nntpp-announce Messages: Lists

The 2005 National Conference on Tobacco or Health held in Chicago, Illinois came to a close May 6, 2005. The conference was well attended with many wonderful sessions. I would like to highlight a couple of sessions I attended at the conference that I thought would be beneficial to others.

Bringing Labor Unions to the Table: Lessons from the Field

WorkSHIFTS: Partnering with Labor Unions on Tobacco Control Issues - WorkSHIFTS is a program of the Tobacco Law Center, working with the labor community in Minnesota to provide education, training, and assistance to Minnesota workers and labor management about the health risks and economic consequences associated with exposure to tobacco smoke in the workplace.

WorkSHIFTS key activities include:

Actively involving labor leaders in the development of educational, training, and resource materials that inform their coworkers about health, safety, and economic issues related to secondhand smoke in the workplace.
Providing training for labor leaders so they can share with union members information about tobacco, its relationship to other workplace toxins, the benefits of quitting smoking, how these concerns can be addressed with voluntary workplace smoke-free initiatives, collective bargaining, and other mechanisms to produce policy changes.
Providing resources for labor and management to develop workplace tobacco policies that improve and protect the health of employees.
Working closely with labor unions, public health organizations, and others in Minnesota and beyond that share a commitment to worker health and safety and seek to protect workers and safeguard their rights.

WorkSHIFTS did a study on MN unions and found that:

Approximately 30% of Minnesota union members smoke
75% support union bargaining for reasonable smoking restrictions
Approximately 85% believe cessation programs are an important benefit for unions to negotiate

WorkSHIFTS goals are to:

Reduce exposure to SHS for all workers, regardless of occupation or class.
Reduce tobacco use among blue-collar, service and hospitality workers

- Build union support for smoke-free workplace policies

- Build union support for policy action to ensure workers’ access to effective cessation services

- Link labor unions with MN tobacco control community

Increase awareness among blue-collar and service unions about work-related tobacco and cessation issues
Equip labor leaders and activists with tools and resources to build rank-and-file awareness and to effect policy change
Increase employer and labor-management awareness about health, economic and legal issues
Build bridges between MN labor and tobacco control communities

Lessons Learned from working with Unions:

Meet labor where it is now
Identify receptive leaders: Cultivate relationships, trust
Identify how tobacco combines with other labor issues
Frame workplace-related tobacco issues

- Worker health and safety

- Healthcare costs

Equip labor leaders with tools and resources
Maintain steady contact and explore new opportunities

Contact Information:

Susan Weisman, J.D., Director, WorkSHIFTS & Senior Staff Attorney

sweisman@wmitchell.edu

Website: www.workshifts.org

Incorporating Motivational Interviewing into the 5A’s

Park County Tobacco Use Prevention Program, Livingston, Montana

5A’s Intervention Model

ASK about tobacco use at every visit
ADVISE all tobacco users to quit
ASSESS willingness to quit at this time
ASSIST the patient with preparations for quitting
ARRANGE for follow-up contact

About 1/3 of smokers report never being asked about their smoking or advised to quit during appointments and only 3% had a follow-up appointment to address tobacco use.

Pitfalls of 5A’s from a provider’s perspective are that there is not enough time and not comfortable talking with patients about tobacco cessation. Pitfalls from a patient’s perspective are they often get lectured about tobacco use, provider tells patient how to quit, and there is poor follow-up.

What is needed? Motivational Interviewing which is:

Patient-centered counseling style that enhances motivation to make a behavior change.
Goal is to create and amplify discrepancy between present behavior and the person’s broader goals.
The client is in the driver’s seat. MI fosters their ownership of the problem and the solution.

Principles of Motivational Interviewing

Develop Discrepancy
Express Empathy
Avoid Argumentation
Roll with Resistance
Support Self-Efficacy

Incorporating MI into the 5A’s

Use same structure of 5A’s
Use open-ended questions and statements
Add decisional balance tools
Help client move to next stage of change, not necessarily to quit right now

Conclusions & Recommendations

Incorporating motivational interviewing into brief clinical interventions can increase motivation to quit and increase success rates.
Research should be undertaken to evaluate this approach and if warranted, consider it for inclusion in best practices.

