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Common Myths about Smoking and Behavioral Health

Posted by Gary Tedeschi, PhD

May 9, 2017 12:02:13 PM

Older Man_Web.jpgMay is Mental Health Month and a good time to revisit some of the common myths about smoking and behavioral health.

People with behavioral health conditions (mental illness and substance use disorders) smoke at higher rates than those without behavioral health conditions.  Alarmingly, people with mental illness and substance used disorders are dying up to 25 years earlier than the general population. The major causes of death are often smoking related cancer, heart disease, and lung disease.1,2

Unfortunately, there are still misconceptions that smokers with behavioral health conditions are not interested in smoking cessation and lack the ability to quit.  There are also concerns that these smokers will experience increased psychiatric symptoms when they quit.3 As a result, providers may not include smoking cessation in their treatment plans.  Instead, they focus primarily on behavioral health symptom management.

The reality is that people with mental illness and substance use disorders want to quit smoking and can quit successfully. Health care professionals can play an essential role in this process. Providers can bolster a broad health and wellness philosophy for patients by seeing tobacco cessation as a key component of behavioral health treatment and recovery.

Myths and Facts About Smokers with Behavioral Health Conditions

Here are some common myths and facts about smokers with behavioral health conditions.

Myth #1: Persons with mental illness and substance use disorders don’t want to quit.

Fact: The majority of persons with mental illness and substance use disorders want to quit smoking and want information on cessation services and resources.

Several research studies indicate that the majority of persons with behavioral health conditions want to quit smoking and want information on cessation services and resources. 4, 5, 6 


Myth #2:  Persons with mental illness and substance use disorders can’t quit smoking.

Fact:  Persons with mental illness and substance use disorders can successfully quit using tobacco.

There is a growing body of literature indicating that this clientele can quit.  For example, results from a large, internationally run randomized controlled trial showed that smokers with behavioral health conditions can quit successfully using nicotine patches, Zyban, or Chantix, compared to placebo, with no significant increase in neuropsychiatric adverse events.7


Myth #3:  Smoking cessation worsens psychiatric symptoms.

Fact:  Smoking cessation can improve psychiatric symptoms.

This myth has historical ties to the tobacco industry, which directly funded, or monitored, research supporting the idea that individuals with behavioral health conditions (schizophrenia in particular) were less susceptible to the harms of tobacco and that they needed tobacco as self-medication.  Fortunately, research has been emerging to debunk this myth.8,9


Myth #4:  Smoking cessation will threaten recovery for persons with substance use disorders.

Fact:  Smoking cessation can enhance long-term recovery for persons with substance use disorders.10

Research has shown that smoking cessation can encourage and support recovery.  For example, a systematic review of 17 studies found that concurrent tobacco cessation treatment with individuals in addictions treatment was associated with 25% increased abstinence from alcohol and illicit drugs six months or longer after treatment. 6

Increasingly, these myths about smoking and behavioral health are giving way to the facts. This is important for a clientele who will benefit greatly from an integrated treatment approach that includes smoking cessation as a priority focus.

For More Information

For more information about smoking and behavioral health, please visit our website or explore our free CE Courses on a variety of smoking and behavioral health issues.


1 Colton, C. W. & Manderscheid, R. W. (2006). Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing Chronic Disease, 3(2).

2 Walker, E. R., McGee, R. E., & Druss, B. G. (2015). Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA psychiatry, 72(4), 334-341.

3 Prochaska, J. J. (2010). Failure to treat tobacco use in mental health and addiction treatment settings: A form of harm reduction? Drug and Alcohol Dependence, 110(3), 177- 182.

