The week of February 14-20, 2016 is designated Through With Chew Week, to call attention to the dangers of using smokeless tobacco, which includes chewing tobacco, spit tobacco, dip, snus, and snuff.

The use of smokeless tobacco products remains prevalent in some California communities.¹ This is a concern because chew products can contain a higher concentration of nicotine and be more habit-forming than cigarettes. ^2,3 

Smokeless tobacco products also contain at least 28 chemicals known to increase the risk of developing cancer of the mouth, esophagus, and pancreas. In addition, these products are linked to oral health problems like mouth sores, gum recession, tooth decay, bad breath, and permanent discoloration of teeth.

 Warning signs of possible health problems from chew include:

• A lump in the neck
• Change in voice
• A growth or white spots inside the mouth
• Swallowing problems
• Persistent earache
• Blood in saliva or phlegm
• Changes in the skin

1.California Department of Public Health, California Tobacco Control Program. Behavioral Risk Factor Surveillance System (BRFSS). 2013.

2. Centers for Disease and Control. Through with Chew. 2015 http://www.cdc.gov/tobacco/calendar/feb/through_with_chew

3. National Cancer Institute. Smokeless Tobacco and Cancer. 2010. http://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/smokeless-fact-sheet

Caller demographic reports are now available from the California Smokers' Helpline for the time period July 1, 2015 to December 31, 2015.

The report includes aggregate data about callers from each county in California including age, gender, ethnicity, language spoken, and referral source.

Starting with the July-December 2015 report, all data is now included in a single Excel file with tabs for each county.

These reports are a good way to gauge your county's success in increasing cessation among tobacco users.

The Helpline call reports page may also be accessed from the bottom of the Community Partners page.

Please feel free to contact me at y2ng@ucsd.edu  or (858) 300-1015 if you have any questions, or would like to know more about Helpline resources for increasing tobacco cessation in your county.

The California Smokers’ Helpline is pleased to host this free webinar, How to Talk with Patients about Smoking Cessation and Depression, on Wednesday, January 27th from noon to 1pm PST.

The relationship between depression and smoking is a significant concern among health professionals.

Smokers often have a cigarette when they feel down. This reliance on cigarettes to manage mood can keep smokers from even trying to quit. And if they do quit, feelings of depression can get them to start smoking again. This webinar will address key strategies to help smokers with depression to quit.

The following continuing education credits are offered for this course: CA BBS, APA, CAADE, and CME.

Target Audience

This course is designed for primary care providers and behavioral health professionals interested in the most current research surrounding smoking cessation and depression.

Objectives

At the conclusion of this activity, participants should be able to:

• Discuss the evidence regarding tobacco use among patients with depression.
• Discuss program and policy strategies to reduce tobacco use among patients with depression.
• Identify and implement evidence-based treatment for treating tobacco dependence.

Presenter

Robert M. Anthenelli, MD Professor and Executive Vice Chair Director, Pacific Treatment and Research Center Department of Psychiatry University of California, San Diego, School of Medicine

Accreditation

University of California, San Diego School of Medicine Accreditation Statement
The University of California, San Diego School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

University of California, San Diego School of Medicine Credit Designation Statement
The University of California, San Diego School of Medicine designates this live webinar for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Mental Health Credit Designation Statement
CE Learning Systems designates this live webinar for a maximum of one credit (1.0), available for members belonging to the American Psychological Association (APA) or California Association for Alcohol/Drug Educators (CAADE). Individuals belonging to California Board of Behavioral Sciences (CA BBS) may earn credit based on the APA approval.

Everybody wins when your patients and providers can easily find a link on your website to the free, evidence-based tobacco cessation services of the California Smokers' Helpline.

We are providing a little extra motivation to do so by offering a chance to win one of four $25 VISA gift cards simply by providing a link on your organization's website to the California Smokers' Helpline website at http://www.nobutts.org. Please also delete any old links to the former Center for Tobacco Cessation website.

Check out the example below on the resources page of the the Los Angeles County Health Department website at http://www.laquits.com/quitting/resources:

If you would like to download a free Helpline banner ad like the one below for use on your website, please click here.

To be eligible for the drawing, your organization must serve patients and clients in California and you must enter by Friday, February 12, 2016. To be entered into the drawing, just click the button below to provide your contact information and web address for the page on your organization website showing a link to the California Smokers' Helpline website at http://www.nobutts.org.

Quit smoking to start your year off right.

