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Title:

 Counseling Women Who Smoke

Program/Campaign:

 Women's Health

Version/Time/Date:

 Video/25:00/NA

Producer:

 unknown


Scene: Ripple in a pond.
Video Title
Music

COUNSELING FROM THE HEART:
HELPING WOMEN ELIMINATE TOBACCO USE AND EXPOSURE

June 2007

Scene: Two narrators, one male and one female, sitting on stools speaking directly to the viewer. Narrators take turns narrating.
Props: stools

Narrator: We know, and most women know, that smoking and tobacco use is harmful across one's life-span and especially during the reproductive years. Most women are concerned about the effects of smoking on their children's health - particularly when they are pregnant or have young children. This concern gives you the opportunity to counsel women who smoke when they have additional motivation to quit.

This video teaches healthcare providers how to effective counsel women to quit smoking and eliminate their exposure to secondhand smoke.

Patients expect their physicians and healthcare providers to ask them about smoking. Your personal support to facilitate smoking cessation is critical. In this video, you will learn how to assess your patient's readiness to change, determine the most relevant information for your patient, help her create a quit plan , identify strategies for dealing with difficult situations and provide quit smoking resources.

Remember, stopping tobacco use is a process. Effective counseling happens any time you help a woman think about quitting, aid in her decision to quit, help her quit or help her to stay quit.

Narrator: This video compliments A Guide For Counseling Women Who Smoke. Both use the 5A's counseling techniques. The 5A's are a clinically-proven, best practice approach for smoking cessation counseling and are a quick way to organize a counseling session. In this video you will see counselors ASK, ADVISE, ASSESS, ASSIST, and ARRANGE follow-up as they help women stop smoking.

ASK

  • Ask about tobacco use status at every visit
  • Document tobacco use status

ADVISE

  • Provide clear, strong advice to quit
  • Discuss health benefits of quitting

ASSESS

  • Determine willingness to quit smoking or using tobacco
  • If not yet willing, provide motivational intervention

(Scene: Footage of Counselor on telephone, has calendar in hand)

ASSIST

  • Encourage S.T.A.R.
    • Set a quit date and develop a quit plan
    • Tell family and friends
    • Anticipate challenges
    • Remove tobacco products from the environment
  • Provide support and help patient obtain social support
  • Discuss triggers and coping skills
  • Provide educational and self-help materials
  • Discuss pharmacology
  • Refer to NC Tobacco Use Quitline for support between visits

ARRANGE

  • Follow-up at next visit or by phone
  • Contact shortly after quit date - 1 week
  • Congratulate success
  • Identify problems, answer questions

Narrator: This video uses the STAGES OF CHANGE model to help you provide immediate, individualized smoking cessation counseling as you interact with your patient. This model enables you to tailor your conversation as you assess a woman's readiness to quit or to remain smoke-free if she has already quit.

The 6 STAGES OF READINESS FOR CHANGES are:
PRE-CONTEMPLATION - Not considering quitting; may not be interested in hearing about it.
CONTEMPLATION - Beginning to think smoking is a problem for her and is likely to respond to information.
PREPARATION - Interested in quitting. Has taken some steps to quit.
ACTION - Actively quitting and following her quit plan. Needs help to stay quit during first few weeks.
MAINTENANCE - Has quit smoking.
RELAPSE - Has started smoking again.

Narrator: Using the 5A's techniques and the Stages of Change Model allows you to:

  • Personalize the quitting smoking process
  • Enhance motivation to quit
  • Guide your patient with relevant skills and information
  • Tailor your messages to the patient's stage
  • Promote appropriate follow-up and
  • Provide information and referral based on needs

Using these techniques also show that you care about your patient, are listening to her and look to her as the expert in her life.

Narrator: Observe the counselors' techniques and how they learn where the patient is with smoking and her readiness to change or maintain life as a non-smoker.

(Graphics with the names Kathy and Sarah appear)
First, let's compare Kathy's counseling, using the 5A's with Sarah's that does not use the 5A's

(Scene: Counseling Room - counseling in session. Counseling K and Patient 1 are sitting next to each other at right angles at a desk.)

VO: Step one, ASK.
Determine if the patient smokes or uses other tobacco products. If she does not use tobacco, praise her and reinforce the importance of her decision not to smoke or use tobacco.

Find out if she was a smoker or used tobacco, and, if so congratulate her on quitting. Reinforce the importance of staying quit. This is an opportunity to ask if she has cravings and offer assistance.

Ask about her exposure to secondhand smoke. The same 5A's can be applied here.

If the patient smokes, move on the the second A, ADVISE.

(Scene: Counselor holding patient's record folder.)

Counselor K: Linda, I see that you indicated that you smoke cigarettes. Are you still smoking? (Graphic: Text box - ASK)

Pregnant Patient 1 (Linda): Yeah.

Counselor K: Well, what have you heard about the effects of smoking during pregnancy? (Graphic: Text box - ADVISE)

Patient 1 (Linda): Well, some people say don't do it.

