Overview of Smokers Helpline and Youth Cessation in Newfoundland

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Niki Legge, BSW RSW BADirector of Cessation
Initiatives and Tobacco Control

• Overview of Smokers Helpline and Youth Cessation
  in Newfoundland Labrador

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Smokers Helpline

• SHL telephone-based counseling service which
  triages/refers callers to other cessation
  services within the community
• SHL is a Hub for cessation
• All calls welcome
• All Smokers (youth, adults, seniors)
• Family Members
• Students / Teachers
• Health Care Providers
• The Business Community
• The Community as a whole

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Our Programs

• Lung Association Offers
• Smokers Helpline 1-800-363-5864
• Counseling Individual / Group
• Training Workshops Facilitators, Counsellors,
  HPs
• Smokers Help On-line www.smokershelp.net
• (e-messages, e-counseling, message boards, self
  help)
• CARE Program (workplaces and Schools)
• Workplace Programs
• School / Community Presentations
• Corporate / Community Support
• Resource Centre

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We Offer Smokers

• Self-Help Materials - Quit kits, pamphlets,
  booklets, videos, NicA,
• Smokers Help-Online - www.smokershelp.net
• Chat rooms/message boards
• E-Quit Messages
• Private E-counseling shl_at_smokershelp.net
• Individual Counseling - By phone, internet,
  email, face to face
• Group Counseling - Workplace or community

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We Offer Non-Smokers

• Telephone support - How to help a love one,
  stats, community referrals,
• CARE Program - CARE kits / training, how to
  delivery brief interventions
• Training facilitators, counseling, how to
  delivery interventions, etc.
• Presentations - Schools, workplaces, communtiy,
  Youth adult
• Smokers Help-Online message boards for
  non-smokers and health care providers to share
  best practices. Private E-counseling
  shl_at_smokershelp.net
• Resource Materials- Quit kits for family/friends,
  workplace quit kits, Materials for schools and
  promotional items and prizes for communtiy
  groups.
• Smokers Helpline Tobacco Control Network
  E-Newsletter, updates.

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The CARE Program
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What is CARE?

• CARE Community Action Referral Effort
• Free, quick, easy way for
• health care providers/community leaders
• to refer patients/clients to the
• Smokers Helpline for
• help with tobacco addiction.
• Tool for community action
• The CARE program signifies that we as a
  community CARE about smokers and their health and
  are willing to work in collaboration to combat
  tobacco addiction.

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How CARE Works

• Ask if they have used tobacco products within the
  last six months.
• Advise tobacco cessation and ask if they would
  like to be referred to the Smokers Helpline for
  free support in quitting and/or staying
  tobacco-free.
• If the patient agrees, Refer them to the Helpline
  by completing the CARE Fax Referral Form.
• Fax the Referral Form to the Smokers Helpline at
  709-726-2550.
• If the patient disagrees, provide the Smokers
  Helpline toll-free number and website and
  encourage them to call when they are ready.

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CARE Referral FormWho can refer?Anyone!
...with client consent
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CARE Success

• CARE has highest quit rates
• 45 of family physicians refer
• 60-70 of SHL client-base fr. CARE
• NAQC promotes SHL as leader for Fax Referral
  Programs other Helplines in North America
  consult with SHL for best practices
• Received 2006 IABC Pinnacle Award for Excellence
  in Community Relations
• CARE will soon be available to all HP and
  community leaders and integrated into health care
  policy/practice
• CARE improves the reach of smokers

Quit Rates for clients who completed
intake between January, 2003 and
September, 2005 (Sample size 517)
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CAREs Success

• CARE has had a lot of success. But the three
  things I think we are most proud of
• CARE clients have more success in quitting
• More HCP/ Communtiy Leaders are actively getting
  involved in tobacco control (Brief intervention)
• Systematically reaching more smokers

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Supporting Youth to Be Tobacco Free
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Support Youth in Living Tobacco Free

• It takes a whole village to raise a child
  (African proverb)
• Many Partners Support Cessation and TRS Goals
• RIHA , ACT, Wellness Division, Wellness
  Coalitions, TFN, CTAC, Smokers Helpline, NLTA,
  School Councils, Schools Counselors Association,
  Parents, NGOs, Health Associations, Addictions
  Services, School Liaisons, Dept. of
• Health, Dept. of Education, community programs,
  local sports and recreation, Healthy Students
  Healthy Schools, etc,.

