Austin Steeves City of Austin/Travis County Health & Human Services Public Health Educator

Agenda Economic impact Community Changes Health Impact Tobacco is Addictive Free Quit Resources How medication can help

Cost Us All U.S. consumers spent $90 billion Annual economic losses –$96 billion in health-care costs annually –$97 billion per year in productivity losses Each household in Texas –$750 cover health-care costs

Live Tobacco-Free Austin Community Changes

Telephone Survey Tobacco-Free Public buildings, including their outside areas –72% Support Tobacco-Free outdoor areas where families and children are present, including at events –69% Support Tobacco-Free Hospitals & other healthcare facilities –64% Support

CPPW Smoke-/Tobacco-free Organizations Capital Metro Austin/Travis County Integral Care Huston-Tillotson University Austin Volunteer Health Clinic People’s Community Clinic ACTIVE Life Inc. Mexican Consulate Seton Family of Hospitals Austin Community College Austin Recovery Central Health/CommUnityCare African American Men & Boys Harvest Foundation The Arc of Capital Area Yogagroove Austin Fit Magazine Cadence Marketing ZuZu City Of Austin Library Power to Perform Green Ribbon Schools Juice Homes My Fit List Parks and Recreation Texas Certified Development Company Wild Basin Wilderness Preserve 360 Signs Austin/Travis County HHSD

Healthcare Electronic Medical Record/System Changes –Central Health/Community Care –Seton/St. Davids –ATCIC Seton Tobacco Resource Center

Smoke-Free Housing Village Christian Apartments (Senior Living) The Gables at Park Plaza M Station Apartments (Affordable Housing) Villages at the Domain Bridge Hollow/Point South The McClintock Apartments Village at 47th Street Fountain Terrace (Student Housing)

Point of Sale Signage New signs are going out in January 2012 statewide.

Media

Health Impact of Tobacco

Tobacco is Addictive Nicotine is a Drug Causes brain chemistry changes It reaches your brain in 8-10 seconds Pleasurable effects last minutes

What is in Tobacco Smoke Over 7,000 chemicals - 69 of these are known to cause cancer! Carbon monoxide Formaldehyde Arsenic Tar

Secondhand Smoke Same cancer-causing substances and poisons 50,000 deaths annually There is NO risk-free level of exposure Health problems –Immediate adverse effects on the cardiovascular system –Causes lung cancer

We’re Not Just Talking About Cigarettes Menthols Clove cigarettes Cigars Hookah Smokeless tobacco (spit, chew, snus) Other

How do we break the cycle of addiction…? We need to realize where we are at in our addiction and how to move forward.

Stages Of Change Precontemplation Contemplation Preparation Action Maintenance Relapse Don’t want to quit Want to quit sometime Will quit in next 30 days Am quitting now

Strategies for Quitting Don’t Give Up! Telephone/ Web counseling Group counseling Individual counseling Nicotine Replacement Therapies Pharmaco-therapies Holistic therapies

Who They Are Seton Tobacco Education Resource Center (STERC) Made possible by a grant initiative through City of Austin and other community partnerships. Provides education along with a group counseling and NRT

Program Structure Mayo Clinic Model –Group-based outpatient program –6-15 participants per cohort –6 week series –Meet once a week for 60-90min Worksites –1hr in-service –6 week class series No –Shame –Guilt –Scare Tactics

Class Outline Week 1 Introduction: Orientation and Exploration –Neurobiology of Addiction –Getting Ready to Quit –Glimpse at Medications –Withdrawal Symptoms Week 2 –The quitting process: Withdrawal vs. urge –Stress Management –Quit Day Plan –Pharmacotherapy- participant specific

Class Outline Week 3: Quit Week –Relapse Prevention –Plan of Action –Proper usage of NRT –Coping Mechanisms/Stress Management Week 4 –Using Motivational Interviewing address concerns –Reinforcement & Maintenance –Pharmacotherapy

Class Outline Week 5 –A healthier you- Eating Habits –Relapse Prevention –Preparing for end of series (support group, identify concerns, etc) Week 6 –Relapse Prevention –Wrap up (confirm plan of action to remain tobacco free) –Open forum

Quit For Life 35 years of combined experience in tobacco cessation Evidence-based combination of: –Physical –Psychological –Behavioral strategies

A Critical Mix Phone-based cognitive behavioral coaching Text messaging Web-based learning Medication support

Quit Coaches Identify and resolve any hesitation about quitting Reinforce existing motivation to change Cognitive behavioral coaching strategies Select the appropriate intervention strategy Tailor a plan to overcome the barrier to change.

Web Coach Personalized pre-quit / post-quit homepage Interactive quitting plan Medication decision support & fulfillment Tracking tools Community support Available in English and Spanish

How Medications Can Help Double your chance of quitting Increase your comfort and sense of control Help lessen urges and desires for tobacco Stop Date Intensity