Everyone Can Live Smoke-Free

Presentation to NAMI

August 4, 2011

What We Do

Reduce Exposure to Secondhand Smoke

Fight Big Tobacco

Prevent Kids From Smoking

• Tobacco Facts

• Who Smokes?

• Barriers to Tobacco Intervention

• Myths?

• Current Projects

• Process of Quit Smoking

Agenda

You Tube Viedo

Tobacco use, alone kills more people each year, than all deaths from HIV, drugs,

alcohol, car crashes, suicides and murders COMBINDED!

Smoking is the leading cause of preventable death

Tobacco Kills!

435,000 deaths in the US/year

4.8 million deaths worldwide/year

10 million annual deaths estimated by year 2030

50,000 annual deaths in the US due to second-

hand smoke exposure

Tobacco’s Deadly Toll

What is in a Cigarette?

Asthma Cancer

4,000 chemicals

No Safe Level of Exposure

Heart Disease

Secondhand Smoke is Toxic

A Wellness

Philosophy

To assist people to lead meaningful lives in their communities, we need to promote behaviors that lead to health

Persons with mental illnesses die up to 25 years

earlier and suffer increased medical comorbidity

• Often from tobacco related diseases

• More likely to die from these diseases than

from their alcohol use

Smoking and Mental Illness

Tobacco’s Deadly Toll

• 200,000 of the 435,000 annual deaths are people with mental illness and substance use disorders

• For patients in treatment for alcohol and drug dependence, more than half die from tobacco-caused illnesses¹

• Among treated narcotic addicts, smokers’ death rates are 4 times that of nonsmokers²

¹Hurt et al., 1996

²Hser et al., 1994; Lynch & Bonnie, 1994

Smoking by Diagnosis

22.5

44.7 45.3

56.1 54.6

67.9

60.6

0

10

20

30

40

50

60

70

80

% S

mo

kin

g

None Maj. Dep. S-phrenia Alcohol Anxiety Drug Bipolar

• 30% - 35% of mental health providers smoke as

compared to-

• Primary Care Physicians 1.7%

• Emergency Physicians 5.7%

• Psychiatrists 3.2%

• Registered Nurses 13.1%

• Dentists 5.8%

• Dental Hygienists 5.4%

• Pharmacists 4.5%

Smoking Among Mental Health Providers

• Rates of smoking are 2-4 times higher than among the general population.¹

• About 41% of people with mental illness & substance use disorders smoke.²

• 60% of current smokers report having had a mental health or substance use diagnosis sometime in their lifetime.¹

• This population consumes 45% of cigarettes smoked.³ 111

Smoking and Behavioral Health

“I’ve been schizophrenic since I was 14. I was told more or less when I went to the hospitals that cigarettes help control certain areas in my brain and the way we function out in society. I became more of a smoker because I was told it would help me with my illness. I was taught more about it helping my illness than I was about cancer and stuff like that.”

- Consumer focus group participant

Morris et al, 2009

• Expectation of failure

• Lack of knowledge

• Fear of withdrawal symptoms

• Fear of weight gain

• Concern about recovery

• Concern about stress management (tension, anxiety)

• Doubt about dealing with boredom

• Part of daily routines

• Integral to social activity

• Tobacco industry targeting

Barriers to Tobacco Interventions:

Client/Consumer Factors

• Promotion of health

• Changing philosophy around addictions & co-occurring treatment

• Putting the “T” back in ATOD

• Increased treatment effectiveness

• A key component of the recovery process

• You are in the best position to offer these services

Why Now? This slide needs WORK

Competing demands

Tobacco as socialization activity, behavioral reward

Staff acceptance and promotion

Not part of current treatment milieu

Lack of reimbursement for services

County of San DiegoBuilding Better Health

3Behaviors

4Diseases

Over

50 %Of all deaths

SmokingPoor nutritionLack of physical activity

Heart disease/strokeCancerType 2 diabetesRespiratory conditions,

100% of California state psychiatric facilities are smoke-free

• Napa – 7/08

• Coalinga – 8/08

• Atascadero – 11/08

• Patton – 4/09

• Metro – 4/09

“There have been no significant

Issues in any of the hospitals” California Department of Mental Health

Smoking in Psychiatric Facilities

• Right to smoke is not protected under the law

• Smokers are not a “protected class” such as age, race, gender, etc.

• No smoking policies are legal

• Same as the restriction of “no pets”

• No smoking policy is not discrimination

There is NO Constitutional Right to smoke!

Slide about SAY

San Diego County Tobacco Control Coalition

MaterialsCollaboration

TrainingsQuit

SmokingHelp

How You Can Help

Quitting SmokingHow you can quit or help a friend quit

Quit Smoking3 Chains of Addiction

Social Psychological

Physical

Where Are You?

Not Ready

Ready to Quit

Slipping & Relapsing

Ready to Quit

Are you willing to set a quit date within 30 days?

Smoking Triggers

Money Saved Slide

-Mark Twain

Slipping and Relapsing

Every relapse begins with a slip, but not every slip ends in a relapse.

“Quitting smoking is easy.I’ve done it a hundred times.”

Staying Quit

Have you stayed quit for 6 months or longer?

Over the counter products:

Prescription products:

Breaking the Chain of Addiction:

FDA-Approved Nicotine Replacement Products**The American Lung Association in California and SAY San Diego do not endorse any products.

Both are prescription products:

Other FDA-Approved Medications

*The American Lung Association in California and SAY San Diego do not endorse any products.

xx

x

x

Don’t use products that haven’t been approved by the FDA for quitting smoking

Self-help guide

Telephone counselingOnline

Groups

If you’re ready to quit

Thank You

Lisa Archibald, American Lung Association in California

619-683-7520 · larchibald@alac.org

Mary Badiner, Social Advocated for Youth (SAY) San Diego

858-974-3603 x207 · mbadiner@saysandiego.org