Every January 1, people all over the world make New Year's resolutions, according to the Centers for Disease Control. If you're one of the nearly 7 in 10 U.S. smokers who want to quit, why not make a resolution to get started? Smoking is still the number one cause of preventable death and disease in the United States. Quitting now can cut your risk for diseases caused by smoking and leave you feeling stronger and healthier.

Tiffany, a former cigarette smoker, was 16 when her mother—also a smoker—died of lung cancer. Despite her loss, Tiffany started smoking. She finally decided to quit when her daughter Jaelin turned 16 because she could not bear the thought of missing out on any part of Jaelin's life, like her own mother did. Her effort to quit began with setting a specific date to quit smoking and reaching out to family and friends for support. In the video "Tiffany's Decision" from CDC's Tips From Former Smokers (Tips) campaign, she talks about the "aha" moment that sent her on a different, healthier path for her own life.

Most smokers who want to quit try several times before they quit for good. The most important thing is to never give up. There is help available for you to reach your goal of quitting smoking once and for all.

Free, Effective Resources

The California Smokers' Helpline offers a variety of free quit smoking resources in English, Spanish, Chinese, Korean, and Vietnamese, proven to double a smokers chance of successfully quitting:

• Telephone Counseling. One on one support over the phone from a trained, caring counseler who will help you make a quit plan, send you free materials, or refer you to other resources in your area. To get started now, call 1-800-NO-BUTTS (1-800-662-8887) or register online.
• Texting Program. This free 24/7 texting program sends encouragement, advice, and tips to help you quit smoking for good. Register online to get started.
• Online Help. A wealth of online tips and resources for quitting smoking are available in English, Spanish, and Asian languages (Chinese, Korean, and Vietnamese).

Quitting Aids

Because cigarettes contain nicotine, a powerfully addictive drug, when you first quit, your body may feel uncomfortable until it adjusts. This is known as withdrawal, and there are quitting aids that can help lessen this feeling and the urge to smoke.

Studies show that smokers who use quitting aids to help control cravings, along with coaching from a quitline, in a group, or from a counselor, are much more likely to succeed than those who go it alone.

Talk to your doctor, pharmacist, or other health care provider before using any quitting aids if you:

• Are pregnant or nursing
• Have a serious medical condition
• Are currently using other medications
• Are younger than 18

For More Information

Visit our website or download one of our free fact sheets.

As the start of a new year approaches, isn't now the perfect time to quit smoking? Start off 2016 by taking control of your smoking.  Use the free resources available to you and make a plan to quit for good.  Even if you don't smoke yourself, you can share the information here to help a friend or family member become smokefree in 2016!

University-wide program links health records with 1-800-NO-BUTTS helpline

Buster Halcomb was just 5, a scruffy shoeshine boy in a billiard hall in Cumberland, Ky., when three men approached with packs of “tailor-made” cigarettes.

“Bring them home to your mom and dad,” they told him. He did, and kept a few for himself, too. By age 7, smoking had become a habit, one that the now 66-year-old is ready to quit on account of his own health and for the sake of his new granddaughter.

“I love that baby even before she is born,” he gushed on the day his daughter went into labor. “I know that if I smell like smoke, I am not going to be holding her.”

Halcomb, along with his wife, Julia, plan to quit smoking together with the help of UC Quits, a University of California program that marries established tobacco cessation counseling with the electronic health records of every patient who gets care at the academic health center at UC Davis, UC San Diego, UCLA, UC Irvine or UCSF.

Patients more apt to quit with provider push

The program aims to simplify and streamline what should be routine preventive health care, but too often is neglected by providers. It began as a pilot project at UC Davis through a grant from the UC’s Center for Health Quality and Innovation and led by UC Davis internal medicine physician and tobacco control researcher Elisa Tong. The university later expanded the program across the entire system.

The idea is to reach people at risk of tobacco-related diseases when they are more open to quitting – in the hospital or during doctor visits. Project leaders estimate that at least 100,000 people who get their care at a UC center can directly benefit; already, 2,700 patients who smoke have been referred to the California Smokers Helpline, operated by UC San Diego.

After several unsuccessful quit attempts, Halcomb acknowledged that his doctor’s recommendation in mid-December came at a good time – just hours before his daughter gave birth and brought her new baby to her parents’ home to live.

“Everybody who smokes knows that if the doctor says something, deep down they feel ashamed,” he said.

The UC Tobacco Cessation Network also is designed to meet federal and other health care targets for improving patient outcomes and lowering the costs of care.

