Certified Tobacco Cessation Counselors – 11/30/05

Q: Does your state have people trained and certified as tobacco cessation counselors? In what capacity do they work (local health dept, WIC facilitates, etc.)? Are individual counseling sessions offered for patients/clients? Is it a single session or multiple sessions? How is this incorporated into other cessation programs and services offered statewide or locally? Do you have recommendations or lessons learned from using individual counseling sessions?

Partners: "Help Your Patients Quit Smoking"
 
Become a Tobacco Dependence Treatment Specialist
University of Medicine and Dentistry of New Jersey
School of Public Health, Tobacco Dependence Program
 
5-DAY TRAINING - 2006
February 6-10
April 3-7
June 12-16
September 25-29
 
The Tobacco Dependence Program of the University of Medicine and Dentistry of New Jersey, School of Public Health has been specializing in providing intensive training for Tobacco Dependence Treatment Specialists since 2000. Our 5-day curriculum prepares health care professionals to provide treatment for tobacco dependence. Participants gain an in-depth understanding of Tobacco Addiction as well as essential evidence-based treatment tools necessary to help their patient's achieve freedom from tobacco.
 
The nationally recognized faculty, brings a wealth of expertise in tobacco control, nicotine addiction, medical consequences of tobacco use, treatment of tobacco dependence, program development and evaluation, as well as treating special populations such as those with mental illness, other addictions or young people.
 
The training format allows for an interactive and comprehensive educational experience. This training is based on the US Public Health Service Guidelines for Treatment of Tobacco Use and Dependence. Participants will learn how to assess nicotine dependence, conduct treatment planning and deliver face-to-face treatment, including counseling and the use of medications. Participants can expect to leave the training competent to effectively treat patients for tobacco dependence with knowledge of the latest research-based medications and behavioral techniques and to provide other services that will help their organizations address tobacco use.
 
This nationwide training is offered four times per year and meets the necessary educational requirements as described in the Public Health Guidelines, ATTUD - the Association for Treatment of Tobacco Use and Dependence and to become a "Certified Tobacco Treatment Specialist" through The Certification Board, Inc.
 
To Register, check our website at: www.tobaccoprogram.org
Contact Joan Maurer for more information.

A:

1. Arkansas: In Arkansas, we established a Cessation Network, 10 sites around the State that provide group and individual cessation counseling. We contract for this service with the UAMS, College of Public Health. The COPH hires and trains the counselors.
    
2. Iowa: You can go through a one-day Freedom From Smoking training and receive a certificate, although my understanding is that it doesn’t carry much weight.
    
3. Micronesia: For Micronesia, we do not have any certified counselors.
    
4. Michigan: Michigan does not require training or certification for cessation counselors. From what we can tell, most cessation counselors in the state have been trained through the Lung Association, NAADAC, Mayo or an older American Cancer Society program. Quite a few counselors have designed their own programs either based on the above training or by researching other training programs. The number and types of counseling available is diverse and varied by county. Counselors here are most often associated with hospitals, local health departments, voluntary agencies or private health education consulting firms. Individual counseling is most frequently found at hospitals and local health departments. In hospitals, most individual counseling is offered to inpatients rather than outpatients. The local health departments that do individual counseling seem to have success with it. The downside is that they can find it time-consuming and more costly than groups. The upside is that the attendance rate is higher and the quit rate may be a little higher. Follow up and reminder phone calls to attendees increase attendance. We have not done formal evaluation of all the different programs, so it is difficult for us as the state, to be sure of the efficacy of each program.
    
5. New Hampshire: NH does not provide the service directly. There is one TPCP staff member who has taken the CTTS course on-line via UMASS-to increase capacity/understanding and the like. All of our cessation counseling is contracted out. We are looking at a "virtual call center" in other words trained staff may NOT be sitting together at the same address but may be dispersed throughout the state. FYI--keep HIPPA in mind as it has come up as a bit of an issue. Last year we did not fall into HIPPA but this year we might. It seems to be related to interpretation at the AG's office.
    
6. New Jersey: NJ has established a Quitcenter program throughout the State where smokers can make an appointment for an initial counseling session and can choose individual or group sessions. This program is in addition to the NJQuitline and the NJQuitnet to offer services from which the client can choose what is appropriate to them. The Quitcenter goal is to offer service when the client feels the need to stop smoking and to seize this critical moment. While we have funded as many as 17 centers at one time, due to budget restrictions, we are down to 5. Fortunately, some Quitcenters, although not State funded, have continued to offer the service.
    