4 Prochaska, J. J., Rossi, J. S., Redding, C. A., Rosen, A. B., Tsoh, J. Y., Humfleet, G. L., . . . Hall, S. M. (2004). Depressed smokers and stage of change: Implications for treatment interventions. Drug and Alcohol Dependence, 76(2), 143-151. doi:DOI: 10.1016/j.drugalcdep.2004.04.017

5 Prochaska, J. J.,Reyes, R.S., Schroeder, S.A., Daniels, A. S., Doederlein, A., & Bergeson, B. (2011). An online survey of tobacco use, intentions to quit, and cessation strateies among people living with bipolar disorder. Bipolar Disorders, 13(5-6), 466-473. doi:10.1111/j.1399-5618.2011.00944.x

6 Joseph, A. M., Willenbring, M. L., & Nugent, S. M. (2004). A randomized trial of concurrent versus delayed smoking intervention for patients in alcohol dependence treatment. Journal of Studies on Alcohol, 65(6), 681-691

7 Anthenelli, R. M., Benowitz, N. L., West, R., St Aubin, L., McRae, T., Lawrence, D., ... & Evins, A. E. (2016). Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial. The Lancet, 387(10037), 2507-2520.

8 Prochaska, J. J., Hall, S. M., Tsoh, J. Y., Eisendrath, S., Rossi, J. S., Redding, C. A., . . . Gorecki, J. A. (2008). Treating tobacco dependence in clinically depressed smokers: Effect of smoking cessation on mental health functioning. American Journal of Public Health, 98(3), 446-448. doi:10.2105/AJPH.2006.101147

9 Evins, A., Cather, C., Deckersbach, T., Freudenreich, O., Culhane, M., Olm-Shipman, C., . . . Rigotti, N. (2005). A double-blind placebo-controlled trial of bupropion sustained-release for smoking cessation in schizophrenia. Journal of Clinical Psychopharmacology, 25(3), 218-225. doi:10.1097/01.jcp.0000162802.54076.18

10 Prochaska, J. J., Delucchi, K., & Hall, S. M. (2004). A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery. Journal of Consulting and Clinical Psychology, 72(6), 1144-1156. doi:10.1037/0022-006X.72.6.1144

Smokers Have Help to Kick the Habit as Tobacco Tax Increases

Posted by Kristin Harms

Mar 28, 2017 4:19:30 PM

California Department of Public Health
Number: 17-031 
Ali Bay or Corey Egel
916.440.7259  
FOR RELEASE
Tuesday
March 28, 2017
 

Cigarette Tax Increases $2 on April 1

SACRAMENTO. In light of the new tobacco tax going into effect this week, the California Department of Public Health (CDPH) reminds Californians that resources are available to help them kick the habit. 

On April 1, the tax on a pack of cigarettes will increase $2, from $0.87 to $2.87. This increase is a result of Proposition 56, the California Healthcare, Research and Prevention Tobacco Tax Act, which was approved by voters last November. 

Californians who want help to quit smoking can call the California Smokers’ Helpline at 1-800-NO-BUTTS. The Helpline provides smokers free telephone counseling and plans to help them quit. The Helpline is staffed with trained counselors who are fluent in English, Spanish, Mandarin, Cantonese, Korean and Vietnamese. Additional resources and materials are available at www.nobutts.org.

“We know most smokers want to quit, and paying more for their habit could be the extra motivation they need to make an important life-saving step,” said CDPH Director and State Public Health Officer Dr. Karen Smith. “Quitting smoking helps protect your physical and financial health. A smoker who quits today could save nearly $1,500 in just one year.”  

Smoking remains the number one cause of preventable death and disease in California. About 3.1 million, or one out of nine, California adults smoke, and an estimated 34,000 Californians die from smoking-related diseases each year.

The state’s new tax increase also impacts tobacco products like electronic cigarettes and e-liquids, which are taxed based on their wholesale cost.

Proposition 56 funds tobacco-use prevention programs, the new state Oral Health Program and research on tobacco-related illnesses such as cancer and heart disease. It also strengthens the Medi-Cal health care system and provides additional resources for CDPH to enforce underage tobacco-sales laws. 

The California Tobacco Control Program was established by the Tobacco Tax and Health Protection Act of 1988. California’s comprehensive approach has changed social norms around tobacco use and secondhand smoke. California’s tobacco control efforts have reduced both adult and youth smoking rates by 50 percent, saved more than one million lives and have resulted in $134 billion worth of savings in health care costs. Learn more at TobaccoFreeCA.com.


