Monday, April 29, 2013

Strong Advocacy Effort Needed to Help Smokers with Mental Illness By Jill Williams, M.D., and Marie Verna

Reposted at http://www.tobaccodeathray.blogspot.com,


In February, the Centers for Disease Control and Prevention (CDC), in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA), issued a report about the rates of smoking among adults with some form of mental illness, Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years with Mental Illness — United States, 2009–2011. The report finds that 36 percent of adults with a mental illness are cigarette smokers, compared with only 21 percent of adults who do not have a mental illness. This translates to about 16 million smokers with mental illness in the United States today.

This report is historic for many reasons, but the most important is that it clearly reveals the lack of attention given to the needs of people managing mental illness by our health system. Now that we mental health advocates—both individuals with mental illness and those without—see these stark numbers, our response must be strong, focused and forceful.

Although the CDC routinely publishes reports on smoking rates among the general population, this analysis is the first to also include smoking rates among individuals with mental illness. For the last 50 years, an area of public health termed “Tobacco Control” has been effectively reducing smoking rates in the U.S. through policy, public education and regulation. Smokers with mental illness, however, have benefitted very little from these efforts and, even today, have very few opportunities to access services that could help them quit.

Based on the trends in the CDC report, smokers with mental illness could easily represent the majority of U.S. smokers in the near future. This has many serious implications for individuals with mental illness.

As smoking becomes less common, it will no longer be considered the community norm. We know that smokers often experience discrimination in housing, but for people with mental illness, who are already struggling to find jobs and housing, the challenge will be even greater. Not only do employers prefer to hire non-smokers, landlords prefer to rent to non-smokers due to lower damage and insurance costs. Programs that provide multi-unit, publicly funded housing, are already forming policies that prohibit smoking (not even in one’s own apartment) because second-hand smoke circulates through a building’s airways and poses a risk to all residents. Increasingly, landlords are discriminating against smokers for the simple reason that being a cigarette smoker has become a marker for individuals who have a mental illness or other substance use disorder, adding to the stigma of having a mental illness.

The financial implications are great as studies confirm that people in low-income brackets spend up to one-third of their monthly income on cigarettes. But the most important reason to think about addressing tobacco is that consumers who smoke have a 50 percent chance of dying from a tobacco-caused illness. This is at least 25 years before the average age of death among those who do not smoke. People who struggle to overcome the symptoms of a mental illness don’t deserve to die from tobacco use.

As advocates, we have many ways to address this problem, just as public health advocates had when they brought about change in the general population. But we’ll need to start by acknowledging that within the existing mental health system, unique barriers exist, and we’ll have to start by cleaning up our own house.

Professionals in the treatment community have been slow to change. Most behavioral health treatment programs (including both mental health and addictions) still do not offer routine access to tobacco treatment in their range of services. Many professionals are not up-to-date on advances that have been made in tobacco treatment, therefore, offer old fashioned, ineffective approaches.

State programs that offer free or low-cost treatments still target middle class community smokers who are able to quit with brief interventions. But smokers who have a mental illness often smoke more cigarettes per day and are more addicted than other community smokers, warranting a more intensive treatment approach. This means that, although most states invest significant dollars into tobacco control programs, they never see a return on that investment because they’re targeting the wrong people. The bottom line is that these programs in fact, may not benefit the smokers who need help the most.

Perhaps one of the biggest barriers is that smoking remains part of the culture in most mental health and residential facilities. In partial hospital programs, daily schedules take into account the needs of smokers. In inpatient programs, consumers are allowed outside only during smoke breaks. In housing programs, we expect people who want to quit to live side-by-side with people who smoke, a pack of cigarettes a day. In case management programs, we consider it our jobs to drive people to stores to buy cigarettes.

At the same time, mental health professional and family advocacy organizations have hesitated to demand tobacco treatments. Indeed, some have continued to lobby for exemptions to smoke-free air provisions for hospitals and other mental health treatment facilities.

