Nicotine Recovery Tools to Help Individuals Make Healthy Changes

Cohosted by NBHN and myStrengthWednesday, March 11

2:15 – 3 p.m. ET

To access closed captions, see chat box for link:https://www.streamtext.net/player?event=NicotineRecoveryTools

Welcome!

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Dana LangeProject Manager of Practice

Improvement,National Council for Behavioral Health

Dr. Amy Lukowski, Psy.DClinical Product Director

Livongo (myStrength)

Chuck TepperVP Public PartnershipsLivongo (myStrength)

Housekeeping

o Webinar is being recorded. All participants placed in “listen-only” mode.

o For audio access, participants can either dial into the conference line or listen through your computer speakers.

o Submit questions by typing them into the chatbox.o To access closed captions, see chat box for link:

https://www.streamtext.net/player?event=NicotineRecoveryToolso Slide handouts and recording will be posted here:

ohttps://www.bhthechange.org/resources/resource-type/archived-webinars/

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National Behavioral Health Network 2019 Annual Membership Survey:https://is.gd/NBHN2019MembershipSurvey

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fo r Be h a vio ra l He a lt h

Em p o w e rin g P e o p le w it h Ch ro n ic Co n d it io n s t o Live Be t t e r a n d He a lt h ie r Live s

b y ®

Nicotine Recovery Overview

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Dr. Amy Lukowski, Psy.DClinical Product Director

Dr. Lukowski is a licensed psychologist, Certified Tobacco Treatment Specialist (CTTS)and a Motivational Interviewing Network of Trainers (MINT) trainer with over a 13 years of experience working clinically with both individual patients and populations, as well as providing clinical oversight for health behavior change products.

She has also served as Associate Professor at National Jewish Health and the Department of Psychiatry at the University of Colorado Denver.

Dr. Lukowski currently serves as Clinical Product Director at myStrength, which offers evidence-based self-help resources for emotional health and overall well-being, overseeing coaching, content and providing clinical oversight

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Chuck is a senior health care executive with over 35 years of healthcare experience. Chuck joined myStrength in 2013 and has been a driving force in digital behavioral health with public and community behavioral health partners, collaborating with over 150 partners in 33 states.

Chuck played a key role in the growth of the online learning behavioral health company, Relias Learning (formerly Essential Learning) as its Senior Vice President of Business Development and was previously the the Senior Vice President of Business Development for a publicly-traded behavioral health contract management company, Psychiatric Management Resources (PMR). Chuck’s responsibilities included its national expansion of partnerships with health systems and community mental health providers that also included the national expansion of the company’s disease management Pharmacy business.

Chuck has spoken at numerous conferences and is adept at facilitating discussions and addressing issues of cost, lack of access, stigma and delivering behavioral and well being at scale.

Chuck TepperVP Public Partnerships

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myStrength: The Market Leader in Full - Spectrum Digital Behavioral Health

Personalization

Breadth

Scale

Results

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Focus Areas• De p re ssion• An xie t y• In som n ia• Su b st a n ce Use Diso rd e rs• Ch ron ic P a in• Op io id /MAT• St re ss• Min d fu ln e ss• Ba la n c in g Em ot ion s• P re g n a n cy & Ea rly

P a re n t in g• Nico t in e• Tra u m a

Evidence -Based Interventions• Cog n it ive Be h a vio ra l Th e ra p y• Be h a vio ra l Ac t iva t ion• Min d fu ln e ss• Mot iva t ion a l In t e rvie w in g• P osit ive P sych o log y• Acce p t a n ce a n d

Com m it m e n t Th e ra p y• Dia le c t ica l Be h a vio r Th e ra p y• Me d ica t ion -Assis t e d

Tre a t m e n t (MAT) fo r Op io id Re cove ry

Full - Spectrum Digital Behavioral Health

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P re va le n c e a n d Im p a c tSmoking is the leading preventable cause of death in the U.S.1

Vaping/e-cigarette use is contributing to rising rates of nicotine addiction among youth. As a result, rates of adult combustible use are expected to rise in the coming years.2

