1. Introduction Session 1 Remember to have with you: Participant Manuals
Tobacco Tracker Sheets
QuitCore intake forms
If you plan to offer an optional support person session take invitation letters for participants to take home
Flip Chart
PowerPoint projector
Suggest bringing AlbertaQuits brochure and/or Helpline Fax Referral – let participants know they can access concurrent support through Helpline and/or through the AlbertaQuits website and community forum. Another option is the encouragement text messages or e-tips when they have selected a change/quit date. Note text message encouragement still uses the language of quit date.
If you have a carbon monoxide analyzer provide participants the option of checking baseline at end of session – and again after making a significant change (reduction or stop smoking)

2. Welcome to QuitCore Session One
Introduction
Name, what are you looking for in attending?
Creating Safe and Secure Guidelines
Identify that as a group program we want to provide a safe and secure place for people to be able to learn from each other, share experiences, problem-solve, and encourage each other. Have a flip chart ready and indicate you would like group participants to identify what group guidelines would make them feel comfortable participating in the group. If no one starts provides a suggestion i.e. conversations in the group will be kept confidential
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3. What we will talk about in this session…
Basic structure & content of the course
Individual Goals
Quitting Support Techniques
Stages of change model (Where am I)
Nicotine Addiction
Self-Monitoring
Lets talk about the program…
Program schedule – six 90 minute sessions
Content of the program: Provide each person with a participant manual and ask them to write their name on it. This manual is yours as a “how to quide” and a journal to record your experiences and planning as you progress through the sessions.
Why is it designed this way? Group support format: Page 22 of Facilitator Manual
Designed to help each participant to explore their own tobacco use, your reasons for change, and assist with creating plans to change your tobacco use and meet your goals whether you are ready to stop smoking, wish to do a reduce to quit, or reduce your tobacco use towards a future quit. The structure of the sessions is designed to provide information, and strategies, you can chose from while you also learn from each other. We will support you in problem-solving, learning skills, and making behavior changes to meet your goals.

4. Where are you at? Importance Confidence Readiness ________________
Ideas – print a Ready, Willing, and Able tool from the downloadable tobacco cessation toolkit on AlbertaQuits. Provide this to each individual to look at as you ask people how important is it for you to change, how confident are you in your ability, and how ready to you feel. Based on responses you could explore what people need to increase confidence and tie this to what will be covered over the six sessions of the group.
Second idea – laminate numbers and put them up on the walls of your room. Have participants walk to the number which identifies them when you ask about importance, confidence, and readiness
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5. Why did you choose to
make a change
in your tobacco use now?

6. What are your benefits of becoming tobacco free?
We often focus on the negative impacts of smoking and what will be avoided when people stop smoking. It is important to look forward to what you believe will be better after you stop smoking or using other forms of tobacco. What are you most looking forward to happening? What will be better in your life?

7. Stages of Change Model 11 Pg 11
Reviewing Stages of Change is an opportunity to identify where people see themselves? Are they attending to prepare to Quit or Reduce? Are they ready to take Action? Did they Stop using tobacco before joining QuitCore and are looking to maintain the change?
Make sure to talk about Quitting or Stopping Smoking as a process not an event. It takes practice to change behavior – especially if something has been an automatic part of your life for many years. Talk about each prior attempt as an opportunity to learn instead of a failure. Get people to talk about what skills they have learned with previous attempts, what worked for them, what were the reasons they started smoking again and identify the group will support them in developing new approaches to support their success and/or remove barriers.
For the following – chose wording which you feel comfortable with and at the understanding of participants.
You can share we consider tobacco dependence to be a chronic relapsing condition involving addiction to nicotine. Like any chronic condition people have cycles of relapse and remission. 11

8. Fagerström tolerance questionnaire
This scale is used to measure level of dependence or addiction to the nicotine in cigarettes or other forms of tobacco. Pg 12
Ask each person to go to page 12 of their participant manual and answer the questions for their own knowledge/self assessment.
You can ask if anyone would like to volunteer their results? Was anyone surprised by their score? 12

9. Quitting Support Technique #1 Self-monitoring: When, where & why I use tobacco
GOALS
To become aware of triggers and cues
To stop and think before using tobacco
To cut out “automatic” tobacco use
To monitor progress:
use tracker sheet
Talk about each person’s tobacco dependence is based on both their individual level of nicotine addiction and all the ways that tobacco has become woven into their life
In an unconscious or automatic way. We provide nicotine replacement therapy, or prescription medication, to reduce discomfort from withdrawal while people make the behavioral changes to replace tobacco’s role, break associations, and make not using tobacco their new normal. 13

10. Quitting Support Technique #1 Self-monitoring: When, where & why I use tobacco
Date/Time
Craving 1 - 5
Situation
Mood
Ask who likes to record, diary, and/or journal – and who doesn’t.
Emphasize the importance of this homework between session one and session two so people can learn more about their own tobacco use and become consciously aware of all of their triggers. This will allow them to develop coping strategies and chose behavior change options which will support their goals for change.
Provide each participant cut out copies of the tobacco tracker sheet (print from downloadable tobacco cessation toolkit or QuitCore facilitator online files) and review how to complete the chart. Provide people with the option of recording each day between session one and two – or to consider at least recording one week day and one weekend day (if they work weekdays). Let them know if they miss recording a cigarette/tobacco use on their recording day not to worry about it. This is for their learning they are not handing it in to you. 13

11. Quitting Support Technique #2 The butt jar
GOAL
To give me a powerful negative experience of cigarettes and
smoking
Keep the jar away from children and pets
Provide as an optional activity participants may try. Works best to have a sample jar if you are able to access the materials. Some people will find the butt jar unpleasant or disgusting – someone with a high level of nicotine addiction may find it a trigger. 14

12. Quitting Support Technique #3 The money jar
GOAL To give a visual cue of how much my tobacco use hurts me financially and to provide for future external rewards when I quit or reduce my use
Participants may prefer to use the financial calculator on AlbertaQuits
Or apps which do this tracking – two tobacco cessation apps in Canada which have been validated are Crush the Crave and Break it Off.
One other alternative is to use the tobacco wheel from the tobacco quit kits 15

13. Self Evaluation - Homework
Monitor tobacco use – tracker sheet
Change brands of tobacco.
Buy only one package at a time
Start a butt jar - Start a money jar
Invite a support person to attend session 3
My Quit Plan – list reasons to quit using tobacco.
Read the “Participant’s Manual
Suggest to people that they read the info at the end of section one in their participant manual on nicotine addiction/withdrawal, NRT, medications and caffeine pages 16 through 30. If you have not already talked about the barrier free access to NRT option for people committing to attend the six sessions of QuitCore cover it now. Remind them that they will need to chose during session two if they want to enroll in this support as the enrollment will be sent in right after Session two. Let them know that people wishing to access the support will receive their cards during Session Four.