Collectively, we, as advocates, have failed to raise this issue onto the national agenda. When we buy cigarettes for others, or remain silent because of our own ambivalence, we allow another generation of our loved ones to be lost to this deadly addiction. The same rules and standards we apply to other addictions should be applied to tobacco use whether in the hospital, the clinic or the home. We should feel the same outrage about the lack of services for smoking cessation as we feel about the lack of crisis, housing or employment services.

Community-based initiatives for addressing tobacco are a foundation of current CDC best practices and are critical in transforming the social norms around the way tobacco is promoted and used. Community tobacco coalitions help to build demand for services, strengthen advocacy, move treatment efforts forward and enhance the importance of the issue among administrators and key decision makers.

Creating strong coalitions by partnering with individuals and community agencies will facilitate more rapid systems change by making tobacco use in mental health systems less desirable, less acceptable and less accessible. The same strategies that have been effective in targeting tobacco in our communities need to be applied to our mental health system.

People living with mental illness, organizations advocating for those individuals, families, provider agencies federal, state and local government allies are all essential. Through an organized advocacy effort we can begin to undo the legacy of smoking and mental illness. This will require that we work together to disseminate education, develop local policy, garner resources and, most importantly, ensure that every smoker who has a mental illness can access evidence-based treatment to try to quit.

The CDC/SAMHSA report, while the first of its kind, cannot be the last word from us. As people who care deeply about the wellbeing of those among us who manage serious, life-changing mental illnesses, we must use the hard facts it reveals to fight the hard battle we face in changing our public health system and ourselves.

Jill Williams is a Professor of Psychiatry and Director of the Division of Addiction Psychiatry at UMDNJ-Robert Wood Johnson Medical School. Marie Verna is a Program Support Coordinator at UMDNJ-University Behavioral Health Care and MPAP Candidate at Rutgers University Bloustein School of Planning and Public Policy.

 

 

 

Targeting of Vulnerable Populations by Tobacco Industry

Originally posted on by eshorpanda, this article is an important one, so I have reposted it here at http://www.tobaccodeathray.blogspot.com,

Last week I went to a training by La Tanisha Wright, former trade marketing manager for Brown and Williamson Co (now a part of RJ Reynolds), currently a fierce anti-tobacco/tobacco control activist. This was some of the most interesting information that I have heard to date about how the tobacco corporations screw over marginalized communities because it was an inside perspective on all of those little things that are put in place to target our communities to become life long addicts. Let me extrapolate…

Let’s talk about language. Corporate tobacco knows we are watching them, so they have crafted a linguistic system to keep litigation and keen tobacco control activists always guessing what their intentions are. For example, corp-tobaco doesn’t want you to think that they target minors (cuz that’s ILLEGAL) so they use the language ASU 30 (adult smoker under 30…insert any age) and ASO 21 (adult smoke over 21). Now, this might not seem that deceptive to you, but there are distinct differences between the demographics of ASU 30 and ASO 30, and corp-tobacco incorporates marketing campaigns that appeal to MSU 18 (minor smoker under 18, an e.shor creation) into these campaigns. Check out this picture of the Kool MIXX campaign if you don’t believe me…


