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Clinical Program

It is now universally accepted by primary oversight and regulatory agencies that efforts to facilitate tobacco cessation are both effective and cost-effective. Substantial documentation exists regarding the benefits of cessation, including improved health and decreased health care costs.

The two most influential documents guiding tobacco cessation policy and practices are Best Practices for Comprehensive Tobacco Control Programs (Centers for Disease Control) and the recent update of the clinical practice guideline, Treating Tobacco Use and Dependence (Public Health Service). A strong position is now taken as to the impact of providing cessation services. As noted in the CDC Best Practices, "Programs that successfully assist young and adult smokers in quitting can produce a quicker and probably larger short-term public health benefit than any other component of a comprehensive tobacco control program." In a similar vein, the PHS (2000) guideline provides data supporting that, "Brief advice by medical providers to quit smoking is effective. More intensive interventions (individual, group or proactive telephone counseling) that provide social support and training in problem-solving skills are even more effective." Based on these and related publications, it is the position of the ACT Center that a comprehensive approach is necessary to address nicotine dependence in our society.

To date, the demand for ACT Center clinical services has steadily increased, and continues to do so. Our population is diverse with respect to ethnic background (34% African-American), gender (64% women), age (13 - 78), and other factors (broad range of income, education, work status, and insurance coverage). In the latter part of 2001, we screened 60 new patients per month. During the first half of 2002, this increased to 80 per month, and most recently 110 new patients have been seen monthly. We have redistributed some resources and are preparing for our 2003 target of 125 - 150 per month. Our standard protocol consists of a series of six, intensive group therapy sessions, and 6 - 8 follow-up sessions over the ensuing year. Success rates for treatment completers are in the 30 - 35% range for long-term follow-up (6 - 12 months); 20 - 25% using conservative estimates. We believe these to be very good outcomes, given the difficult population we routinely service:

RISK FACTOR FOR POOR OUTCOME Limited education Limited SES Heavier use Comorbidities present

ACT PATIENTS WITH CHARACTERISTIC 67% high school or less 45% unemployed; 55% income < $20,000 Average 22½ cigarettes/day for 24.6 years 33% report depressive symptoms 33% report anxiety symptoms 15% treated for substance abuse

The ACT Center is prepared to meet these challenges by applying a high standard of quality and intensity. We also recognize the need to improve our efforts by applying and being actively engaged in clinical research.

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This page last modified on October 26, 2007