MAY/JUNE 2007
Volume 13 - No. 2
Oceania Tobacco Control Meeting
14th World Conference on Tobacco or Health
SRNT Newsletter
May/June 2007, Volume 13, Number 2
The ACT Center For Tobacco Treatment, Education, & Research
The ACT Center opened its doors for business in 1999, funded
by Mississippi's Master Settlement Agreement. Thomas
Payne and Karen Crews jointly developed the Center's vision and structure,
and have provided ongoing leadership to facilitate the growth of our
treatment, education, and research programs.
Initially, the ACT Center strived to serve those residing in the Jackson greater metropolitan area. This was based on two complementary approaches. First, we facilitated the treatment of tobacco users via training of primary care providers in brief treatment approaches. Second, we established our intensive, CBT-based outpatient program, an extension of the clinical program developed and implemented by TJP over the previous 15 years. During the first 2-3 years, we watched our intakes grow from 25 per month to over 100. As our catchment area grew, we actually began receiving complaints about the availability of treatment solely in Jackson (central Mississippi). To address this concern, in 2003 we devised a plan to render services available on a statewide basis. Twelve locations were selected, based on population density, geographic location, ethnic factors, and presence of appropriate healthcare facilities to base operations. At each site, we required two individuals with appropriate backgrounds be identified from current staff to conduct this program 1-2 days per week. For each institution's provision of staff, space, and administrative support, we provided Tobacco Treatment Specialist training, all program materials, an administrative fee for salary support, and medications. We also arranged for routine data collection (with IRB approval and contractual agreements) by providing touch-screen laptops loaded with our custom-designed software for conducting and uploading assessments to our secure web-based server. This has proven to be an effective approach, as highlighted by significant community demand for services. Across all sites, over 9500 intake evaluations and 40,000 clinic visits have been logged, with 6-month outcomes of 34% (intent-to-treat) and 44% (treatment completer). Our staff's efforts have been acknowledged via the receipt of two program awards for contributions to reduce chronic disease and cancer burden. Our treatment program has proven to be cost-effective as well, at $420 per treated individual, and less than $600 for those receiving extended treatment (e.g., combination pharmacotherapy, additional sessions).
Education is a second key area of Center activity. We have provided numerous local and national presentations, and hosted a national conference on tobacco-related scientific and clinical advances. Two core programs currently comprise the thrust of our training efforts. The first is our Certified Tobacco Treatment Specialist workshop. This 4-day training event addresses a broad range of philosophical, clinical, and administrative considerations central to establishing and delivering high intensity services. Importantly, we train individuals to implement our standardized treatment program, for which attendees receive the Therapist Guide, Client Workbook, and all necessary resources. This approach minimizes the time needed to get up and running, and facilitates consistency of delivery. PHS (2000) Guidelines are addressed, and this program was designed to meet the Association for the Treatment of Tobacco Use and Dependence (ATTUD) provider competencies criteria. A review of our training model and treatment program was the topic of a recent presentation to the President's Cancer Panel, emphasizing the perspective that disseminating high intensity interventions is an important and cost-effective component of a comprehensive public health approach targeting tobacco dependence.
We also offer a workshop in brief interventions, geared towards healthcare practitioners. This curriculum represents an enhanced version of NCI's 5As approach. Enrollees attend a 2½ hour workshop covering intervention basics (counseling and pharmacotherapy), motivational enhancement, managing special populations, and key clinic / team administrative considerations. Over 5000 providers in our state and nationally have been trained. Trained sites have also proven to be excellent referral sources for our intensive programs.
Our research program has grown substantially over the years. We receive funding from NIH, pharmaceutical companies, foundations and local organizations. Projects have been diverse in focus, spanning treatment dissemination, outcomes, the genetics of nicotine dependence, cue reactivity, and treatment adherence, among others. Collaborating with scientists at home and from other institutions has been a key feature of our operations. We have published over 30 papers and chapters, primarily in the last four years.
We are pleased to report the future for the ACT Center looks promising. Many of our colleagues are aware that this past year has been difficult. Due to political reasons, the funding mechanism for managing the portion of MSA funds directly committed to tobacco prevention and cessation activities was no longer viable, affecting all subcontracts. Thus, while our training and research efforts continued to flourish, treatment activities have dwindled this past year. Fortunately, we have recently been notified that our funding will be restored on July 1, now via a mechanism that is fully supported. Over the next 1-2 years we plan to expand our services, addressing the need for a broader range of clinical programs, greater reach of training programs, and continued growth of research activities. We look forward to these challenges, along with the possibility of additional collaborations with some of our colleagues in SRNT. For additional information, please visit our website at http://actcenter.umc.edu/.