   One requirement to become a Quitcenter is to have at least 2 Tobacco Dependance Treatment Specialists available. These Specialists must complete a 5 day training at the UMDNJ-SPH covering tobacco dependence treatment. While there is no specific State certification, this is being viewed on a State and national level. The certification issue is a critical issue in determining who will be paid by insurers, Medicare and Medicaid.
    
7. North Dakota: North Dakota has started to use certified tobacco cessation counselors. We have three or four so far and they work in local public health units and local hospitals/clinics. Some offer individual counseling, some provide group sessions. The number of sessions varies depending on the program. The certified counselors are cessation counselors that were already providing the service and have used this training to enhance and upgrade their skills. Our state is considering making this a requirement for our grantees that apply for funding for state and city county cessation programs.
    
8. Ohio: Foundation response: Starting next Monday, Ohio is conducting a one week course being delivered by Mayo Clinic which will result in Mayo certification to the ATTUD core competencies. We have 50 service providers registered for the course. Most of them come from cessation programs which our Foundation funds from all across Ohio and have been conducting tobacco cessation counseling for several years. This certification program will allow them to incorporate the state of the art techniques into their sessions. Our present programs are offered by a variety of types of providers, some are health departments, some are drug treatment programs, some are hospitals, some are faith based and some are by minority focused organizations such as the Urban League. We are in the midst of the difficult process of pulling them all together in an integrated form. Our goal is to have at least one counselor certified to ATTUD competencies in every cessation program in Ohio. Most of our programs now offer individual counseling, but most of the service is provided through group counseling.
    
9. Rhode Island: Rhode Island has trained certified tobacco treatment specialist. They take the certification through UMASS Behavioral Health Program. Most of our tobacco treatment specialists work in Health Centers, or outpatient mental health and substance abuse program. Rhode Island offers individual and or group counseling. Length of treatment is usually 8-10 weeks. We have 6 funded local tobacco treatment programs. Rhode Island smokers call 1-800-Try-To-Stop. They are screened by a tobacco treatment specialist and are offered telephone counseling, interactive website and or face-to-face counseling. Referrals for treatment are also promoted by our community based tobacco programs. We preferred to offer group counseling whenever possible. Group setting promotes more support and is more cost effective.
    
10. Vermont: In Vermont we run a program where we have a tobacco counselor in every hospital in our state. (N=14) They provide Fresh Start Classes and individual sessions. The average number of sessions a person receives in the program is 3. In some sort of combination of group or individual sessions. Being in hospitals they also talk to or provide cessation information at the bedside of every smoker that is admitted. They have, in this past year, began to do more and more outreach to businesses. They also do the medical screening and administration of our nicotine replacement coupon system.
     
    Vermont does not have any certification process for our counselors. We are in the process of developing one. It would be an ad hoc committee that would run the certification process, as it would take legislative action in Vermont to get tobacco cessation counselors to be recognized as a group. We are adpoting many of the componants of the UMass ATTUD program.
     
    Some Vermonters really like the "local touch" of this program, as opposed to speaking to someone via a quit line. They work that they can do inside a hospital and allows us to "recruit" patients and other smokers we might miss with an advertising campaign. The quit rates of this program rival that of our quit line. (I can provide more information about this if someone is interested.)
     
    However, this program is VERY expensive to run. Our budget for this program is more than double that of our Quit Line plus our media programming budget to drive calls to our Quit Line. If there is a state looking to develop a program like this, another lesson learned would be to make sure that they spend adequate time and money on a database system to record smoker information and be able to measure quit rates. We lost a lot of data in the beginning part of our program because we did not have a database that would allow us to describe adequately the population that we they were serving, and it took a lot of time and money to fix these errors.
     
11. Wyoming: I'm Rosi Davidson the only CTTS-M in Wyoming. We have 2-3 others who have been through UMASS training, but not certified. I'm currently working for the Dept of Corrections helping staff and offenders quit. I will be offering group and one-on-one sessions. If you have any questions, I'd be happy to correspond - rosi@johnsoncountycrc.org.

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