 
Another language lesson that La Tanisha taught me was about “focus” communities and “non-focus” communities. Instead of saying let’s target African American people or LGBTQ people or Native American and American Indian communities, now corp-tobacco says “focus” and “non-focus.” Focus is the term corp-tobacco literally uses to refer to “low socio-economic status communities with urban characteristics with high economic insecurity and risk of poverty, lower education, and less access to health insurance.” Corp-tobacco, RJ Reynolds and Lorillard (they have the biggest market share in focus communities) put more marketing in focus communities, provide more coupons in focus communities, and give more discounts of tobacco products in focus communities. So who are they targeting?
“We don’t smoke that shit, we just reserve the right to sell it to the young, the poor, the black, and the stupid.”
–as quoted in a New York Times editorial by Bob Hebert, 1993
The inspiring part of La Tanisha’s story is that she identified the ruthless and manipulative marketing ways of corp-tobacco through the branding of the Kool MIXX campaign (see pic above) and is now teaching tobacco control folks about how the company she worked for silenced her, silenced her community, and has sneakily coerced millions of people into becoming slaves to their poisonous products. La Tanisha painted an earnest history of African American people emerging from slavery in the tobacco fields to the slavery of addiction of corp-tobacco due to the intensive marketing in African American communities. This is not an accident. Corp-tobacco knows your history and they will use your pain and weaknesses to make you believe whatever you want…as long as you use their products.

I have so much more to say here, but I understand the attention span of most readers is longer than mine and I am…mmmmm pretty colors.

Whoa…I’m back.

I know this blog is about LGBTQ tobacco control, but unfortunately, one of the things I am learning on my journey in this field is that LGBTQ folks are targeted by corporate tobacco alongside the African American communities, Native communities, Latino communities, Southeast Asian communities, people in poverty, homeless people, and so many others. In my work, I need to constantly acknowledge that we are all working in solidarity with one another.
Hope you have a wonderful holiday time,
e.shor

Monday, April 22, 2013

IHA Health Literacy Conference Features Alliance to Reduce Disparities in Diabetes Leaders

Reposted at http://www.tobaccodeathray.blogspot.com,
The Institute for Healthcare Advancement will hold its12th Annual Health Literacy Conference May 8-10 in Irvine, California and Alliance program leaders from Chicago, Dallas and Memphis as well as the Alliance’s program evaluator RTI International will participate.
Click here to register and use the discount code ARDD13to receive a $50 discount on the registration cost.
See below for highlights of the Chicago and Dallas poster presentations. Make sure to visit the Alliance’s Twitter and Facebook pages for more information and to share your thoughts. Stay tuned for our next E-Blast that will feature the presentations from the Memphis program and RTI International.
Dallas Program Addresses Health Literacy Outside the Doctor's Office With Community Health Workers (CHWs)   The Alliance’s Dallas program, the Diabetes Equity Project (DEP), aims to reduce disparities in diabetes care and diabetes outcomes in the largely Hispanic, medically underserved communities surrounding Baylor Health Care System hospitals. CHWs work to extend the patient-provider relationship and increase access to health services and education. Initial program results show that DEP patients had significantly higher scores on the Perceived Competence Scale in Diabetes (PCSD) one year post-baseline. The high rates of success in the program indicate that the use of CHWs to coordinate care and provide diabetes education to underserved populations could be an effective model for use with similar populations in other cities.
Read Dallas’ IHA abstract submission here for more information on the use of CHWs to improve health outcomes in underserved populations.

Chicago Program to Present Poster at IHA on Benefits of Combining Tailored Education and Shared Decision-Making  Leaders from the Chicago program have teamed up with local community health centers and community partners to empower patients to better manage their diabetes. The intervention addresses two well-known barriers facing racial/ethnic populations and those from lower socioeconomic backgrounds: limited health literacy and lack of cultural tailoring of programs. The program consists of 10-sessions co-taught by nurses, diabetes educators and dieticians, and program participants showed improvements in diabetes self management skills and clinical measures.