“The goal is to try to address tobacco use at every clinical encounter, and ultimately align with tobacco quality measures set forth by the Centers for Medicaid and Medicare Services, which will probably offer incentives to health systems based on how they are performing on tobacco,” said Tong.

Tobacco’s toll on health

The health impacts of smoking are indisputable: Tobacco use is a leading cause of preventable illness in the U.S., including cardiovascular disease and several types of cancer. By the same token, quitting can have immediate and long-term health benefits. But nicotine is an addictive drug, and most smokers attempt to quit several times before they’re successful.

Health care provider involvement increases the chances that someone will quit, explained Linda Sarna, interim dean of the UCLA School of Nursing and a UC Quits nurse champion.

“The majority wants to quit, and those with an illness may be even more motivated,” she said. “When a provider has an interaction with a patient who smokes it’s an opportunity to connect the dots and help the patient understand how their condition is influenced by tobacco use.”

Training healthcare providers key

A critical component of the program is training providers. Sarna, for example, has worked with nurses at all the UC campuses to understand their role in supporting quit efforts, including strategies to help smokers suffering nicotine withdrawal.

In addition, the Smoking Cessation Leadership Center, run by UCSF Distinguished Professor of Health and Healthcare Steve Schroeder, coordinated education materials to ensure providers know how to flag smokers in the hospital or clinic, inform patients about the benefits of quitting and how to do it. At UC Davis, for example, Halcomb was given a prescription for nicotine patches and tobacco lozenges.

Health care providers now can “e-refer” patients to the Helpline. The referral triggers a call to the patient from a trained counselor, said Helpline Project Director Chris Anderson, whose team worked across the UC health centers to connect the Helpline to electronic health record systems and integrate the referral capability into clinical workflows.

Offered in English, Spanish, Mandarin, Cantonese, Korean and Vietnamese, the counseling can involve up to six sessions spread over the course of a quit attempt, from a routine intake survey to a quitting preparation conversation and relapse prevention sessions.

Anderson said UC Quits’ long-term goal is to screen patients at every clinical visit, “so the patient who doesn’t quit this time gets encouraged to do so next time.”

Halcomb said he and his wife are ready this time.

“Smoking is not the way to go,” he said. “Life is too short to mangle it up. And we want to see our grandchildren grow up.”

For more information

If you are interested in establishing patient referral via electronic health record to the California Smokers' Helpline, please contact the California Smokers' Helpline Communications Department at cshoutreach@ucsd.edu or (858) 300-1010.

Just in time for New Year's resolutions to quit smoking, the California Smokers' Helpline has updated it services flyer for patients and is offering it in six languages including English, Spanish, Simplified Chinese, Traditional Chinese, Korean, and Vietnamese.

These colorful, one page flyers include testimonials from real clients as well as information about our new text messaging program, expanded hours, and social media pages. Some flyers also feature photos of real patients.

Just download, print, and hand to patients who are either thinking about quitting smoking or are ready to quit!

The California Smokers’ Helpline and the University of California, San Diego School of Medicine are pleased to host this free webinar, How to Talk with Patients About Smoking Cessation and Substance Use Disorders on Wednesday, November 18th from noon to 1pm PST.

Smoking rates among people with substance use disorders are high. Contrary to popular belief, many smokers with substance use disorders want to quit and can quit successfully. The skills gained through quitting smoking can enhance recovery from other substances.

Target Audience

This course is designed for primary care providers and behavioral health professionals interested in the most current research surrounding smoking cessation and substance use disorders. While anyone can take this course, it is currently available only for 1.0 AMA PRA Category 1 Credits. We are working on expanding continuing education credits for other health professionals for future courses.

Objectives

At the conclusion of this activity, participants should be able to:

• Discuss the evidence regarding tobacco use among patients enrolled in addiction treatment
• Discuss patient, program, and policy strategies to reduce tobacco use in addiction treatment populations
• Refer their patients or clients who smoke to the California Smokers’ Helpline for additional help quitting

Presenter List

Joseph Guydish, PhD

Joseph Guydish, PhD, is Professor of Medicine and Health Policy at the Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco. His research concerns access, delivery, and organization of substance abuse treatment services. He has led studies evaluating efforts to improve access to publicly-funded drug abuse treatment, assessing federal policy to end drug addiction and alcoholism as an SSI disability category, and investigating Drug Court and intensive case management interventions for drug-involved offenders. In recent years, his work has focused on tobacco dependence in addictions treatment, because of the high rate of smoking in this population, the known health consequences, and the increasing evidence that quitting smoking in addictions treatment also improves drug abuse outcomes.