 

Free Webinar: How to Start and Maintain a Smoking Cessation Group

Posted by Kristin Harms

Mar 14, 2017 11:31:35 AM

The California Smokers’ Helpline and its training and technical assistance arm, the Center for Tobacco Cessation, are pleased to host this free webinar on Thursday, March 23rd from noon to 1 pm PST, How to Start and Maintain a Smoking Cessation Group.

Webinar Overview

Group-Class-Shot.jpgSmoking cessation groups have been a mainstay of cessation interventions for years, but starting and maintaining groups can sometimes prove challenging.  In this webinar Ken Fitzgerald from the Stanislaus County Office of Education and Zoila Reyna, MPH from the American Lung Association will offer insights, tools and resources for getting cessation groups up and running and for keeping them going:

  • Ken will discuss the development of the Stop Tobacco And Nicotine Dependence (STAND) curriculum which was created as part of the smoke-free parks and colleges initiative, as well as recognize key partners and potential uses in local settings. 
  • Zoila will discuss how to successfully facilitate tobacco cessation groups for adults and how the Freedom from Smoking Facilitator Training content has helped healthcare professionals in clinical settings address tobacco cessation needs in their own organizations.

Register Now!

Presenters

Ken Fitzgerald | Director of Student Services and Support
Stanislaus County Office of Education

Ken-Fitzgerald_200px.jpgKen has been coordinating public health and prevention programs in Stanislaus County since 2002.  His experience includes leading policy initiatives for smoke-free outdoor areas in parks and colleges  He also helped develop the Protecting Health And Slamming Tobacco (PHAST) Youth Coalition, which has grown into one of the largest tobacco prevention youth coalitions in California.  Ken led in the development of the tobacco cessation curriculum known as Stop Tobacco And Nicotine Dependence (STAND).  He provides training and technical assistance to schools and community organizations to support student wellness and strengthen school climate. 

Zoila Reyna, MPH | Charter Director of Health Education
American Lung Association in California

Zoila-Reyna_200px.jpgZoila trains and supports health professionals throughout California in tobacco cessation programs in both clinical and public settings. She received her Master’s Degree in Public Health from UC Davis. She has 10 years of experience in program management, community engagement, and public health programs for underserved populations, in both rural and urban areas.

 


 

New Provider Toolkit: Online Referral Options to Tobacco Treatment

Posted by Kristin Harms

Mar 6, 2017 12:50:27 PM

African-American-Provider.jpg

Download our free Provider Toolkit, Online Referral Options to Evidence-Based Tobacco Treatment, from the California Smokers’ Helpline and its training and technical assistance arm, the Center for Tobacco Cessation.

In 2015, the California Department of Public Health (CDPH) determined that the California Smokers’ Helpline meets the Specialized Registry Reporting measure. Eligible professionals can choose to report smokers to the Helpline as part of their Meaningful Use Compliance.

The Helpline offers a variety of options for referring patients and clients to the Helpline's evidence-based telephone counseling for quitting smoking, including web-based referral, DIRECT messaging, and other Internet options.

Kristin Harms and Carrie Kirby with the California Smokers' Helpline describe the various options available for referring patients online to the Helpline including cost, technology requirements, and fulfillment of Meaningful Use Requirements.

Our free toolkit includes:

  • Webinar recording and slide deck
  • Provider flyer: Online Referral Options

Download Now!


 

FREE Webinar: Online Referral Options to Evidence-Based Tobacco Treatment

Posted by Kristin Harms

Feb 22, 2017 12:43:42 PM

JyothiMarbin_stethoscope.jpgThe California Smokers’ Helpline and its training and technical assistance arm, the Center for Tobacco Cessation, are pleased to host this free webinar on Wednesday, March 1st from noon to 1 pm PST, Online Referral Options to Evidence-Based Tobacco Treatment.

Webinar Overview

The California Smokers' Helpline offers a variety of options for referring patients and clients to the Helpline's evidence-based telephone counseling for quitting smoking, including web-based referral, DIRECT messaging, and other Internet options.

In 2015, the California Department of Public Health (CDPH) determined that the California Smokers’ Helpline meets the Specialized Registry Reporting measure. Eligible professionals can choose to report smokers to the Helpline as part of their Meaningful Use Compliance.

