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California Smokers’ HelplineCenter for Tobacco Cessation
Kirsten Hansen, MPP
Curriculum Development Manager
Today’s Objectives
California Smokers’ Helpline Services– Callers with Behavioral Health Conditions
Coverage for Cessation Treatment
Center for Tobacco Cessation Services– Ad Campaign
California Smokers’ Helpline1-800-NO-BUTTS
Free statewide tobacco cessation program
Funded by tobacco taxes– Propositions 99 & 10
Scientifically proven to be effective
Adults, teens, pregnant women and proxyMon. – Fri.: 7:00am – 9:00pm & Sat. 9:00am – 1:00pm
Multiple languages– Spanish, Mandarin & Cantonese, Korean, and
Vietnamese
Available Services
Self-help materials
Referral lists of local cessation programshttp://nobutts.org/CountyListings.aspx
Individual telephone counselingConfidential
One pre-quit call, multiple proactive follow-up calls
Trained counseling staff
Types of Calls
Intake session– 5-7 min. call to determine client needs
Initial counseling session– Comprehensive, 25-30 min. call– Preparation to quit– Setting a quit date
Proactive follow-up sessions– Up to five 10-15 min. calls– Relapse prevention– Pharmacotherapy review
Days after quitting
Relapse-Sensitive Scheduling
Source: Zhu & Pierce (1995), Prof. Psych. Res.& Practice, 26, 624-625
Pe
rce
nt
abs
tin
ent
3014730 1
100
80
60
40
20
0
Helpline Intervention Summary
– Identify a strong reason
– Bolster belief in ability
– Develop a solid plan
– Adopt a new view of self
– Keep trying
(Motivation)
(Confidence)
(Skills)
(Self-image)
(Perseverance)
Relapse Curves for the 3 Groups
0
20
40
60
80
100
0 30 60 90 120 150 180 210 240 270 300 330 360
Days after quitting
Per
cen
t ab
stin
ent
Multiple CounselingSingle CounselingSelf-Help
Source: Zhu et al. (1996), JCCP, 64, 202-211
Helpline Callers with Behavioral Health
Conditions
Self-Reported Behavioral Health Conditions Among Helpline Callers
Do you have any current mental health issues such as:– An anxiety disorder?– Depression?– Bipolar disorder?– Schizophrenia?– Drug or alcohol problem?
If yes, have you been actively using/drinking in the last month?
Self-Reported Behavioral Health Conditions Among Helpline Callers
% S
mo
kin
g
(Zhu,et al, 2009. Unpublished data)
Received Counseling
No Mental Illness
Mental Illness
74.0%
84.0%
(Zhu,et al, 2009. Unpublished data)
Use of Nicotine Replacement Therapy(NRT)
No Mental Illness
Mental Illness
33.3%
41.7%
(Zhu,et al, 2009. Unpublished data)
Quit Attempts
No Mental Illness 53.1*
56.4*
Quit in 2 Months (%)
Mental Illness
* Descriptive data, not based on results of a randomized controlled trial
(Zhu,et al, 2009. Unpublished data)
Quitting Success
20.8*
19.0*
30-Day Point Prevalence (%) at 2 Months
No Mental Illness
Mental Illness
(Zhu,et al, 2009. Unpublished data) * Descriptive data, not based on results of a randomized controlled trial
Points from the Helpline
Smokers with mental illnesses call in high numbers– Across all demographics
They appear to be more motivated– More likely to get counseling & use NRT
The motivation and use of treatment seem to compensate for the vulnerability associated with their mental health condition.As a result, they are equally likely to try to quit & succeedRandomized controlled trials are needed to determine efficacy of telephone counseling for smokers with mental illnesses
Helpline Referral Options
For smokers who want to be contacted by the Helpline:– Fax referral– Two-way call– Coming soon – electronic referral
For smokers who prefer to contact the Helpline:– Gold Card– Regale Salud Card– Brochures
Coverage for Cessation Treatment
Public CoverageMedi-Cal– Behavior-modification, e.g. 1-800-NO-BUTTS– Prescription
Zyban (12 wks), Chantix (12 wks) and NicoDerm CQ patches (14wks)Two courses per year – no break required
CMSP and Path2Health– Medications require a pre-authorization
Zyban, Nicorette gum, Nicotine patch (OTC patches only) and Nicotrol Nasal Spray
Medicare – Prescription drug benefits – Part D– Reimburses for cessation counseling – CPT Codes
• 99406 (3-10 minute intervention)• 99407 (>10 minute intervention)
Center for Tobacco Cessation
Overview
Provider in-person trainings and webinars
Technical assistance – incorporating cessation into patient care, electronic health records, quality measures
Online, CME/CEU-approved training
Digital & print ad campaign for behavioral health providers
Webinars – July 31, 2012 – Mental Health
http://cessationcenter.adobeconnect.com/e1ubot96yvb/event/registration.html?campaign‑id=santarosa
– August 7, 2012 – Substance Use Disordershttp://cessationcenter.adobeconnect.com/e390i3uk52i/event/registration.html?campaign‑id=santarosa
Ad Campaign Summary
Target Audiences– Drug and alcohol counselors– Psychiatric nurses– Licensed clinical social workers – Marriage and family therapists – Licensed clinical psychologists– Physicians
• Family practice • Psychiatry• Internal medicine
Core Message– "People with mental illness/substance use disorders
want to quit smoking, can quit successfully, and you can help them quit."
More than half of patients in drug and
alcohol treatment will die from tobacco-related disease.
Smokers want to quit more than you may
think. And they can. Talk to them about it. For more help, refer them to 1-800-NO-BUTTS. And visit
nobutts.org for free training, resources
and patient materials.
People with serious mental illness die up to 25 years earlier,
often from tobacco-related diseases.
Their desire to quit is stronger than you may think. Talk to them about it. For
more help, refer them to 1-800-NO-BUTTS. And visit
www.nobutts.org for free training,
resources, and patient materials.
