Division of Addiction Psychiatry - Newsroom
News Release - October 9, 2009 Smoking Cessation Program for Mental Health Patients Honored by American Psychiatric Association
New Brunswick, NJ -- The division of addiction psychiatry at UMDNJ-Robert Wood Johnson Medical School has championed efforts to reduce tobacco use among individuals with mental illness, a group estimated to consume nearly half of all cigarettes in the United States. Those efforts have received national recognition by the American Psychiatric Association (APA), which granted a Silver Achievement Award to the CHOICES program today at a ceremony in New York City.
CHOICES – Consumers Helping Others Improve Their Condition by Ending Smoking – employs peer counselors, called Consumer Tobacco Advocates (CTA), to promote smoking cessation in smokers with mental illness. The CTAs are nonsmokers or former smokers who are moderately impaired or disabled by mental illness. They receive 30 hours of intensive tobacco training and then reach out to their peers in mental health centers, psychiatric hospitals, group homes, and self-help centers. Their goal is not to provide treatment, but to assist and motivate their peers to address tobacco use by sharing their own experiences with quitting, providing educational materials, and linking their peers to treatment, referrals, advocacy and support for smoking cessation in New Jersey.
“Peers are less threatening than professionals,” said Jill Williams, MD, associate professor of psychiatry at Robert Wood Johnson Medical School and co-founder and medical director of the program. “CHOICES symbolizes empowerment and personal choice in recovery by utilizing peer counselors to deliver the vital message to smokers with mental illness that addressing tobacco use is important to their health and to motivate them to seek treatment.”
By presenting the Silver Award, the APA honored CHOICES’ unique peer-to-peer grass-roots approach to promoting tobacco cessation. In its October issue of Psychiatric Services journal, the APA noted, “The CHOICES program exemplifies many aspects of a successful wellness and recovery initiative. For example, it targets a group with a vital health care need; seeks to reduce tobacco’s harm in a vulnerable group; focuses its efforts in the community, which best accommodates the target population; employs peers to reduce educational and cultural barriers; and develops successful partnerships with key stakeholders for sustainability.”
According to Dr. Williams and co-founder Marie Verna, the program’s advocacy director and senior training and consultation specialist at UMDNJ-University Behavioral Healthcare’s Center for Excellence in Psychiatry, the CHOICES team has conducted more than 280 community visits, reaching more than 9,600 smokers with mental illness, since the program’s inception in 2005. The team also participates in consumer conferences and health-related fairs.
In an outcome study of the CHOICES program, consumers that had met individually with a peer counselor for personalized feedback about their smoking experienced a significant decrease in the number of cigarettes smoked each day and an increase in the number of quit attempts. Many study participants reported that after meeting with a CTA they had talked to their mental health provider about getting help with quitting smoking. Participants also reported that the CTAs were extremely knowledgeable about tobacco and interested in their smoking. Seventy percent of those surveyed said that talking to a peer about their smoking was much easier than talking to a mental health professional.
The CTAs also reported that their experience of working with CHOICES has helped them achieve greater recovery in their own mental illness. Each has gone on to achieve personal milestones including participating in publications, statewide and consumer conferences on wellness and recovery and/or have gone on to seek additional formal education.
CHOICES is based in the department of psychiatry at Robert Wood Johnson Medical School and partnered with the Mental Health Association of New Jersey, a consumer-driven mental health advocacy organization, and the New Jersey State Division of Mental Health Services, a primary source of funding for the program. CHOICES is listed as a best-practices resource in several national provider toolkits for the treatment of tobacco use in mental health settings, including those published by the Smoking Cessation Leadership and the Behavioral Health and Wellness Program of the University of Colorado in 2009. The CHOICES model is expanding beyond New Jersey to reach a larger audience of smokers. A multistate implementation of CHOICES is now underway on the West Coast.
More information on CHOICES, visit http://njchoices.org/.
 October 20, 2009
Heartbeats: Smoking cessation program draws national attention
Pop quiz: What group is estimated to consume nearly half of all
cigarettes in the United States? Go ahead, think about it. I'll wait.
Give up? ... Need more time?
The answer, according to research gathered by the American Psychiatric
Association, or APA, is mental health patients.
