the web portal very quick and easy to use, and I love that I get immediate confirmation so I know my referral has been received. I also train other providers on how to refer patients to the Helpline using the web-referral system, and we all appreciate that it's so user-friendly and simple to use.”
To hear more about the benefits of Helpline services, please listen to Dr. Patricia Essilfie of St. John's Well Child and Family Center in Los Angeles:
Established in 1992 by researchers at the University of California San Diego, Moores Cancer Center, the California Smokers’ Helpline provides free, personalized and confidential services to 40,000 Californians each year from diverse communities throughout the state. Quitting assistance is provided in English (800-NO-BUTTS), Spanish (800-45-NO-FUME), Korean (800-556-5564), Vietnamese (800-778-8440), and Mandarin and Cantonese (800-838-8917). Specialized services are also available for pregnant smokers, tobacco chewers and teens. Hours of operation are Monday to Friday, 7 a.m. to 9 p.m., and Saturdays and Sundays, 9 a.m. to 5 p.m. The Helpline is funded by the California Department of Public Health and First 5 California.
The Great American Smokeout on November 21 is a perfect time to encourage your patients who smoke to make a quit attempt. To help smokers stay quit, the Helpline is offering its Top 10 Tips to Help Smokers Quit flyers in six languages:
Quit attempts are vitally important to population-based cessation as most tobacco users must try repeatedly to quit before they succeed. Fortunately, 70% of smokers say they want to quit. And, asking and advising a patient to quit can actually double the chance that he or she will try.
So, take this opportunity on the Great American Smokeout to ask all your patients if they smoke, advise them to quit, and provide them with our Top 10 Tips to Help Smokers Quit flyer. For smokers who need additional support, refer them to 1-800-NO-BUTTS (1-800-662-8887) for free help and a plan to quit.
Have you ever wanted to listen in on a counseling call of the California Smoker's Helpline to hear first-hand how our telephone-based services work? Now you can!
We have recorded a series of simulated calls to give you a better understanding of each step in the Helpline's evidence-based counseling protocol, including:
- Initial intake
- Medi-Cal process
- Building motivation
- Setting a quit date
- Quitting aids
- Planning ahead
- Dealing with withdrawal
You can also download presentation slides delivered by the Helpline's Clinical Director, Gary Tedeschi, PhD, which provide a more in-depth overview of the Helpline's counselor training program and counseling protocol.
We hope this information helps you feel confident in referring your patients who smoke to the California Smokers' Helpline.
Medi-Cal members who call the California Smokers’ Helpline at 1-800-NO-BUTTS can now receive a free, four-week supply of nicotine patches delivered directly to their home. Callers must be 18 or older, have a valid Medi-Cal ID, and enroll in Helpline counseling. If a caller has contraindications, the Helpline will seek medical approval before dispensing.
The Helpline is a free service that helps tobacco users quit. Studies have shown that smokers who use Helpline counseling are twice as likely to quit as those who don’t, and that those who use both counseling and a quitting aid such as nicotine patches quit at the highest rates.
“Patches have been a covered Medi-Cal benefit for some time, but were not easy for members to obtain,” said Dr. Cathy McDonald, an Oakland pediatrician who refers smoking parents to the Helpline. “They had to get a prescription from a doctor, participate in an approved quit smoking program, and then go to the pharmacy to have their prescription filled. Research has shown that barriers like these reduce quitting.”
The new patch service is expected to generate increased interest in quitting statewide. A similar service available to callers from Los Angeles County more than doubled Helpline calls from that county since it took effect in 2011.
According to recent estimates, the prevalence of smoking among adult Medi-Cal members is more than 36 percent higher than in the general population in California. Nationwide, the cost of treating tobacco-related illness is estimated at 11 percent of total Medicaid program costs.
“The most cost-effective way to reduce health care costs is to help smokers quit,” said Dr. Steven Schroeder, Director of the Smoking Cessation Leadership Center at UCSF. “Better access to effective treatment means more Medi-Cal members will quit, leading to better health for members and economic savings for the state.”