Contact Information:

Clare Lemke, R.N., Program Coordinator

Park County Tobacco Use Prevention Program

(406) 222-8282

parkcountytupp@hotmail.com

2) Tobacco Cessation for Correctional Populations, A Health Education Manual – Now Available

The National Network on Tobacco Prevention and Poverty and the National Commission on Correctional Health Care are proud to announce that the Tobacco Cessation for Correctional Populations, A Health Education Manual is now available.

This is one of the few tobacco education/cessation resources specifically developed for use in correctional facilities. The Guide was developed with the assistance of national organizations, tobacco control experts, organizations serving incarcerated individuals and ex-offenders, and the administrative and health staff of prisons, jails and juvenile facilities nationwide.

The Guide contains two curriculum modules: Module One is designed to educate individuals on the health effects of tobacco use; Module Two is a guide for quitting. The curriculum also contains instructions for facilitators, reproducible handouts and a resource section to obtain additional information and materials.

The Guide is available for $125.00 which includes the manual, CD ROM, colored overhead transparencies, and shipping. It can also be purchased for $75.00 without the transparencies. For more information, please call the Health Education Council/NNTPP at (888) 442-2836 or you may email kbrown@healthedcouncil.org to request an order form.

3) Medicare Starts Smoking Cessation Plan

By Kevin Freking

The Associated Press

03/23/05

You’re never too old to quit smoking, government officials said Tuesday, announcing that Medicare will immediately start covering the cost of counseling for certain beneficiaries who want to quit tobacco.

Medicare’s new smoking cessation program “has great potential to save and improve lives for millions of seniors,” said Mark McClellan, administrator for the Centers for Medicare and Medicaid Services.

Not every Medicare beneficiary qualifies for the new benefit – only those who have an illness caused by tobacco use or complicated by tobacco use.

Medicare officials said Tuesday they did not have an estimate of how much the new program would cost or how many people would be eligible for it. It covers only counseling sessions, not the cost of nicotine patches and gum or products pitched to help smokers quit. About 300,000 senior citizens die annually from smoking-related illnesses, according to the Centers for Disease Control and Prevention.

The new nationwide benefit covers only those with smoking-related illnesses.

Dr. Ronald Sturm, a senior economist with the RAND Institute, a nonprofit research group, said Medicare’s decision to limit the annual benefit to two cessation attempts per year – each including a maximum of four counseling sessions – would limit the program’s costs.

Still, elderly people who have smoked throughout much of their life aren’t typically the best candidates to quit smoking – unless they are facing a life-threatening scenario.

“Will they quit smoking in their last few years? Not likely,” Sturm said. “It’s not going to change much. It’s not going to cost much.”

Officials at the American Medical Association applauded the government’s move. They said seniors actually have a better chance of successfully quitting smoking than do people in other age categories.

4) Cessation Resource Center (CRC)

Introducing the Cessation Resource Center! The site contains cessation-focused resources developed and tested by state tobacco control programs, CDC Office on Smoking and Health (OSH), partner organizations, and other federal agencies. These cessation resources are available to registered state and organizational tobacco cessation programs. Login is required to download resources. The CDC does not use your login information for any other purpose.

5) Introducing the Enhanced KaiserEDU.org

KaiserEDU.org .... New Look, New Features, and New Tools

(www.kaiseredu.org)

Introducing the newly updated KaiserEDU.org website! It designed to give health policy students and faculty -- and others interested in the latest information on health policy issues -- easy access to data, literature, news and developments on major health policy topics and debates. The new site features new, easier topic navigation from the home page to provide you with direct access to background information and analysis on topics at the center of national health policy debates.

