Mental Health Professionals
All providers of mental health services are in a unique position to provide tobacco cessation interventions due to expertise in behavior change and interpersonal counseling.
Psychologists and other Mental Health Care Providers are in a unique position to provide tobacco cessation interventions due to expertise in behavior change and interpersonal counseling.
This is particularly true for professionals working with individuals who have been diagnosed with severe mental illness (SMI). Approximately 80% of individuals with SMI are also dependent on nicotine. Therefore, providers are continuously in contact with individuals who may benefit from such intervention. Although it may be necessary to focus on treating SMI in therapeutic sessions, opportunities for brief (or even prolonged) interventions for tobacco cessation are likely to emerge.
Treating Tobacco Use and Dependence (TTUD)1, a clinical practice guideline, was published to assist clinicians in implementing effective treatments for cessation. This guideline recommends that all clinicians should have a systematic routine for identifying smokers. There are five steps involved in providing a minimal intervention, called the "5 As": Ask, Advise, Assess, Assist, and Arrange.
Despite the introduction of this resource, research has found that the recommendations have not been widely implemented by psychologists.
- A Kentucky study found that although psychologists in that state believed that tobacco use and cessation were important to address in treatment, few report active participation in helping clients quit and only one of three knew about the TTUD.2
- Of 143 psychologists surveyed in Oklahoma, 83.9% reported an absence of training in the assessment or treatment of tobacco use and only 14.7% knew of the TTUD.3
- In a study done by Miller and Brandon (2004), less than one in three of 256 psychologists reported asking all of their clients about smoking; thus, smokers who could potentially benefit from treatment remain unidentified and missed the opportunity to receive cessation help.4
Resources
The Smoking Cessation Leadership Center, a national program office of the Robert Wood Johnson Foundation, provides some resources to help you promote the use of smoking cessation interventions among colleagues.
Recommendations
From Miller & Brandon (2004)4
- Expand psychologist training on
- The costs of tobacco use
- The co-occurrence of tobacco use and other mental health & substance use disorders
- The effectiveness of intervention
- The use of five As interventions
Fax to Assist
See Fax to Assist for more information on our Fax Referral Program.
References:
1 Fiore, M.C., Bailey, W.C., Cohen, S.J., Dorfman, S.F., Goldstein, M.G., Gritz, E.R., et al. (2000). Treating tobacco use and dependence—Clinical practice guideline. Rockville, MD: U.S. Department of Health and Human Services, Public Health Services.
2 Miller, B.F., Lotz, C.S., Worth, C.T., Sorelll, C.L., & J.L. Studts. Knowledge, attitudes, and clinical practices involving tobacco cessation among Kentucky psychologists. Poster presented at the 2004 International Scientific Conference of The International Society for the
Prevention of Tobacco Induced Diseases.
3 Leffingwell, T.R., & Babitzke, A.C. (2006). Tobacco intervention practices of licensed psychologists. Journal of Clinical Psychology, 62, 313-323.
4 Phillips, K.M., & Brandon, T.H. (2004). Do psychologists adhere to the clinical practice guidelines for tobacco cessation? A survey of practitioners. Professional Psychology: Research and Practice, 35(3), 281-285.
Other Resources:
Jarvis, M.J. (2004). Why people smoke. British Medical Journal, 328, 277-279.