As an added incentive to use the Helpline, members can receive a $20 gift card bonus. To be eligible, callers must ask for the gift card, have a valid Medi-Cal ID, and complete the first counseling session.
Both the free patches and gift cards are expected to be available through December 2015 as part of the Medi-Cal Incentives to Quit Smoking (MIQS) project. MIQS is funded by a grant from the Centers for Medicare and Medicaid Services under the Affordable Care Act.
About the Medi-Cal Incentives to Quit Smoking project
The Medi-Cal Incentives to Quit Smoking (MIQS) project provides incentives to help members quit smoking. It is funded entirely by the U.S. Centers for Medicare & Medicaid Services (CMS). California received a CMS grant to increase the number of Medi-Cal members who use the California Smokers’ Helpline. The grant pays for incentives, counseling services, statewide outreach, project administration, and evaluation. The ultimate aim of the project is to improve health and reduce costs by preventing tobacco-related disease. For more information on MIQS, visit www.caldiabetes.org.
Callers to the Smokers' Helpline receive free one-on-one support from trained cessation specialists, self-help materials and referral to local quit-smoking programs. It is open Monday to Friday, 7 a.m. to 9 p.m., and Saturdays and Sundays, 9 a.m. to 5 p.m. The Helpline has specialized services for pregnant smokers, tobacco chewers and teens. Services are available in multiple languages:
1-800-838-8917 Mandarin & Cantonese
The free patch and gift card offers are available through all of the phone lines above. For more information about Helpline services for Medi-Cal members, visit www.NoButts.org/Medi-Cal.
This communication made possible by funding from the California Department of Public Health and First 5 California
The California Smokers' Helpline is developing a new logo and would like your feedback! We have created 3 logo options and would appreciate 5 minutes of your time to answer 8 questions. Please click here to take the survey now. Please complete the survey by Wednesday, July 17th!
The 3 logo options are in grayscale so that you can focus on design rather than color. Once a final logo has been selected, color will be added.
Thank you for your assistance in helping us select a new logo for the California Smokers' Helpline!
Please join us for our next free, CE webinar: Tobacco Dependence Treatment Considerations for Special Populations: What's the Same and What's Different?
In April 2013, the Centers for Disease Control and Prevention (CDC) launched a continuation of its groundbreaking national tobacco education campaign to increase awareness about the negative health effects caused by smoking and secondhand smoke exposure and to encourage smokers to quit. The campaign, Tips From Former Smokers, features former smokers who have experienced smoking-related diseases at a relatively young age. The ads, which first aired in 2012, have been highly effective in motivating smokers to quit, with calls to the toll-free 1-800-QUIT-NOW quitline (1-800-784-8669) more than doubling compared with the same 12-week period in 2011.
As part of the this year’s Tips campaign, CDC has partnered with five medical societies (American Medical Association, American Academy of Pediatrics, American Academy of Family Physicians, American College of Physicians, and American Congress of Obstetricians and Gynecologists) to support a new initiative called “Talk With Your Doctor,” which encourages smokers to talk with their health care providers about quitting. From May 27th through June 2nd, select Tips From Former Smokers television ads as well as digital and online ads will feature the following tagline: “You Can Quit. Talk With Your Doctor for Help.” The goal of this initiative is to engage health care providers and encourage them to use the Tips campaign as an opportunity to talk with their patients who smoke about quitting. The initiative can also serve as a reminder for smokers to talk with their health care providers about effective methods to help them quit.
"Physicians play an important role in helping patients take steps to improve their health,” said Tim McAfee, MD, MPH, director of the Office on Smoking and Health at CDC, and a primary care physician. “Patients with tobacco dependence should be identified and treated in the same way that patients with diabetes, hypertension, or other health issues are identified and treated. We hope that this initiative provides a conversation starter for physicians to proactively talk with their patients about how they can quit smoking.”