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Partner Support

• Other Partners
• Dept. of Education Curriculum
• Health Canada
• Other NGOs
• RIHA / Wellness Coalitions
• School Liaison position
• Healthy Commotion Day
• Health Associations
• ACT school kits
• ACT mass media campaigns
• SHL mass media
• Many, many, more Refer to SHL website for full
  cessation directory

• Cessation Programs
• Addictions Services
• Other Treatment Centers (Labrador)
• Kick the Nic Dept. of Health
• TROY TFN
• Youth Speak - CTAC
• Learning for Life Program
• Born a Non-Smoker
• Story of Smoke-free
• One Step at a Time CCS
• Toxic Tunnel Lab-Grenfell.
• Quit for Life
• DARE program

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What SHL Offers Youth

• School presentations / Health fairs
• Telephone Counseling
• Youth specific packages
• Youth protocols
• Website with Self-help
• E-Counseling
• E-Quit Messages
• Chat rooms for youth
• Wellness Contests
• Schools CARE Program

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Tailoring CARE for Schools

• Requests from schools for a tangible tool they
  could use to support youth in quitting.
• Teachers began using fax referral program.
• Program tailored for schools
• Two options
• fax with parental consent
• email without consent

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How Schools CARE Works

• Ask if the student uses tobacco
• Advise that they should quit and receive support
• Refer them to the Newfoundland and Labrador SHL
  by completing the referral form online at
  www.smokershelp.net
• Email Hit send! A SHL Counselor will email the
  student to set up counseling and referral
  services.

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PFD of Website page
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Pop up box Schools CARE Referral
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Youth Support

• UK has Youth Quitline
• NL in contact with UK around best practices

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Whats the Problem?
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Whats the Problem?
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Moving Forward

• Young people attempt to quit twice as much as
  adults, but have less success
• Good News . Theres a lot of interest to support
  youth, there are many services and supports
  available, and youth are attempting to quit early
  in life.

• Be innovative to engage youth and involve them in
  program development
• Schools/Community got to walk the talk
  (culture/green spaces)
• Support partners and foster community capacity
  building (tools, resources)

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Moving Forward

• Identify current gaps and solutions
• Tailor programs for youth
• Invest in evaluation
• Find systematic ways to reach youth
• Stay connected and networked to one another
• Comprehensive and integrated means involving the
  entire community to create change.
• Ask the question How can I get involved?

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Food for Thought

• How do we build capacity?
• How do we build motivation/buy-in
• How do we show the importance of the issue?
• How do we get involved?
• What impact will our actions have?

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Why Get Involved?

• Tobacco addiction is an epidemic
• 16 of youth 15-19 currently smoke
• 80 of young people who smoke 2 cigarettes or
  more go on to battle a lifetime of tobacco
  addiction
• Half of tobacco users will die from their
  addiction 1000 people in Newfoundland
  Labrador (equal to 2-3 small communities)
• Positive health implications and large impact of
  helping a young person quit early in life.

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Why Get Involved?

• Example from Health Missed Opportunity
• Smokers are 3X more likely to make a quit attempt
  if their health provider recommends it Very
  powerful!!
• Smokers are 3X more likely to connect with
  supports and programs when recommended
• 70 of smokers want to quit.
• 80 of smokers see HCP at least once a year
• Less than 50 reported being advised to quit
  lost opportunity.

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Whos Job is it?

• Consider these questions?
• Are health care providers the only ones
  responsible for addressing tobacco control and
  treatment?
• What other missed opportunities are there in
  reaching smokers and impacting change,
  particularly youth? (school, sports, at home,
  workplaces, etc.)
• What message do we send if we dont address
  tobacco use with young people
• How do I get involved?

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How Can I Get Involved?

• What level of involvement?
• Self-help, brief, moderate, intense
• Time commitment
• 20 sec poster, email SHL website
• 2 minutes - CARE referral
• 20 minutes - presentations, brief counseling
• few hours - group, health fairs, health challenge

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How Can I Get Involved?

• Area of interest
• Youth, young adults, at risk youth, youth within
  after school programs
• Need in your setting/community
• Accessible, realistic, low cost, tailored to youth

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Real Examples of Communtiy Action

• Rachel 14 years old called SHL in Sept. 2007
  received SHL pamphlet from teacher. She called
  us from school on recess break and is now
  enrolled in counseling services.
• Paul from Nain called SHL because his son
  brought home a ruler from school (ACT SHL, Dept.
  of Health, Teacher). Father enrolled in cessation
  services and successfully quit. Positive impact
  on youth.

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Examples of Action
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Real Examples of Communtiy Action

• Amendment to Smoke-Free Environment ACT
• Govt. said it was not a priority - 2003-2004
• Campaign Second Hand Smoke it Kills
• Campaign Shut the Last Door - Register your
  vote
• Letters of support from partners
• NLMA passed resolution
• MOHs and many partners wrote letters of support
• Polled public to identify level of support
• Brought Heather Crowe in May 2005
• Legislation brought into effect July 2005.
• Smoke free public places means reduced exposure
  to ETS and sends a strong message about the
  importance of being tobacco free and protecting
  the air we breathe.

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Final thoughts

• Cessation is part of a board comprehensive
  strategy for healthy province.
• Stop focusing on problem (smoking / smokers)
  focus on the solutions for a healthy community
• Everyone has a role to play in tobacco control -
  Consider what your role is
• How do we continue good work, build on our
  community partnerships and strengths, and reach
  more youth to assist them in living tobacco free
• Dont underestimate the impact of your efforts -
  We are making a difference!

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• We ourselves feel that what we are doing is just
  a drop in the ocean.
• But, the ocean would be less, because of that
  missing drop.
• -Mother Theresa

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Thank You For more information
Smokers' Helpline 1-800-363-5864 Smokers' Help
Online  www.smokershelp.net