Counselor K: People say don't do it because it harms the baby and I do recommend that you stop smoking. I know quitting can be hard, but it is the most important thing you can do for the health of your baby and for you. (Graphic: Text box - ASSESS)

Patient 1 (Linda): Uh... I'm doing alright.

Counselor K: Have you ever thought about quitting? (Graphic: Text Box: PRE-CONTEMPLATION)

Patient 1 (Linda): No, not really.

(Scene: Kathy and patient shown in background still talking (freeze frames and faded) while narrator speaks. Narrator is shown in right foreground of counseling scene)

Narrator, Voice Over (VO): ASSESS includes exploring the patient's smoking habits, her family's smoking patterns, her past attempts to quit and identifying the stage of tobacco use that describes her.

Let's see how Kathy continues to ASSESS her patient using reflective listening.

(Scene: Resume counseling scene)

Counselor K: Okay, well, tell me a little about your smoking, Linda. (Graphic: Text box - ASSESS)

Patient 1 (Linda): Well, I get up in the morning, make my coffee, and smoke a cigarette. My husband smokes, most of my friends smoke. My sister smoked when she was pregnant. I don't plan on quitting just because I'm pregnant.

Counselor K: It sounds like you smoke regularly and that most of the people around you are smokers, so you're not ready to quit. (Graphic: Text box - Pre-contemplation)

Patient 1 (Linda): Yeah, well, we smoke. We smoke in the house...the car. We go out and everyone smokes, it's not a big deal.

Counselor K: Have you or has anyone you know tried to quit smoking?

Patient 1 (Linda): Yeah, well, some of my friends. But it would be such a hassle if I tried to quit now and if I tried to get everyone not to smoke around me. I'm not even going to try.

Counselor K: So it sounds like you don't see any point in quitting since your husband smokes and your friends smoke. But did you know that most people won't smoke around you if you ask them not to? (Graphic: Text box - ASSESS)

Patient 1 (Linda): Well, I hadn't thought about that.

Counselor K: Linda, can you think of any reasons why quitting would be a good idea? (Graphic: Text box - Pre-contemplation)

Patient 1 (Linda): For my baby.

Counselor K: Okay. Tell me more about that.

Patient 1 (Linda): I've heard that smoking can cause health problems. And this is our first child; I'd like her to be healthy. I've heard that smoking can make babies get more colds and stuff.

Counselor K: That's true, and these are good reasons to quit. But smoking during pregnancy and after the baby comes can cause more serious problems too. So, it seems that you think there are reasons why quitting would be a good idea . For example, the baby's health, is that right? (Graphic: Text box - Advise)

Patient 1 (Linda): Yeah.

Counselor K: Okay, so where does that leave you now? (Graphic: Text box - Assess)

Patient 1 (Linda): Well. I'd like to think about all this stuff. And, talk to my husband about this and maybe look it up on the internet.

Counselor K: There are some good web sites and I'll give you some addresses. (Graphic: Text box - Advise)
Well, Linda I appreciate you talking with me about smoking; it's not always easy to talk about. I hear you saying that you are not ready to quit right now, but I really recommend that you do stop smoking.
(Graphic: Text box - ADVISE)
At your next visit, let me know how talking with your husband goes. And, Linda, if you or he have any questions before then, you can call me. Okay? (Graphic: Text box - ARRANGE)

(Props: Quitline card)

Patient 1 (Linda): Okay.

(Scene: The narrator in foreground of freeze-frame and lighter image of Kathy and Patient 1 (Linda) in background.
Narrator: Kathy listened carefully and asked questions that opened up the dialogue between her and her patient.

Narrator: She ASKED about smoking and ADVISED her patient to stop, ASSESSED the patient's smoking habits and thoughts about quitting. ASSISTED her in exploring reasons to quit smoking, and ARRANGED a follow-up plan.

(Scene: Sarah and patient shown in background still talking - freeze frame and faded - while narrator speaks.)
Narrator: Let's see how Sarah is doing. Remember, she is NOT using the 5A's approach.

Counselor S: At your last appointment, you were still smoking but agreed to try and quit. Did you?

Pregnant Patient 2 (Sue): Well no, But (sigh) but, I -

Counselor S: Well you should. Smoking is bad for your health and for your baby's health. Even cutting back would be good. So, do you think you could quit by your next visit by cutting back one cigarette each day?

Patient 2 (Sue): Well, I, I, I've tried - but I've heard that but some women smoke and still have healthy babies.

Counselor S: Well, a baby may seem healthy even though the mother smoked when she was pregnant. But it increases the chances of the baby being born too small to be healthy, affects the baby's brain and doubles the baby's risk for SIDS. So you're taking a big gamble.

Patient 2 (Sue): W-e-l-l, I, I can try but...

Counselor S: Quitting is the best thing you can do. So do you think that you can try and do that before your next appointment.

(Scene: Sarah and patient shown in background during counseling session - freeze frame and faded - while narrator speaks)
Narrator: You can see the difference in how Sarah and Kathy counsel patients. Sarah is frustrated. She gives good information and a clear message to quit, but she is not ASSESSING her patient. She missed recognizing Sue's readiness to change. By not using reflective listening Sarah did not engage Sue in her own quitting process.