You might find that surprising, but the CHOICES program of the division
of addiction psychiatry at Robert Wood Johnson Medical School in New
Brunswick does not.
The program has conducted a lot of research in this area, and recently
was rewarded for its efforts by receiving national recognition from the
APA in the form of a Silver Achievement Award.
CHOICES, or Consumers Helping Others Improve Their Condition by Ending
Smoking, utilizes peer counselors to promote smoking cessation in
mentally ill patients.
The counselors, who receive 30 hours of intensive training, are
nonsmokers or former smokers who are moderately impaired or disabled by
mental illness. Their goal is not to provide treatment, but to assist
smoking patients who are in mental
health centers, psychiatric hospitals, group homes and self-help centers
by linking them to treatment, referrals, advocacy and support for
smoking cessation in Central Jersey.
"Peers are less threatening than professionals,'' said Dr. Jill
Williams, associate professor of psychiatry at the medical school and
co-founder and medical director of the program. "CHOICES symbolizes
empowerment and personal choice in
recovery by involving persons with mental illness talking with peers
with mental illness who smoke and who may have low motivation to address
their tobacco use.''
In presenting the Silver Award, the APA noted CHOICES' unique
peer-to-peer approach to promoting tobacco cessation.
In the October issue of its Psychiatric Services journal, the APA said,
"The CHOICES program exemplifies many aspects of a successful wellness
and recovery initiative. For example, it targets a group with a vital
health care need; seeks to reduce tobacco's harm in a vulnerable group;
focuses its efforts in the community, which best accommodates the target
population; employs peers to reduce educational and cultural barriers;
and develops successful partnerships with key stakeholders for
sustainability.''
The program has conducted more than 280 community visits and reached
more than 9,600 smokers with mental illness since the program's
inception in 2005. More information is available by visiting
http://njchoices.org <http://njchoices.org>
NEWS RELEASE
Date: January 8, 2009
UMDNJ Study Shows Menthol Cigarettes Are More Addictive
NEW BRUNSWICK – Menthol cigarettes are harder to quit, particularly among African American and Latino smokers, according to researchers at the University of Medicine and Dentistry of New Jersey (UMDNJ).
“Lower quit rates among African American and Latino menthol cigarette smokers at a tobacco treatment clinic” appears in next month's print edition of The International Journal of Clinical Practice. Journal subscribers may view it online now by visiting the following Wiley-Blackwell link: http://www3.interscience.wiley.com/cgi-bin/fulltext/121615913/HTMLSTART.
“We previously found that menthol cigarette smokers take in more nicotine and carbon monoxide per cigarette. This study shows that menthol smokers also find it harder to quit, despite smoking fewer cigarettes per day,” said study author Kunal Gandhi, MBBS, MPH, a researcher in the Division of Addiction Psychiatry at the UMDNJ-Robert Wood Johnson Medical School.
NEWS RELEASE
Date:February 5, 2008
UMDNJ-Robert Wood Johnson Medical School Physician
Advocates for Eliminating Tobacco Use in Mental Health Facilities
-- Commentary in Journal of American Medical Association --
New Brunswick, NJ – “The United States public mental health system must address the issue of tobacco use in psychiatric hospitals,” urges Jill Williams, MD, associate professor of psychiatry at UMDNJ-Robert Wood Johnson Medical School and at UMDNJ-School of Public Health, in the February 6 issue of the Journal of the American Medical Association. In the commentary, Dr. Williams implores mental health advocates to support a move toward tobacco-free hospital policies to create a healthy environment and improved behavioral outcomes for patients.
“Programs that treat behavioral health problems such as depression or schizophrenia are the only remaining sector of health care that fail to systematically help patients quit smoking,” Dr. Williams says.
In her commentary, Dr. Williams cites evidence of poor cardiovascular health and death in mental health patients that is on average 25 years earlier than the general population. In addition to improving the patient’s physical health, tobacco dependence treatment further supports a patient’s success toward full mental recovery. Dr. Williams emphasizes that mental health advocates must demand increased access to tobacco dependence treatment, to ensure that patients receive safe alternatives to nicotine withdrawal.
