1. SMOKEFREE Consumer leadership Kaaren Beverley R N, Diploma Counselling Healthy Lifestyle Co-ordinator Buchanan Rehabilitation Centre

2. Buchanan Rehabilitation Centre  Specialist mental health, re-covery focussed inpatient service which provides assessments, treatment, and intensive rehabilitation combined with a high level of clinical support in a structured and positive environment  Sub regional, 40 bed service  Clients aged 16 – 65  Most young adults  Average age 17-25  Severe mental illness  Psychosis  Co-existing disorders

3.  Re-covery model consumer led process  Fits with rehabilitation model of care and skill building  Powerful voice and role model to breakdown smoking culture  Opportunity to try new approach  Literature review to facilitate ongoing research Why Smokefree Champion?

4. Engaging smokefree champions  Awareness raising geared to age group  Education on tobacco related harm  Support to stay smokefree  Survey demonstrated desire to be smokefree; (82% have attempted to stop) Peer pressure key smoking factor  Discussion of issues e.g. seeking, trading  Seeking solutions for behavioural issues with clients

7. Supports for Smokefree Champions with Policy and Legal Drivers  SFE Legislation workplace smokefree  ADHB smokefree policy (buildings and grounds)  BRC Tenancy agreement (Houses Smokefree) National Association of Mental Health Service Consumer Advisors Key Recommendations 1.Smokefree begins in outpatient / community settings 2.Consistency of practice 3.Therapeutic engagement and support is available in inpatient units

8. Ongoing Processes  Smokefree consumer champion team continually evolving (includes both smokers and non smokers)  Consumer role defined by selves with regular support and supervision  Access to smoking cessation clinic  Rewarding those who respect each other by keeping smokefree site.  Rewarding those clients that quit

9. What Benefits to Clients?  Clients that are smokefree leaving acute unit feel supported to remain smokefree  Peer Support for clients who are quitting  Promoting smokefree message on t shirts  Clear message from champion that smoking harmful to health  Promoting off site smoking  Consumer team work

10. Outcomes  Modelling smokefree behaviour  Record of smoking behaviours directs tobacco work to care team for supportive interventions  Other clients keen to be smokefree champions  Leads to clients problem solving smoking behavioural issues

11. Where to from here?  Consumer Smokefree Champion Team  Skill building and access to training  Strong voice to staff about smokefree service delivery  Rewards and references for those involved in smokefree champion team  Peer led smoking cessation model

12. Champions say  M says “that she has more money and feels healthier”.  Being a smokefree champion keeps me smokefree  R says “Smokefree is a good opportunity to keep healthy”  “A wise way is the way to go….

13.  Smoking Cessation and Serious mental illness; Snyder et al, Archives of Psychiatric Nursing, Vol 22,No 5 (October),2008;pp297- 304  Do social support interventions (“buddy systems") aid smoking cessation? A review; Sylvia May and Robert West,Tob Control 2000 9:415-422 doi 1136/tc.9.4.415  Peer counselling in schizophrenia; Patients consult patients, Kluge et al, Patient Education and Counselling 70(2008)357-362 Research