Read the IHA abstract submission here for more information on the Diabetes Empowerment Program.
About the Alliance to Reduce Disparities in Diabetes The Alliance to Reduce Disparities in Diabetes, a national program launched and supported by the Merck Foundation, works to improve health care delivery among those populations most at risk for diabetes – African-American, Hispanic/Latino and Native American adults. The five health care delivery sites that comprise the Alliance to Reduce Disparities in Diabetes have implemented multifaceted evidence-based approaches designed to eliminate gaps produced by inequity and lack of targeted attention to those adults and their families who are most likely to be severely burdened by diabetes.
The Center for Managing Chronic Disease | University of Michigan  1415 Washington Heights | Ann Arbor, Michigan 48109 | 734-763-1457
 

Get Set! National Minority Mental Health Awareness Month 2013 is Just around the Corner


This July, organizations across the country will be taking part in this year's celebration. We come together this time of year in recognition of National Minority Mental Health Awareness Month to keep building awareness of the importance of mental health and supports in every community. Don't be left out. To help you get ready to take part, the National Alliance on Mental Illness (NAMI) and the National Network to Eliminate Disparities in Behavioral Health (NNED) are organizing a series of planning webinars. These webinars are designed to help interested individuals and organizations big and small plan a variety of community events.

 

Please mark your calendar with the following dates and watch for updates to come:
History and Highlights: Learn about National Minority Mental Health Awareness Month
Wednesday, April 24, 2013 1:00 PM - 2:00 PM EDT
Learn about how Bebe Moore Campbell, loving mother, NAMI member and respected author, inspired this special month to increase public awareness of mental health among minority communities and increase access to services and support. Now what can you do? The session will provide an overview of available resources to help you plan your own event and celebrate the month.
Presenters:
·         Dr. Linda Wharton Boyd, Special Assistant, DC Department of Health -- Was a personal friend of the late Bebe Moore Campbell and played an active role in the dedication of NMMHAM in Campbell’s honor.
·         Elicia Goodsoldier, NAMI Colorado Board of Directors -- Recipient of the 2012 Boulder County Multicultural Award.

 

Are You Ready? Planning and Preparing for National Minority Mental Health Awareness Month
Wednesday, May 15, 2013 1:00 PM - 2:00 PM EDT
Already have an idea or plan for July? Share it! You may find some new ideas too. This webinar will provide customizable resources and concrete examples of activities from previous years. Whether you plan to recognize this month personally or with a group, this webinar will equip you with the tools and suggestions for a successful endeavor.
Presenter:
·         Cecily Rodriguez, VA Department of Behavioral Health

 

Our Strength and Support: Celebrating National Minority Mental Health Awareness Month
Wednesday, July 17, 2013 1:00 PM - 2:00 PM EDT
A panel of inspiring presenters will share their perspectives on mental health in minority communities, emphasizing the strengths of our cultural communities to come together to find support and carry a banner of hope for all individuals touched by mental illness.
Presenters:
·         Bassey Ikpi, The Siwe Project
·         Ramey Ko,Partner at Jung Ko, PLLC; Associate Judge at Austin Municipal Court

Wednesday, April 17, 2013

Upcoming Tobacco Trainings


Apr 29-30          Tampa, FL                    FSU CTTS Re-Certification   (www.med.fsu.edu/healthaffairs/ahec)

Mar 13-16         Boston, MA                   SRNT annual mtg (www.srnt.org)

Mar 18-21         Worcester, MA             UMass TTS training (www.umassmed.edu/tobacco)

Mar 20-23         San Francisco              Soc Behav Medicine annual mtg (www.sbm.org)

May 17             Worcester, MA              Applying Stress Reduction to Tob Tx (www.umassmed.edu/tobacco/training)

May 20-21        Rochester, MN             Nicotine Dep. Ctr. Annual Conf. (http://ndc.mayo.edu)

May 22             Rochester, MN             Nicotine Dep. Ctr. Annual Post-Conf. Workshop (http://ndc.mayo.edu)

May 27-31        Toronto                         Training Applied Cessation Counselling Program:  www.teachproject.ca

June  3-7           Rochester, MN            TTS Training (http://ndc.mayo.edu)

June 15-20       San Diego                     College Probl Drug Dependence (www.cpdd.vcu.edu)

June 27-28       London, UK                   UK Ntl Smoking Cessation Conf (www.uknscc.org)