Valerie Gruber, PhD

Valerie Gruber, PhD, is Clinical Professor in the Department of Psychiatry at the University of California San Francisco. As a licensed psychologist, she has designed, provided, and supervised outpatient addiction treatment integrated within medical and mental health programs serving culturally diverse low-income clients. As a co-investigator in studies led by Dr. Guydish, she has designed and trained staff on leading smoking cessation groups in residential alcohol and drug treatment.

La Línea de Ayuda para Fumadores de California, el único servicio gratuito en California para dejar de fumar, ha introducido una sección especial en su página web con información en español para los usuarios del tabaco y sus familiares. Los usuarios del tabaco también se pueden inscribir en línea para recibir asesoría gratuita por teléfono en español. Visite la página web en español aquí.

Esta información también es un recurso valioso para los proveedores de servicios médicos que prestan sus servicios a pacientes y clientes que hablan español. La comunidad hispana tiene una tasa más baja de fumadores que otros grupos étnicos y son más propensos a ser fumadores ligeros o de no fumar a diario. Sin embargo, ya que fumar no es seguro a ningún nivel, los proveedores de servicios médicos deben preguntar rutinariamente a todos sus pacientes si ellos fuman y referirles a programas para dejar de fumar.

“Hemos ayudado a miles de fumadores hispanos a dejar de fumar desde 1992, y nos complace ofrecer este servicio adicional para los hispanohablantes y sus familiares,” comenta Jesus Calleros, Supervisor Clínico de la Línea de Ayuda para Fumadores de California. “Recibimos muchas solicitudes de información de personas que quieren ayudar a sus familiares a dejar de fumar y de proveedores de servicios médicos quienes necesitan acceso fácil a materiales culturalmente apropiados para sus pacientes y clientes que fuman.”

Fundada en 1992 por investigadores de la Universidad de California en San Diego, Moores Cancer Center, la Línea de Ayuda para Fumadores de California ofrece servicios gratuitos, personalizados y confidenciales a más de 40,000 personas de comunidades diversas de todo el estado de California. La asistencia para dejar de fumar se ofrece en español (800-45-NO-FUME), ingles (800-NO-BUTTS), coreano (800-556-5564), vietnamita (800-778-8440, y mandarín y cantonés (800-838-8917). También hay servicios especializados para fumadoras embarazadas, mascadores de tabaco y adolescentes. El horario de servicios es de lunes a viernes, de 7 a.m. a 9 p.m., sábados y domingos de 9 a.m. a 5 p.m. La línea de ayuda es financiada por el Departamento de Salud Pública de California y por First 5 California.

Helpline Now Offers Online Quit Smoking Help in Spanish

The California Smokers' Helpline, California's only free, statewide telephone counseling service for quitting smoking, has launched a special section on its website with information in Spanish for tobacco users and family members. Tobacco users can also enroll online for free telephone counseling in Spanish. Visit the Spanish website here.

This information is also a valuable resource to health care providers who provide services to patients and clients who speak Spanish. Hispanics generally have lower rates of smoking than other ethnic groups and are more likely to be light or non-daily smokers.  However, smoking is not safe at any level so health professionals should routinely ask all their patients if they smoke and refer them to resources for quitting smoking.

"We have helped thousands of Hispanic smokers quit smoking since 1992, and are pleased to offer this additional resource to Spanish-speakers as well as their family members," says Jesus Calleros, Counseling Supervisor with the California Smokers' Helpline. "We get many requests for information from family members who are concerned about their loved ones who smoke, as well as from health professionals who want easy access to culturally appropriate materials for their patients and clients who smoke."

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 more than 40,000 Californians each year from diverse communities throughout the state. Quitting assistance is provided in Spanish (800-45-NO-FUME), English (800-NO-BUTTS), 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.  

If you missed the California Smokers' Helpline webinar on October 22nd, New and Emerging Tobacco Products: An Ever-Changing Market, you can download our free kit now, which includes:

• Webinar Recording & Slide Deck
• Patient Fact Sheet-Cigars
• Patient Fact Sheet-Chew

Kimberlee Homer Vagadori, Project Director for the California Youth Advocacy Network, discusses the following products in this very comprehensive and informative webinar:

• Hookah
• Cigars, Little Cigars, and Cigarillos
• Smokeless Tobacco Products
• e-Cigarettes