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Nicotine Dependence Treatment Programs

Smoking is the leading cause of preventable mortality in the United States today. Approximately 400,000 deaths annually are attributed to smoking-related diseases such as lung cancer, emphysema and coronary artery disease.

As a medical professional, helping patients stop smoking is one of the most important things you can do. But it is not easy. Nicotine is a powerfully addicting drug and people dependent on it cannot easily stop using it.

The Center for Health Behavior Research (CHBR) can be a helpful resource to you in this important intervention. The CHBR builds upon our experience in West Virginia as a leader in the development of smoking cessation programs since 1990. Research has shown that the chances of stopping smoking are increased considerably with formal treatment programs.

VARIETY OF PROGRAMS
The CHBR offers a variety of programs to help people begin their recovery from dependence on nicotine:

• individual programs
• group programs

RESEARCH TO IMPROVE TREATMENT
Phase III clinical trials are conducted with tobacco users-usually to evaluate the safety and efficacy of a new product or method. Each study is designed to answer scientific questions and to discover new and better methods of helping tobacco users. The products and methods tested are awaiting approval by the US Food and Drug Administration (FDA) for marketing in this country. However, frequently The CHBR will work with and FDA approved product or method for new application (Phase IV).

Although clinical trials occur frequently, they are not ongoing. In order to participate, individuals must meet specific inclusion and exclusion criteria. While clinical trials are not for everyone, The CHBR offers "pay for service" nicotine dependence groups on an ongoing basis.

The CHBR staff conduct extensive research to refine and improve treatment approaches. Among areas of investigation are:

• use of new agents for relief of withdrawal symptoms
• devices to validate self report

EXPERIENCE AND RESULTS
We have treated more than 6,000 patients since 1990. The one-year, verified, stop rate for patients ranges from 23 to 37%, depending on the program-comparable to the best results being reported.

SUPPORT FOR PROFESSIONALS
The CHBR is committed to supporting professionals in your efforts to help people stop smoking. Prompt access is available for consultations or appointments. For information, consultation or referral, contact Jessica Rath, PhD, CHES at the CHBR: (301) 405-1028 or jrath@umd.edu.

INDIVIDUAL PROGRAMS
This is the starting point for all patients. The first step is a self assessment questionnaire to gather information on the patient's smoking history, personal situation and motivation to stop smoking.

This is followed by a thorough interview and assessment by a counselor of the patient's medical history; degree of nicotine dependence; stage of readiness for abstinence; and individual strengths and weaknesses that will affect the cessation effort.

The final step is development of a treatment plan and setting a stop date. The counselor will discuss treatment options and may refer the patient to other resources at The University of Maryland or in the patient's own community.

INDIVIDUAL COUNSELING
Individual counseling sessions can be arranged allowing patients to "customize" a program to meet their needs for support and assistance.

SELF-HELP PROGRAMS
A variety of self-help programs can be recommended for patients unable or unwilling to join formal programs.

Start SMART™ (Six-Session Program)
Start SMART™ is a "pay for service" program developed by Penny N. Glover and Elbert D. Glover, which is independent of clinical trials. The program consists of six weekly visits, following an initial screening visit. Each visit, lasting approximately one hour, provides the individual an opportunity to share experiences about stopping tobacco use, receive educational information regarding nicotine dependence, participate in exercises designed to provide a better understanding of nicotine dependence, and receive proper instruction regarding intervention techniques all in a group setting. Moreover, at each visit, vital statistics are monitored (i.e. blood pressure, pulse, weight, etc.). In addition, some insurance providers now cover the cost of the Start SMART™ program.

Patients attend a weekly, one hour group session led by a counselor devoted to helping patients understand critical issues related to stopping smoking. Topics include:

• medical aspects of smoking
• coping skills (featuring a panel of ex-smokers)
• chemical dependency issues
• stress management
• diet and exercise
• relapse prevention

MAINTENANCE GROUP
Weekly group sessions are available for patients who have completed individual or group therapy programs. Sessions are completed individual or group therapy programs. Sessions are led by a counselor. Content focuses on issues related to maintaining a smoke-free lifestyle. Attendance can vary depending on individual needs.

RELAPSE PREVENTION
Every patient who enrolls in Start SMART™ receives a full year of follow-up in an effort to sustain the patient's smoke-free status. This consists of regular phone calls to track the patients progress and offer advice and encouragement.

The National Cancer Institute has published an excellent manual for physicians entitled How to Help Your Patients Stop Smoking. Its key recommendations are:

• Ask about smoking at every opportunity.
• Advise all smokers to stop.
• Assess the patient's readiness to quit.
• Assist the patient in stopping.
• Arrange follow-up visits.

• Personalize the risk to smokers of continued use.
• Provide and monitor pharmacologic therapy for nicotine withdrawal symptoms.
• Patient referral to counseling services to increase their chance of success.

Please call The CHBR for information, consultation or referral.

THE CENTER FOR HEALTH BEHAVIOR RESEARCH
DEPARTMENT OF PUBLIC AND COMMUNITY HEALTH
2387 HHP BUILDING, RM. #2387
THE UNIVERSITY OF MARYLAND
COLLEGE PARK, MD 20742-2611
301-405-1028

COMMUNITY OUTREACH
The health and economic benefits of the treatment of nicotine dependence has been well demonstrated in the literature. Therefore, the treatment of nicotine dependence has become one of the primary goals of health care in business and industry. The Center for Health Behavior Research offers comprehensive treatment of nicotine dependence to institutional and work-site locations; providing consultation and assistance with implementation of these programs in coordination with on-site health care providers.

WORKPLACE COUNSELING SERVICES
The CHBR is equipped to offer Start SMART™ in the workplace. The program and all of its components can easily be conducted in your workplace increasing employee attendance and compliance.

CONTRACTED EAP & HMO SERVICES
The CHBR is able to provide Start SMART™ to employees or members of provider services at a discount rate.

FACILITATOR TRAINING
Individuals are encouraged to become certified facilitators by attending a one-day workshop teaching key elements of the program-counseling pharmacotherapy, and follow-up.

Center for Health Behavior Research Department of Public and Community Health 2387 HHP Building, Room #2387 University of Maryland, College Park, MD 20742-2611 Phone: 301-405-0128 Fax: 301-314-5835 Contact us with questions, feedback, and comments.