Sept 9-16          Anchorage, AK             ANTHC TTS training (www.anthc.org/chs/wp/tobacco/tts.cfm)

Sept 16-19        Worcester, MA             UMass TTS training (www.umassmed.edu/tobacco)

Sept 16-20        Rochester, MN             TTS Training (http://ndc.mayo.edu)Se

Sept 20             Fairlee, VT                    Koop Tobacco Tx Conf (www.ccehs.dartmouth~hitchcock.org)

Oct 7-11           New Brunswick, NJ      CTTS Training (www.tobaccoprogram.org)

Oct 14-18         Jackson, MS                2-Day TTS Update Training (www.act2quit.org/education/)

Oct 26-31         Chicago, IL                   Am College Chest MDs (www.chestnet.org

Nov. 4-8           Rochester, MN             TTS Training (http://ndc.mayo.edu)
 
Provided by ActionToQuit. Reposted at http://www.tobaccodeathray.blogspot.com,

Excellent Archived Webinar

" Helping Smokers With Behavioral Health Comorbidity Requires a National Effort"
Presented by Jill M. Williams, M.D., Professor of Psychiatry and Director
Division of Addiction Psychiatry
University of Medicine and Dentistry of New Jersey,  Robert Wood Johnson Medical School

Originally posted Tuesday, April 16, 2013, 10:00 a.m. – Noon
Building 45 (Natcher), Balcony C, NIH Campus | Bethesda, Maryland

Resources: Live and archived videocast will be available at videocast.nih.gov.

Cosponsored by U.S. Department of Health and Human Services  Working Group on Tobacco Control and Behavioral Health

About the Seminar
Dr. Williams will be speaking about the fact that although public health interventions have led to lower smoking rates in the United States over the last 40 years, smokers with mental illness or an addiction other than smoking have benefited less from these efforts. At this time, little is being done nationally at the mental health or public health systems level to promote smoking cessation in this population. Moreover, she will talk about how little is known about smokers with mental illness or an addictive behavior because of the lack of critical information on their tobacco use patterns and trends, as well as on the effects of tobacco control measures such as excise taxes, advertising, or clean indoor air laws on this population. Dr. Williams will discuss how smokers with behavioral health comorbidity are not listed as a disparity group or priority population by most national public health or tobacco control groups, although they fulfill the criteria commonly used to designate other groups (e.g., targeted marketing by the tobacco industry, greater smoking prevalence rates, increased economic and health burden from tobacco, less access to treatment services, and longer durations of smoking with less cessation). Designating them a priority group will bring much needed attention and resources. The disparity between smoking rates in the behavioral health population compared with the general population will worsen over time if their needs remain unaddressed.

Posted at http://www.tobaccodeathray.blogspot.com,

Free Tobacco Education Webinar

SAVE THE DATE!

May 9, 2013 2 p.m. webinar on tobacco and the unique needs of Individuals who Experience Mental Illness.
Co-sponsored by Mental Health America of Licking County and Society of Public Health Educators.
More information to come.

Posted at http://www.tobaccodeathray.blogspot.com,

Cigarette Butts Are Toxic Waste

We know that cigarettes are the number one cause of preventable death in the United States and around the world. Here’s a fact that isn’t as well-known: Cigarettes are also the number one littered item on U.S. roadways and on beaches and in waterways worldwide.

In advance of Earth Day later this month, Legacy and the Leave No Trace Center for Outdoor Ethics have launched a new set of TV and radio Public Service Announcements (PSAs) to raise awareness and spur action about this form of toxic trash.

The campaign urges smokers and nonsmokers alike to “Rethink Butts” and consider the harm they cause to the environment. According to Legacy, “The dangers from smoking don’t stop once a cigarette is stubbed out. Cigarette butts leach toxic chemicals and carcinogens that pollute the environment. They’re poisonous to wildlife and can contaminate water sources.”

