Evaluation of the CHOICES Program of Peer-to-Peer Tobacco Education and Advocacy

Abstract

CHOICES is a consumer driven program for addressing tobacco in people with mental illness that employs mental health peer counselors. Since 2005, CHOICES has conducted over 298 community visits reaching more than 10,000 smokers with mental illness (about 2500/year). A telephone based outcome study was conducted in 102 outpatient smokers who received a CHOICES peer-to-peer session. At 1-month follow up participants (N = 86; 84%) reported smoking an average of 13 cigarettes per day which was significantly reduced from a baseline of 19 (P < 0.001). Twenty-five individuals (29%) tried to quit smoking in the month after the peer session and another 47 (55%) reduced their smoking. Feedback from smokers about the program was positive. Most (N = 59, 71%) said it was a lot easier to talk with a consumer about smoking compared to their psychiatrist or staff. Peer-to-peer communication about tobacco use can be effective to increase awareness and change smoking behaviors.

Correlates of Current Smoking Among Adults Served by the Public Mental Health System

“…Both smoking cessation (Ford, Clifford, Gussy, & Gardner, 2013) and treatment for substance use disorders have long traditions of using peer health educators, and this is mirrored in the use of peers in the field of mental health recovery (Swarbrick & Schmidt, 2010). Peer-delivered smoking cessation approaches show great promise (Ford et al, 2013;Williams et al, 2011). Peer enhancement of professionally led smoking cessation programs is also viable (Dickerson et al, 2011).…”

Helping Smokers with Severe Mental Illness Who Do Not Want to Quit

“…These roles have included serving as group co-facilitators, individual counselors within a multi-faceted cessation program and as outreach specialists. For example, Williams (Williams, Dwyer, Verna, Zimmerman, Gandhi, et al, et al, 2011) describe a program employing Consumer Tobacco Advocates (peers) as counselors. Peers first held informational sessions at community agencies and then followed up by providing a 20-minute peer-to-peer intervention based on Steinberg’s (Steinberg, et al, 2004) brief motivational intervention that also included CO level feedback.…”

Implementing Tobacco Education and Cessation Services at a Large Community Mental Health Center: Lessons Learned

“…Carbon monoxide meters measure the amounts of carbon monoxide in the body and serve as effective tools for teaching and monitoring tobacco use (Bittoun, 2008). This strategy was particularly useful in prompting consumers with low motivation to consider quitting (Williams et al, 2010).…”