The California Smokers' Helpline urges health systems and health professionals throughout the state to utilize these free resources to promote cessation to their patients and clients. Click on the links below for more information and resources to share with your patients:
Campaign Download Center
General Campaign Resources
New Free Resource from the California Smokers' Helpline!
Want to know the real stats on tobacco dependence? Want to know specific clinical practice guidelines on the most effective types of treatment? Tune in to learn keys to success in helping your patients live longer and healthier lives.
Title: Tobacco Use and Dependence: How Nurses Can Save Lives
Date: Tuesday, April 23, 2013 from 4:00 – 5:00 pm PDT
Linda Sarna, RN, PhD, FAAN, AOCN, Professor and Lulu Wolf Hassenplug Endowed Chair at the UCLA School of Nursing and Chair of the UCLA Academic Senate, is internationally recognized for her work promoting nursing involvement in tobacco control. She is the co-editor of Advancing Nursing Science in Tobacco Control, 2009 volume of the Annual Review of Nursing Research. She was the Principal Investigator for the first ever national program to help nurses quit smoking and to promote the role of nurses in tobacco control. She was the lead investigator on an analysis of 27-year smoking trends of participants in the Nurses’ Health Study. She also led a team of investigators in the examination of national smoking trends among healthcare professions. Dr. Sarna’s translational research, including projects funded by the Centers for Disease Control and Prevention, aim to increase nursing interventions with hospitalized patients who smoke, using web-based educational program and resources. She holds the honor of Visiting Professor, Anhui Medical University, Hefei, Anhui Province, China, the first nurse so appointed to this position. Dr. Sarna has received distinguished recognition for her scientific contributions from the Oncology Nursing Society as the 2008 Distinguished Research Professor. She has collaborated with national and international nursing organizations on policies related to nurses and tobacco control. She was a member of The Joint Commission Task Force which provided advice about testing improved interventions for helping smokers quit.
Stella Bialous, RN, MScN, DrPH, FAAN, President, Tobacco Policy International, is internationally recognized for her work promoting nursing involvement in tobacco control and research on tobacco control policy. She has published extensively in the field. She is the co-editor of Advancing Nursing Science in Tobacco Control, 2009 volume of the Annual Review of Nursing Research. She was a senior consultant on the Tobacco Free Nurses (TFN) initiative, funded by The Robert Wood Johnson Foundation, the first ever national program to help nurses quit smoking and to promote the role of nurses in tobacco control. This program inaugurated the award winning TFN website. She collaborated with Dr. Linda Sarna on an analysis of 27-year smoking trends of participants in the Nurses’ Health Study. Additionally, Drs. Bialous and Sarna examined national smoking trends among health care professions from data from the 2003 and 2006/2007 Tobacco-Use Supplement Current Population surveys. She is also a senior consultant on several of Dr. Sarna’s translational research, including projects funded by the Centers for Disease Control and Prevention, to increase nursing interventions with hospitalized patients who smoke, using web-based educational program and resources. She is a co-investigator on best practices for capacity building of nurses internationally, with projects in China, the Czech Republic, and Poland. Additionally, she is a senior consultant for the World Health Organization Tobacco Free Initiative. Dr. Bialous received the 2012 Distinguished Merit Award from the International Society of Nurses in Cancer Care for her contributions for the advancement of cancer nursing practice. She has collaborated with national and international nursing organizations on policies related to nurses and tobacco control.
Registration: Click here.
Continuing Education: This is a Gannett Education CE event. Participants who attend the webinar and complete the post-test and evaluation survey will earn: Registered Nurses: 1.0 contact hour. For more information, click here.
The California Smokers' Helpline and the Center for Tobacco Cessation are partnering with Nurse.com in promoting and delivering its educational 2013 Tobacco-Free California Educational Series. For a complete list of the webinars and campaign offerings please visit http://topics.nurse.com/nobutts. For more information contact Kirsten Hansen at firstname.lastname@example.org or 858-300-1012.
This material made possible by funding from the California Department of Public Health.