A story in The New York Times highlights the new campaign and the environmental harm caused by cigarettes, noting that more than one million cigarette butts were removed from U.S. beaches in 2011 as part of an annual coastal cleanup. Watch the PSA and learn more about the campaign at http://rethinkbutts.org/

Reposted at http://www.tobaccodeathray.blogspot.com,

E-Cigarrettes

Insight from a smoker about e-cigerettes and marketing at this youtube posting from on-line smoking reviewer. Reposted at http://www.tobaccodeathray.blogspot.com,

http://www.tobaccofreekids.org/tobacco_unfiltered/post/2013_04_09_legacy

Notice the happy flavors and packaging, as well as the agressiveness of the company to market to ionline reviews.

Native Network Webinars Offered

Reposted at http://www.tobaccodeathray.blogspot.com, From Break Free Alliance

Engaging Tribes to Raise Tobacco Taxes

Learning Objectives:  


• Participants will be able to identify and apply at least one method engage tribal communities to raise tribal tobacco taxes.
• Participants will be able to differentiate between state and tribal tobacco taxes.

Speaker: 

Vanessa Tibbitts, Oglala Lakota, is the Program Manager for the Northern Plains Tribal Tobacco Technical Assistance Center at the Great Plains Tribal Chairmen’s Health Board. She provides assistance to tobacco control activities with tribes in the Northern Plains region.  Vanessa serves American Indians using the skills she has acquired professionally, academically, and through her elders for the future of her people. 

 Tuesday, April 23, 2013 from 3:00 - 4:00 PM ET


Space is limited. After registering you will receive a confirmation email containing information about joining the Webinar.

 


 Global Bridges - Going Mobile: The Potential of mHealth for Tobacco Dependence Treatment

 
Erik Augustson, Ph.D., MPH, the program director of the Tobacco Control Research Branch of the National Cancer Institute, will discuss the use of mHealth for health behavior interventions, particularly in tobacco dependence. mHealth has been defined as “health-related services delivered by mobile communication devices,” which can be in the form of SMS messaging, smartphone applications, or the mobile web.  The webinar will focus on text message-based interventions, such as NCI’s SmokefreeTXT, and the opportunity to implement such interventions at an international level.

Tuesday, April 23, 2013 from 1:00 – 2:00 pm ET


 



Tobacco Control Network Webinar - An Introduction to E-Cigarettes for States and Locals

This webinar is a collaboration between The National Association of Local Boards of Health and the Tobacco Control Network. It will feature speakers from the Tobacco Control Legal Consortium, Legacy, Americans for Nonsmokers' Rights, California Attorney General’s Office, and Tacoma-Pierce County Health Department, WA.

Participants will be able to:

Describe e-cigarettes and other electronic nicotine delivery devices that are currently on the market.
  • Evaluate policy options for regulating e-cigarettes at the state and local levels.
  • Describe regulatory actions state and local governments can take to protect the public’s health from the potential hazards of e-cigarettes
Monday, April 29, 2013 from 3:00 – 4:30 pm ET


 
American Academy of Pediatrics Webinar - Smokescreens and the Silver Screen: Smoking in the Media

 The webinar will focus on the influence of smoking imagery on children and evidence for smoking initiation. Different types of media will be covered, as well as strategies to discuss the impact of smoking imagery with children, adolescents, and families in a pediatric clinical setting. Featured presenters include Jim Sargent, MD, FAAP of the Geisel School of Medicine at Dartmouth and Jennifer Shu, MD, FAAP, of the Children's Medical Group in Atlanta. This webinar is approved for a maximum of 1.50 AMA PRA Category 1 Credit(s)™. Can't make the live webinar? No problem- the archived webinar will also be offered for a maximum of 1.50 AMA PRA Category 1 Credit(s)™ through the AAP Richmond Center Web site. Contact richmondcenter@aap.org with any questions.

 Monday, May 13, 2013 from 2:00 - 3:30pm ET

 
REGISTER HERE