Associate Director, Division of Addiction Psychiatry

Evidence-based Counseling Approaches for Treating Tobacco

Marc L. Steinberg, Ph.D.,

Associate Director, Division of Addiction Psychiatry

Rutgers Robert Wood Johnson Medical School

April 23, 2014; 3:00pm - 4:30pm EST

In this 90-minute webinar, Dr. Steinberg will discuss the following topics:

·  Engaging smokers in treatment

·  The five As

·  Quit dates and Quit date alternatives

·  Evidence supporting tobacco dependence counseling

Summary of the Webinar:

While smokers with mental illness are just as motivated to quit as are smokers without mental illness (Acton, 2001; Nahvi, 2006) smoking is still significantly more prevalent in this population (CDC, 2013), and smokers with mental illness are significantly less likely to quit (CDC, 2013).

Non-pharmacological interventions for tobacco dependence (e.g., counseling) are often overlooked despite the strong supporting evidence (Fiore et al., 2008; Hartmann-Boyce et al., 2012). Greater behavioral support or counseling increases the chance of quitting successfully by 9 to 24% as compared to just receiving medications alone or medications with little behavioral support.

Although designing better treatments for smokers to use is one way to increase quit rates, increasing the number of quit attempts in the population is another. Motivational interviewing consistent interventions may be useful for encouraging these smokers with behavioral health issues to attend tobacco dependence counseling.

Smokers who are motivated to quit will need to be taught how to prepare themselves for quitting. Traditionally, smokers are encouraged to choose a “quit date” on which they will stop smoking, and while this approach is empirically supported, there are other empirically supported approaches (e.g., scheduled reduction, flexible quit dates) that may be more palatable to our patients who smoke.

Acton GS, Prochaska JJ, Kaplan AS, Small T, Hall SM. Depression and stages of change for smoking in psychiatric outpatients.Addictive Behaviors. 2001; 26,621-31.

CDC. Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years with Mental Illness — United States, 2009–2011. MMWR. 2013;62(05):81-87.

Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

Hartmann-Boyce J, Stead LF, Cahill K, Lancaster T. Efficacy of interventions to combat tobacco addiction: Cochrane update of 2012 reviews. doi: 10.1111/add.12291

Nahvi S, Richter K, Li X, Modali L, Arnsten J. Cigarette smoking and interest in quitting in methadone maintenance patients. Addictive Behaviors. 2006;31(11):372-8.

The information from this webinar will be reviewed with opportunities for questions and discussion at a Technical Assistance webinar session on Thursday May 1, 2014 from 4:00pm – 5:00pm EST. Participants can get detailed input from faculty discussants at the technical assistance webinar session about case examples or about other counseling related issues they may be experiencing in their work.