Approximately 25% of U.S. adults aged 18 years or older have a behavioral health disorder, and 32% are current tobacco users (compared with 23% among adults with no known mental illness).3

Individuals with behavioral health disorders face significant tobacco-related health disparities, comprising approximately 200,000 of the 435,000 U.S. deaths per year due to tobacco use.4 In addition, these individuals consume almost 40% of all cigarettes n

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1 CDC. Fast Facts. Atlanta: CDC; 2019. Available at: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm. Accessed August 19, 2019.2 Truth Initiative. E-cigarettes: Facts, stats and regulations. Washington DC: Truth Initiative; 2018. Available at: https://truthinitiative.org/research-resources/emerging-tobacco-products/e-cigarettes-facts-stats-and-regulations. Accessed August 9, 2019. 3 Centers for Disease Control and Prevention. Tobacco Use Among Adults with Mental Illness and Substance Use Disorders. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/disparities/mental-illness-substance-use/index.htm

January 14, 2019. Accessed August 9, 2019.4 Schroeder S. Moving Forward in Smoking Cessation: Issues for Psychiatric Nurses. Journal of the American Psychiatric Nurses Association. 2009;15(1):68-72. doi:10.1177/1078390308330843.

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Ad u lt To b a c c o Use a n d Be h a vio ra l He a lt h

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Individuals with behavioral health conditions are a group heavily burdened by nicotine.

% of U.S. Adults Using Tobacco

Age 18+ With Mental Health

Disorders

Age 18+ With No Known Mental Health

DisorderCenters for Disease Control and Prevention. Tobacco Use Among Adults with Mental Illness and Substance Use Disorders. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/disparities/mental-illness-substance-use/index.htm January 14, 2019. Accessed August 9, 2019.

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In t ro d u c in g t h e Nic o t in e Re c o ve ry P ro g ra m(Clic k t o Op e n Vid e o In t ro )

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Evidence-based tools for people on their journey to nicotine recovery. The program supports users of combustibles (cigars/cigarettes/pipes), vaping products, and smokeless tobacco.

• The DSM-5 refers to nicotine addiction as “Tobacco Use Disorder” whereas “Nicotine Recovery” encompasses tobacco and vapingto help both new and existing myStrength users recover from the various forms of nicotine addiction.

• Research shows high rates of nicotine dependence comorbidity with other behavioral health issues, including depression and anxiety.1

• Compared to competing point solutions, myStrength offers integrated support for diverse comorbid behavioral health conditions and life challenges that often make nicotine recovery more complex.

1 U.S. Department of Veterans Affairs. DEPRESSION AND ANXIETY & TOBACCO USE. Washington DC: U.S. Department of Veterans Affairs. Available at: https://www.mentalhealth.va.gov/quit-tobacco/docs/DepressionAnxietyandTobaccoUse_508.pdf. Accessed August 19, 2019.

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Th e m e s

• Personalized interventions matched to an individual’s readiness to change

• Non-judgmental approach

• Normalization of many quit attempts and slips or lapses before success

• Education on the complexity of nicotine addiction, including the physiological, behavioral and emotional aspects

• Encourages evidence-based treatment (including medication and counseling) rather than a “cold turkey” approach

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Nico t in e Re co ve ry P ro g ra m Clin ica l P h ilo so p h y40+ personalized myStrength activities based on:

• Stage of Change: to provide the appropriate content based on personal readiness or stage in the change process

• Quitting History: learning from previous quit attempts, slips and relapses

• Compassion and Coping: self-compassion and positive coping strategies

Evidence-based techniques:

• myStrength’s Nicotine Recovery program provides problem solving and skills training, in addition to activities to develop mindfulness and cognitive-behavioral skills. Participants are also educated about:

• Motivational Interviewing (MI): the gold standard treatment for nicotine users who are in the pre-contemplative or contemplative stages of change.1