Learn about the various options available for referring patients online to the Helpline, including cost, technology requirements, and fulfillment of Meaningful Use Requirements. Online referral offers health care providers a number of benefits:

  • Easy, convenient, secure
  • Referral to quitlines is associated with a significantly higher participation rate than simple advice to quit
  • Helps healthcare systems achieve and document Meaningful Use of Electronic Health Records

Register Now!

Presenters

  • Kristin Harms, Communications Manager, California Smokers' Helpline
  • Carrie Kirby, M.S., Project Manager, California Smokers' Helpline
  • Anthony Mayoral, Director of Operations and IT, California Smokers' Helpline


New Provider Toolkit: Child Health Providers Helping Family Members Quit Tobacco Use

Posted by Kristin Harms

Feb 1, 2017 2:51:34 PM

Children_and_Tobacco_Toolkit_Image.jpgIf you missed our webinar on January 18th, you can download our new provider toolkit, Child Health Providers Helping Family Members Quit Tobacco Use.

In this recorded webinar, Jonathan Winickoff, MD, MPH and Jyothi Marbin, MD discuss the impact of tobacco use on families, and list ways in which child health practices can effectively treat tobacco users in a family. They also describe how to implement the basic 3 step CEASE model in a busy office practice and share information about policies that can mitigate tobacco exposure in children.

Our free toolkit includes:

  • Webinar Recording and Slide Deck
  • Patient Fact Sheets:
    • What's in Cigarette Smoke?
    • Secondhand Smoke
    • Quit Aids

Download Now!


 

HUD Public Housing to be Smoke-Free

Posted by Kristin Harms

Nov 30, 2016 6:38:20 PM

HUD No. 16-184
Brian Sullivan
(202) 708-0685
FOR RELEASE
Wednesday
November 30, 2016
 
New rule protects health and safety of residents, saves PHAs millions of dollars in preventable damage

WASHINGTON - U.S. Housing and Urban Development (HUD) Secretary Julián Castro today announced that public housing developments in the U.S. will now be required to provide a smoke-free environment for their residents. In an address to local public housing officials, residents and public health professionals in Boston, Secretary Castro said HUD's new rule will provide resources and support to more than 3,100 Public Housing Agencies (PHAs) to implement required smoke-free policies over the next 18 months. Read HUD's final rule.

Throughout this year, HUD worked with PHAs and stakeholders collaboratively to finalize this rule, which prohibits lit tobacco products (cigarettes, cigars or pipes) in all living units, indoor common areas, administrative offices and all outdoor areas within 25 feet of housing and administrative office buildings. HUD's final rule included input from more than 1,000 comments from PHAs, housing and health partners, and tenant advocates.

"Every child deserves to grow up in a safe, healthy home free from harmful second-hand cigarette smoke," said Secretary Castro. "HUD's smoke-free rule is a reflection of our commitment to using housing as a platform to create healthy communities. By working collaboratively with public housing agencies, HUD's rule will create healthier homes for all of our families and prevent devastating and costly smoking-related fires."

Since 2009, HUD has strongly encouraged PHAs to adopt smoke-free policies in their buildings and common areas, a policy many private housing developments already have in place. During this time, more than 600 PHAs and Tribally Designated Housing Entities (TDHEs) have adopted smoke-free policies.Through HUD's voluntary policy and local initiatives, more than 228,000 public housing units are already smoke-free. Once fully implemented, the smoke-free rule announced today would expand the impact to more than 940,000 public housing units, including more than 500,000 units inhabited by elderly residents and 760,000 children living in public housing.

"My office has long warned the public about the dangers of smoking, including second-hand smoke," said U.S. Surgeon General Vivek H. Murthy. "For children who are exposed to second-hand smoke, it can mean everything from Sudden Infant Death Syndrome and ear infections to asthma. Protecting our children and families from the devastation caused by secondhand smoke must be a priority for all sectors of our society, including public housing."

HUD's smoke-free rule will reduce damage and maintenance costs associated with smoking. According to the Centers for Disease Control and Prevention (CDC), HUD's national smoke-free policy will save public housing agencies $153 million every year in repairs and preventable fires, including $94 million in secondhand smoke-related health care, $43 million in renovation of smoking-permitted units, and $16 million in smoking-related fire losses.It is estimated that smoking causes more than 100,000 fires each year nationwide, resulting in more than 500 deaths and nearly a half a billion dollars in direct property damage.