The following new tools are also available:

Research Tools -- Direct access to searchable databases, links to publicly available national surveys and data sources, and easy access to major government websites dealing with health policy. http://www.kaiseredu..org/research_index.asp

Journal Browser -- Links to the most recent table of contents of leading health policy journals and regular updates on new and noteworthy reports. http://www.kaiseredu.org/journal_index.asp

Policy Fellowships -- One-stop shopping directory of fellowships in health policy for undergraduates, graduate students, and professionals. http://www.kaiseredu.org/policy_index.asp

6) Secondhand Smoke Increases Heart Risks

Source: HealthDay [HealthScout]

Date: 2005-05-23

Author: Steven Reinberg HealthDay Reporter

A new study suggests that even small amounts of secondhand smoke can cause life-threatening changes to a nonsmokers' circulatory system.

And while the immediate effects of this exposure are reversed within a few hours, exposure to secondhand smoke over longer periods of time can have devastating consequences to the heart, including an increased risk for heart attack, researchers warn.

"Secondhand smoke is even worse than we thought," said co-researcher Stanton A. Glantz, a professor of medicine and longtime antismoking advocate at the University of California, San Francisco. "It increases the risk for an acute coronary event like a heart attack or long-term development of atherosclerosis," he added.

Chronic exposure to secondhand smoke is about 80 percent as deleterious to health as being a pack-a-day smoker, Glantz said. "The cardiovascular system is exquisitely sensitive to the toxins of secondhand cigarette smoke. Most of the toxic effects of secondhand smoke occur within five minutes of exposure," he noted.

In their study, Glantz and his colleague Dr. Joaquin Barnoya, an assistant adjunct professor of epidemiology at UCSF, reviewed the existing medical literature on the effects of secondhand smoke on the cardiovascular system. They looked at 29 studies published since 1995 that compared the effects of secondhand smoke with the effects of active smoking.

Glantz and Barnoya found there is sufficient evidence that key aspects of cardiovascular function, including clotting, the ability of blood vessels to change size, arterial stiffness, atherosclerosis, oxidative stress, inflammation, heart rate variability, energy metabolism, and severity of heart attack are all sensitive to toxins found in secondhand smoke.

7) NNTPP – Case Studies and Focus Group Summary Now Available

The National Network on Tobacco Prevention and Poverty announces the release of two case studies written in collaboration with two of our national Stakeholder organizations. Tobacco Policy, Cessation, and Education in Correctional Facilities Case Study highlights NNTPP’s collaboration with the National Commission on Correctional Health Care and a joint survey conducted among correctional facilities across the United States to examine tobacco use policies and cessation programming. Integrating Tobacco Control into The Salvation Army’s Substance Abuse Training Curriculum Case Study focuses on NNTPP’s collaboration with The Salvation Army. It describes our efforts to integrate nicotine addiction treatment into The Salvation Army’s alcohol and substance abuse treatment programs.

In addition, NNTPP also released a summary report of our focus group data collected in collaboration with West Virginia University-Prevention Research Center titled Smoking Habits and Prevention Strategies in Low Socio-economic Status Populations. The objectives of the focus groups were to review the social and cultural nuances that support/encourage smoking in low SES populations, identify communication channels most effective in reaching this population with tobacco cessation/prevention messages, and to tailor prevention messages to reach low SES adults.

Copies of the case studies and the focus group summary may be obtained by calling the Health Education Council, toll-free at 1(888) 442-2836 or emailing kbrown@healthedcouncil.org ..

8) Announcements

2005 Grant Opportunities Notebook

The notebook is a guide to this year's federal funding opportunities for faith-based and community organizations across the U.S. Department of Health and Human Services. Included in the notebook is information on approximately 40 grants in the following areas: Community Development, At-Risk Children and Youth, Senior, Health, and Substance Abuse and Mental Health programs. Also included is information on the Compassion Capital Fund, how to be a grant reviewer, how to make a Freedom of Information request, and web resources for organizations interested in federal funding.