• Medication-Assisted Treatment (MAT): for individuals who are ready to quit. This approach addresses the physiological, behavioral, and emotional aspects via:

o Prescription Medications (Varenicline, Bupropion) or Nicotine Replacement Therapy (NRT)o Behavioral Coaching/Counseling (group/individual/phone)2

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1 Miller W. TIP 35: Enhancing Motivation for Change in Substance Abuse Treatment: Treatment Improvement Protocol (TIP) Series 35. Rockville: Substance Abuse and Mental Health Services Administration; 1999. Available at: http://adaiclearinghouse.org/downloads/TIP-35-Enhancing-Motivation-for-Change-in-Substance-Abuse-Treatment-59.pdf. Accessed August 18, 2019.

2 American Cancer Society. Getting Help with the Mental Part of Tobacco Addiction. Atlanta; American Cancer Society; 2017. Available at: https://www.cancer.org/healthy/stay-away-from-tobacco/guide-quitting-smoking/getting-help-with-the-mental-part-of-tobacco-addiction.html. Accessed August 18, 2019.

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Nic o t in e Re c o ve ry Fo u n d a t io n a l Re so u rc e s

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Th a n ks t o Ou r Co n t e n t P a rt n e r

Proprietary

Journey to Quitting Video Series

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Clin ic a l a n d Co n su m e r So u rc e s

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Expert Advisor Consumer PanelDr. Amy Lukowski, Psy.D.

• Clinical Product Director, myStrength

• Tobacco Treatment Specialist (TTS)

• Motivational Interviewing Network of Trainers (MINT) Trainer

• Former Clinical Director of Health Initiatives, National Jewish Health

• Former Board of Director, North American Quitline Consortium (NAQC)

Current and Former Nicotine Users representing diverse backgrounds and stages of change advised myStrength as the program was developed.

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Nic o t in e Re c o ve ry Ou t lin e

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•The Truth About Nicotine• Why Is Quitting So Hard?• What I Heard: Common Myths About

Nicotine Use• Try This: Manage Stress Naturally• Understanding the Stages of Change

•To Quit or Not?• One Step Closer• What Happens When You Quit

Smoking?• Medication and Nicotine

Replacement• Nicotine Is My Best Friend

•Nicotine and You• Try This: Be Kind to Yourself• Stress: The #1 Reason for Use and

Relapse• I Quit, You Can Too: Stories of Hope• Try This: Where Are You on the Path?

•On the Fence• Try This: Looking Ahead• The Crystal Ball• Try This: Decisions, Decisions• Can Someone Like Me Really Quit?

•Getting Going: Your Path to Success• Try This: Learn from Quit Attempts• Try This: Know Your Triggers• Try This: FLOAT in Mindfulness• The Big List of Tips for Managing

Cravings• Try This: The Reduction Strategy• Try This: Catch Your Mood, Catch

Your Thoughts•Making a Plan & Sticking to It

• Your Secret Sauce• Try This: Adjust Your Routine• Try This: Avoid High Risk Situations• Try This: Alternatives• Your Quit P.L.A.N.

Slips and Relapses• Try This: Red Flag Thoughts• Try This: Breathe, Be

Mindful• Review the Three A’s• Try This: Learn from Slips

The Nicotine-Free Life• The Wolf and the Bucket• Try This: Nicotine Free

Rewards• More Stories of Hope

What About Vaping?• What Parents Need to

Know.• Busting Myths About Vaping• The Rise of Vaping• I Started Vaping. What

Should I Do?

What’s Your Routine?• 7-Day Challenge for Nicotine

Recovery

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Me d ia -Ric h Ac t ivit ie s

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• Quizzes

• Whiteboard Animation Videos

• Guided Meditations

• Video Interviews with Clinicians

• Inspirational Messages from Former Nicotine Users

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Sa m p le Nico t in e Re co ve ry Ac t ivit ie s20

• The #1 Reason for Nicotine Use and Relapse

• The Big List of Tips for Managing Cravings

• Busting Myths About Vaping

• Understanding the Stages of Change

• Review the Three A’s

• I Quit, You Can Too: Stories of Hope

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Thank you

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