"Protecting people from secondhand smoke saves lives and saves money," said CDC Director, Tom Frieden, M.D., M.P.H. "This is especially important in the places where we live. No level of secondhand smoke exposure is safe, and the home is the primary source of secondhand smoke for children."

The CDC estimates cigarette smoking kills 480,000 Americans each year, making it the leading preventable cause of death in the United States. In addition, smoking is the lead cause of fire-related deaths in multifamily buildings. HUD's smoke-free rule will protect the health of public housing residents by reducing the health risks associated with tobacco use and exposure to secondhand smoke.

PHAs are encouraged to take advantage of the information and resources on HUD's Healthy Homes website. Updated guidance and training materials will be available in the coming months.

###

HUD's mission is to create strong, sustainable, inclusive communities and quality affordable homes for all.
More information about HUD and its programs is available on the Internet
at www.hud.gov and http://espanol.hud.gov.


 

Top 10 Tips for Quitting Smoking in the New Year!

Posted by Kristin Harms

Nov 28, 2016 4:08:18 PM

The New Year is a perfect time to encourage your patients and clients who smoke to make a quit attempt. To help smokers stay quit, the California Smokers' Helpline is offering its Top 10 Tips to Help Smokers Quit flyers in six languages.

Download Now!

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 before the New Year 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) our to our online registration form for free help and a plan to quit.


 

8 Ways Tobacco Use Affects Vulnerable Populations

Posted by Regina R. Washington, DrPH

Nov 16, 2016 3:13:29 PM

LGBT HealthLink worked in collaboration with Sibling National Disparity Networks to create a tool that would provide a fast way to convey how tobacco, the cause of one third of all cancers, has a disproportionate impact on disparity populations. The resulting infographic will aid health officials, health providers, as well as decision makers to highlight pertinent information on the key tobacco related disparities, broaden understanding, and promote ideas for action. Please right click on either image below to download and use on your website or in other digital publications.

Infographic Smoking Cancer-english.jpg

Infographic Smoking Cancer-spanish.jpg

"We hope that this tool will empower our stakeholders to draw attention to key tobacco disparities about each of these priority populations around the nation" stated, Regina R. Washington, LGBT HealthLink Director.

Our Collaborators: National African American Tobacco Prevention Network, National Native Network, The RAISE Network, Nuestras Voces, National Behavioral Health Network for Tobacco and Cancer, Geographic Health Equity Alliance, and SelfMade Health Network.

Please feel free to contact LGBT HealthLink for more information, and to share this infographic widely to motivate your grantees to build disparity population engagement in their daily activities.


 

New Provider Toolkit: Youth and Tobacco

Posted by Kristin Harms

Oct 27, 2016 11:07:27 PM

California_Smokers_Hotline_32.jpgThe California Smokers’ Helpline and its training and technical assistance arm, the Center for Tobacco Cessation, are pleased to offer this free Provider Toolkit, Youth and Tobacco, including:

  • Recorded Webinar and Slide Deck: Youth and Tobacco, presented by Kimberlee Homer Vagadori,  Project Director for the California Youth Advocacy Network (CYAN).
  • Patient Handouts: Cigars, Hookah, Marijuana

Tobacco use trends among youth have shifted in recent years.  As cigarette smoking rates decrease, use of other tobacco and nicotine products is increasing.  This webinar highlights changes in tobacco use by teens and explore the factors that contribute to youth use.  Information is also shared about how to encourage teens to quit, and how to engage youth in activities to prevent addiction to tobacco.

Download Now!


 




About this Blog

The California Smokers' Helpline offers free, evidence-based tobacco cessation services in multiple languages to help smokers quit. We also offer free training and resources to health professionals to increase their knowledge and capacity for tobacco cessation.

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Contact Us

For more information about our free training and resources for health professionals, please contact the Helpline Communications Department at (858) 300-1010 or cshoutreach@ucsd.edu.

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