Other advantages of eliminating tobacco use are fewer behavioral problems and less violence. Dr. Williams recognizes that opposition to eliminating tobacco use may result from fear of additional behavioral concerns in patients. However, she notes evidence to the contrary, reporting that faculty and staff in tobacco-free facilities actually spend less time in the bartering and control of tobacco products, thereby reducing incidents of conflict and consequently, providing additional and more effective treatment time.
Dr. Williams also points to the additional stigma smoking causes mental health patients, who are already ostracized from general society due to their illnesses. “Stigma is a resonating issue as the mental health community collectively and individually strives for greater community acceptance and integrations of individuals with mental illnesses,” says Dr. Williams. “Advocacy that aims to protect smoking can further marginalize and stigmatize smokers with mental illness who are looking to succeed in securing housing and employment.”
Ultimately, eliminating tobacco use is in line with national trends that call for mental health care to be more oriented toward wellness and recovery. Dr. Williams concludes, “Patients with mental illnesses deserve the same protection from tobacco exposure that benefits the rest of the public.”
Dr. Williams, of Clinton, NJ, serves as the director of the division of Addiction Psychiatry and director of Mental Health Tobacco Services at the UMDNJ-Robert Wood Johnson Medical School. She also is affiliated with the UMDNJ-School of Public Health Tobacco Dependence Program in New Brunswick and a member of the Cancer Institute of New Jersey. She is a consultant to the New Jersey State Psychiatric Hospitals on Addressing Tobacco, which is funded by the New Jersey Division of Mental Health Services through UMDNJ-University Behavioral Healthcare.
Dr. Williams conducts research on smokers with serious mental illnesses including schizophrenia and bipolar disorder. Her research examines differences in nicotine intake, cigarette puffing and nicotine craving in individuals with schizophrenia in hopes that these discoveries will lead to better treatments in the future. She has received research funding from the National Institute of Drug Abuse (NIDA), the National Institute of Mental Health (NIMH) and the American Legacy Foundation.
Press Release
May 31, 2007
Contact: Terri Guess
Phone: (973) 972-5000
guesstp@umdnj.edu
UMDNJ Manual Designed to Help the Mentally Ill to be Distributed Nationally
Mental health professionals will use to help patients quit smoking
NEW BRUNSWICK — Mental health professionals treating nicotine addicted mental illness patients will now have access to a manual offering a special group treatment intervention approach to stem tobacco use and dependence. The University of Medicine and Dentistry of New Jersey is distributing nationally Learning About Healthy Living, a wellness publication funded by the New Jersey State Division of Mental Health Services.
to read more, click here
Mental Health America Honors CHOICES
ALEXANDRIA, Va. (June 11, 2007) — The CHOICES program was honored at the Closing Night Dinner of the Mental Health America Annual Meeting, Bringing Wellness Home, in Washington D.C. on June 9, 2007. CHOICES is a consumer-driven initiative that strives to meet the needs of smokers with mental illnesses by increasing awareness of the importance of addressing tobacco use and by creating a strong peer support network that encourages mental health consumers to make a positive healthy lifestyle change by addressing smoking and tobacco use. Through its peer-to-peer approach, CHOICES has reached more than 2,000 people.
“These award winners exemplify the exceptional energy, commitment, dedication and creativity necessary to fight against mental health stigma,” said David Shern, Ph.D., president and CEO of Mental Health America. “Our four honorees today have greatly improved the lives of countless Americans through their tireless efforts to improve our nation’s mental health.”
CHOICES Program is featured in Key Assistance Report
The National Mental Health Consumers' Self-Help Clearinghouse recently released a Key Assistance Report Focus on Smoking Cessation. This organization is an important source of information for people with mental illness and this is their first report on smoking cessation. The article features the CHOICES program (www.njchoices.org) was and an interview with CHOICES Consumer Tobacco Advocate, Wayne Holland.
Click here to read the entire article.
Program helping mentally ill smokers
BY JAMIE TALAN jamie.talan@newsday.com
(March 13, 2007) Joe learned to smoke at a psychiatric hospital in the 1980s, when the staff would hand out cigarettes to get patients to take their medicines, mop the floors or clean the dining room. The rewards added up, and pretty soon Joe was hooked - along with the more than 60 percent of people with psychiatric illnesses who smoke cigarettes.
