Quit Core Faciltator Training

LEARNING OBJECTIVES: Use and learn self-monitoring, QST’s; identify stages of change

Materials: Participant & Support Person Manuals, Flipchart paper, Markers, LCD Projector (only), Power Point, USB, pens, notepads, Question/Comment Box, Tracker Sheet, CO Monitors Things to print: Support Persons Letter, Attendance List

Section/Time Learning Activities Resources

Welcome  Distribute participant manuals (stress importance of bringing manual to every Participant Manuals 5 minutes class) Place on chairs  Welcome participants warmly, Congratulate class for making the decision to Name tags enrol in the program , Let class know that becoming tobacco free is a journey

Introductions  Introduce self. Let them know why it is meaningful for you to help them quit 5 minutes

Introductions of  Ask participants to introduce self and what they hope to get out of the Participants QuitCore program. 10 minutes  Ask participants If they are comfortable to share with group, their tobacco use and what it looks like. Session 1 - Introduction

Icebreaker Break off into groups of 3 or 4 and find one thing you all have in common (cannot be Small writing pads 10 minutes anything to do with smoking or being here) Pens Give a specific time (e.g. 5 min.) write a list of everything they have in common.  Tell them to avoid the obvious (e.g. “we’re all taking this course”).  When time is up, ask each group how many items they have listed. For fun, ask them to announce some of the most interesting items.

Safe Learning 1. Explain to participants that dynamics in a learning environment can either Flipchart Paper Environment/Group empower learning or hinder learning for individuals. Ask participants to think Markers Guidelines about what they need in order to feel safe in sharing and participating in this 5 minutes training. 2. What would they like their safe learning environment to include?  Examples: confidentiality, no judgements, acceptance of ideas, right to pass Cell phones off, or on vibrate – Start and finish on time  Write safety guidelines participants would like in the sessions. Post on wall  Support Group – Adults over the age of 18

Introduce program The design of the program is based on results of research and feedback from PowerPoint 5 minutes thousands of tobacco users who have participated in the program since its inception in 1983. There are six sessions in this program: 1) Introduction 2) Tobacco Cessation techniques 3) Quit Night and Former tobacco users visit (Support group session) 4) Stress Management 5) Healthy Living and tobacco cessation 6) Program completion and staying tobacco free Session 1 – Introduction

Discuss Quit Plan/ Research supports the benefit of setting a date to quit. If you are not ready to quit, you Missing a Session can set your own quit time, but keep coming to help support your own journey in 3 minutes quitting, and gain support from the group. If you miss a session – follow the program by using the Participant Manual. Email one of us, if you are going to be away. Keep coming!

Benefits of being Refer participants to page 10 of the manual to review on their own. Stress that it is Participant Manual Tobacco Free beneficial to quit smoking at any point in time...it is never too late Page 10 2 minutes

Stages of Change Stage 1 – Pre-contemplation: I’m not even thinking about quitting tobacco. Flip chart paper or 15 minutes Stage 2 – Contemplation: I think about quitting, I believe negatives and positives laminated posters about using tobacco are about the same With each stage of Stage 3 – Preparation: I’m getting mentally ready to quit, I may try cutting back. change Stage 4 – Action: I quit using tobacco, I commit to staying tobacco free, I use techniques to support my quit. Stand on posters or Stage 5 – Maintenance: I commit to remaining tobacco free post on wall  Ask participants to state why they think they are at the stage they are standing at? Quitting tobacco is a process. During the quitting process you can cycle through all the stages of change at any given point. If relapse occurs use it as a learning experience, it is a normal part of the quitting process, don’t give up ...keep at it.

Session 1- Introduction Section/Time Learning Activities Resources Break 5- 10 minute break – can use CO monitors when participants return from break

Question/Comment Let participants know they can add in a question or comment at any point during the Comment box Box sessions, that we can answer at the end of each session.

Fagerstrom This brief, eight question scale helps you understand your level of dependence for Participant Manual dependence nicotine. Scores on the questionnaire can help you decide on a quit plan, and whether Page 12 questionnaire nicotine replacement therapy may be useful to you. Once completed, have 10 minutes participants move into groups of 2 or 3 – share their scores and reflect on question 3 – Which cigarette would they most hate to give up? Larger group discussion: Review Question 3 – and Discuss 1, 2 & 4.

Thumb on Ask participants to place their right or left thumb on the middle of their forehead. Forehead Exercise Hold it there, concentrate on their thumb on the forehead, continue to talk below about the purpose of Quitting Smoking Techniques or “QST’s” “TIME 3 MINUTES”

QST’s QST’s have two purposes 5 minutes 1) To help participants through situations when they have urge to use tobacco 2) To help them stay motivated. Continue to put effort and energy into quitting, especially when tired or irritable  Point out that the urge or craving to use tobacco comes in waves and is typically intense for only about three minutes. The QST’s can help you get through those 3 minutes.  Experienced quitters learned the hard way that you just can’t have one.

Session 1 - Introduction

End of 3 Minutes Once three minutes is up debrief exercise of thumb on forehead. Most cravings to End of 3 Minutes Debrief Thumb on smoke last about three minutes. As soon as the craving passes, that next cigarette Debrief Thumb on Forehead Exercise no longer seems so necessary. When a craving comes on, identify it as a craving, and Forehead Exercise then get ready to congratulate yourself for beating it.

Cravings – Physical There are two types of cravings people experience when trying to quit: & Psychological Ask Participants - What are the two types of cravings people experience when trying to quit smoking? 5 minutes  Physical cravings - your body reacts to nicotine withdrawal. You may feel tightness in your throat or stomach, tension or mild anxiety.  Psychological cravings - There are lots of unconscious cues to smoke. When you quit, those cues will trigger the urge. Activities like driving, eating, drinking coffee or alcohol, or relaxing can trigger thoughts of smoking.  Keep things simple. Curb cravings as they come, one by one. Shift gears and do something different for a few minutes, the craving will lose its power and be gone before you know it.  Cravings to smoke are not commands. How you choose to react to a craving can either increase or decrease its power over you.

QST #1 Self monitoring will give insight into when, where and why you use tobacco. Once Participant Manual Self Monitoring you know your high craving times, places and situations you can select strategies to Page 13 deal with cravings. You can use the tracker sheet for one day, or use awareness – H/O – tracker sheet make a mental note of it for one day.

QST #2 The Butt Jar – Bring a sample to the class – allow participants to smell it if they Participant Manual Butt Jar choose. Remember – keep butt jar away from children and pets. Page 14

Session 1 - Introduction QST #3 The Money Jar – put in money that you would spend on tobacco and save for future Participant Manual Money Jar rewards or savings Page 15

Support Person Hand our letter for participants to take home to support person. Encourage them to Support person’s bring a support person along; it can be a partner, a friend – someone over the age of letter 18. The support person will learn how to become a good support you and will meet (Hand out) others supporting people quitting tobacco use. The support session is one session only.

Homework  Review the self evaluation on page 17 Participant Manual  Next week we will be covering Tobacco Cessation Techniques/have a Page 17 Pharmacist come to discuss Nicotine Replacement Therapy  Tracker sheet – find at least one day that you can keep track – use tracking sheet or just keep a mental note.  My thoughts after Sessions page at the end of each chapter