Overview of the UTMB Commit to Quit

Tobacco Cessation Program
 

Commit to Quit Program Background and Purpose...

According to the Center for Disease Control and prevention (2005), smoking remains the number one cause of preventable death in the United States.  Currently 21% of Americans smoke and the Health People 2010 goal is to reduce that number to 12%.  To reach this goal, effective smoking cessation programs must be created and made available to all smokers who are ready to quit.  The purpose of the University of Texas Medical Branch Commit to Quit Program (CTQ) is to offer a tobacco cessation program to UTMB employees and Galveston community members to assist them in quitting.  The program is offered to both smokers and smokeless tobacco users.  The CTQ Program is coordinated by a Tobacco Treatment Specialist (TTS).  The program offers education on the physical, psychological, and behavioral aspects of the tobacco addiction and provides a tailored program for each tobacco user.

The University of Texas Medical Branch Commit to Quit program follows the U.S. Department of health and Human Services Public Health Service (PHS) clinical practice guidelines on the Treatment of Tobacco Use and Dependence (2000).  Specific strategies are grounded in the Relapse Prevention Model and guided by the American Cancer Society.  The 2000 PHS guidelines suggest that a combination of behavioral therapies in addition to pharmacotherapy seems to be the best treatment plan for successful smoking cessation.  According to the guidelines, increased contact time, number of sessions, types of clinicians, and multiple formats may increase rates of smoking cessation.  Strongest evidence for increased cessation was found in studies with person-to-person treatment delivered in four or more sessions, and there seems to be a dose-response relationship between the longer individual session length and successful outcomes.  The CTQ program offers 3 individual sessions (1-hour in length), follow-up telephone calls, and follow-up visits at 3-month, 6-month, and one-year post quit date.  The program emphasizes the importance of preparing to quit, and behavioral strategies to prevent relapse.  Information pharmacotherapy is provided, and clients are encouraged to involve their health care provider in pharmacotherapy decisions.  Cessation rates are acquired at quit date and each following month leading to the one-year mark.  Although cessation rates are received using self-report, carbon monoxide levels are tested at all sessions.

The Relapse Prevention Model (Marlatt & Gordon, 1980) suggests that factors such as identification of high risk situations and negative emotional states, coping skills training, stress management, identifying incompatible behaviors, exercise, identifying rationalizations, improving decision making, and seeking outside assistance as important aspects of addiction relapse prevention.  Therefore, the CTQ program equips clients with strategies that encourage the smoker to identify high-risk situations and develop appropriate solutions and coping skills in preparation to respond to situations which may trigger relapse and thus maintain cessation.  In addition, specific strategies encouraged by the American Cancer Society in helping tobacco users quit which are used by the CTQ program include: wrap sheets (preparing to quit), setting a quit date, reasons to quit list, immediate health benefits of quitting, and tips on coping with withdrawal symptoms.   

Wherever possible, the UTMB CTQ program strives to provide cessation services in following the techniques of Motivational Interviewing (Miller and Rollnick, 2004).  This style of client-centered counseling focuses on autonomy of the client, evocation, and collaboration.

Commit to Quit Individual Sessions:

Beginning in July 2004, the cost of the Commit to Quit program is $30.  The program consists of four private sessions, three lasting approximately 60 minutes, and 1 lasting approximately 30 minutes.  Follow-up calls are completed once a week until the one-month mark.  At the one-month mark calls are made each month until reaching the one-year mark.  Private follow-up sessions are provided at three-month, six-month, and one-year marks post quit date.  Exhaled carbon monoxide levels are tested at each session.

*UTMB employees participating in the Free Nicotine Patch Program receive cessation sessions free of charge.

Session 1 - Preparation to Quit (usually two weeks prior to quit date)

Session 2 – Follow-up to session 1.  This session usually lasts 30 minutes and consists of reviewing information from session 1 and discussing any individual needs prior to the quit date.

Session 3 - Quit Date (this session is held on the participant's quit date)

Follow-up Phone Calls often held periodically within the first few weeks of quitting.

Session 4 - Staying Quit Long-Term (usually two to three weeks after quit date)

CTQ Program Success Rate

Individuals attempting to quit smoking without assistance have a general success rate of 5% or less.  Between 1995 and 2002 participants in the CTQ program were seen in groups and the overall success rate was approximately 30% at the one-year mark.  Since 2003 participants have been seen in individual sessions and the program has maintained a quit rate between 20-30%.  Current success rate (2005) for UTMB’s Employee Free Nicotine Patch Program is 40% at the 6 month mark.

For more information on the Commit to Quit program,
please contact Annette Wallfisch or Gerald Cleveland @ 409-772-3689.

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