"Nobody ever discussed smoking as part of the illness," said Joe, who asked that his last name not be used. He has taken part in an innovative program at Clubhouse of Suffolk Inc., a psychiatric rehabilitation and support agency in Ronkonkoma. Under a grant from the state Department of Health, Bernadette Cain, program director at Clubhouse, devised the smoking cessation program. So far, 66 people have participated, resulting in a 36 percent quit rate - better than rates established by programs for the general population.
Joe hasn't smoked in almost 17 months and has made his car and, more recently, his home into "smoke-free" environments. The cessation program includes nicotine replacements, self-help support groups as well as other health-improving interventions for exercise, stress reduction and adopting healthy habits.
About 20 percent of the U.S. population are smokers. The rate is three times that in people with psychiatric illnesses. Studies have shown that people with mental illness die 25 years earlier from cardiovascular diseases, emphysema and lung cancer. Traditionally, the care that many patients receive is centered on their emotional problems and not their medical ones.
"Smoking is thought to be very hard to control in patients with mental illness," said Dr. Jill Williams, director of the division of addiction psychiatry at the Robert Wood Johnson Medical School in New Jersey. "So no one really tries to help them."
Williams and Cain are trying to change that. With the promising results from the Clubhouse program, they have made a video and have received new state funding to put the anti-smoking intervention into community housing programs and in-patient psychiatric hospitals. They will be training people at Mercy Medical Center in Rockville Centre, Stony Brook University Hospital and Pederson-Krag Center in Huntington.
"We have shown that modifying existing programs to help mentally ill people stop smoking works," Cain said. "The truth is that they can stop and are motivated to stop when they have these tailored interventions in place."
"We need an intervention, but we also need to change the culture," said Cain, who is trying to get health professionals to stop giving clients cigarettes. "They need other ways to reward patients," she said. The program includes current nicotine replacements plus support groups and education tailored to the needs of the mentally ill.
Williams said that although most hospitals are smoke-free, "patients are not given treatments to help them quit."
Copyright (c) 2007, Newsday, Inc.
This article originally appeared at:
http://www.newsday.com/news/health/ny-hssmok135128132mar13,0,4529955.story?coll=ny-health-print
Visit Newsday online at http://www.newsday.com.
Substance Abuse Funding News Highlights CHOICES Program
NJ Program Tackles Tobacco Addiction, Mental Illness (June 29, 2007)New Jersey : A program helping people with mental illness quit smoking gets center stage at Mental Health America 's annual meeting in Washington , DC , this year.
The association has awarded New Jersey 's CHOICES (Consumers Helping Others Improve their Condition by Ending Smoking) its Innovation in Programming Award, recognizing the program's unique approach to treating the often co-occurring conditions.
CHOICES is innovative in its use of peer-to-peer outreach, the program's medical director Jill Williams tells SAF . Williams, director of Mental Health Tobacco Treatment Services, at the U. of Medicine & Dentistry of New Jersey , says she and advocacy director Marie Verna co-founded the program because they were frustrated by the lack of progress in educating mental health consumers about the importance of quitting smoking. Aware of the efficacy of peer encouragement in other areas, Williams says she realized this might be the right approach to smoking cessation, too.
The program uses mental health consumers—called Consumer Tobacco Advocates—to deliver the message. They visit mental health centers, self-help centers and health fairs to communicate with and educate other mental health consumers about their smoking. They provide peers with information about the consequences of smoking, issues regarding smoking and mental illness and options available to make quitting easier—and they offer resources about places in the state where smokers with mental illness can receive tobacco dependence treatment.
The program was created in 2005, with support from the American Legacy Foundation, U. of Medicine & Dentistry of New Jersey 's Robert Wood Johnson Medical School-Division of Addiction Psychiatry, the Mental Health Assn. in New Jersey and the State of New Jersey Mental Health Services.
Williams also has received a grant from the Nat'l Institute on Drug Abuse (NIDA)—the Career Development Award (K23): Nicotine Dependence Treatment in Psychiatric Comorbidity. Williams is focusing now on treatments to help people with schizophrenia quit smoking.
Info: CHOICES Program, 671 Hoes Lane , Piscataway , NJ 08854 ; 732/235-4873; or e-mail program director Martha Dwyer at dwyermh@umdnj.edu |