(Scene: Sarah reviewing the Counseling Guide for Women Who Smoke)

Narrator-VO: Now, let's see the changes in Sarah's counseling after attending a training session using the 5A's and the stages of change framework.

(Scene: Sarah is sitting holding the guide and holds up the 5A's card)

Counselor S: The key thing I learned from this training is that I need to understand where a patient is with smoking and her willingness to change, before I can effectively counsel her. Now I listen more. I ask questions to get in-tune with my patient. I recognize that quitting smoking isn't a single event, it is a whole process. Now I do all I can to help a woman make a decision to quit or prepare to quit.

(Scene: Patient's home; other child nearby quietly coloring. Conversation is in progress. The counselor and patient are both sitting on chairs at right-angles to each other)

Pregnant Patient 3 (Kate): I feel like I have been pregnant forever.

Counselor S: It won't be much longer. You're 34 weeks now.

Patient 3 (Kate): Yeah? Maybe he will be a little early.

Counselor S: I can imagine you feel ready to have this baby but he has six more weeks of growing to do. It's better for him to be full-term, and have a good birth weight. Can we spend a few minutes talking about smoking?

Patient 3 (Kate): Alright.

Counselor S: Are you still smoking cigarettes?

Patient 3 (Kate): Yes.

Counselor S: Last time you were thinking about quitting, right? (Graphic: Text box - ASSESS)

Patient 3 (Kate): I was. I guess I still am. But it seems a little too late to quit now, doesn't it? (Graphic: Text box - CONTEMPLATION)

Counselor S: It's never too late to quit! And, I really would like for you to try to stop smoking. Quitting now will help your baby get more oxygen and nutrients so that he grows and develops appropriately. (Graphic: Text box -ADVISE)
It will also help you. What are some of the reasons that make you want to quit Kate? (Graphic: Text box -ASSESS)

Patient 3 (Kate): Well, mainly that my baby will be alright. But I also heard that after you quit you feel better and you have more energy. I'm just tired of being tired!

Counselor S: So you're thinking about quitting for your baby's health and so you'll have more energy?

Patient 3 (Kate): Yes. Oh I have so much to do at work, at home and with my other children. Everything seems to pile up and there's nobody to help me.

Counselor S: I know those day-to-day stresses can feel overwhelming. If quitting is something that you really want to do, I'd be happy to help you make this happen. (Graphic: Text box -ASSIST)

Patient 3 (Kate): Yes, I'd like for you to help.

(Scene: Counselor shows the patient the work booklet, points to some pages and gives booklet to patient. Patient leafs through booklet.)
Counselor S: Okay. This booklet won't make the stress go away, but it can help you figure out what you can do instead of smoking, when you feel stressed.

Patient 3 (Kate): Okay.

Counselor S: So, let's try setting a quit date. This can help give you a goal and help you get prepared. A quit date can be a special date like a birthday or a day within the next couple of weeks. This will be a really great birthday present for your baby! (Counselor gives patient NC Quitline pamphlet.)

Patient 3 (Kate): Yeah, it sure would be.

Counselor S: So, we'll review your quit plan at our next visit. (Graphic: Text box - ARRANGE)
And, in the evening hours you can call the North Carolina Quitline. Did you know that you can use the same strategies in this booklet to help you deal with stress? Now let's talk about that...(Session fades)

(Scene: Sarah and patient shown in the background still talking - freeze frame and fade - why narrator speaks)
Narrator: Sarah did a good job of ASSESSING as she explored her patient's smoking behaviors. By asking her patient questions, the patient told herself why it would be better to quit.

(Scene: Narrator is standing in front of the freeze-framed counseling session between Sarah and Patient 2-Sue)
Narrator: Let's see how Sarah uses her new counseling techniques with a previous patient.

(Scene: The Counselor and patient sitting at desk.)
Counselor S: Sue, at your last visit you were thinking about quitting smoking. (Graphic: Text box - ASSESS)

Pregnant Patient 2 (Sue): Yeah, well, I've been cutting back and now I think I am ready to quit. (Graphic: Text box - PREPARATION)

Counselor S: That's great that you've been cutting back and that you're ready to stop smoking?

Patient 2 (Sue): Yeah, thanks. I guess I just don't know what to do next.

Counselor S: Would you like to take a few minutes and work on your quit plan? (Graphic: Text box: ASSIST)

Patient 2 (Sue): Sure.

Counselor S: (Now with props, If You Smoke and Are Pregnant booklet, NC Tobacco USE Quitline on wall, Quitline brochure, magnet, card) Okay. By answering these questions in this booklet, you can figure out your smoking patterns and what you can change so you can create your own quit plan. Here's a pen. Do you want to go through it together?

Patient 2 (Sue): Yes.

Counselor S: What are some of the reasons you have for quitting?

Patient 2 (Sue): Well...(Scene fades)

(Scene: Counseling continues with Sarah and patient shown in background still talking, while narrator speaks)
Narrator: Sue can continue to work through these questions that take a smoker through a process used by successful ex-smokers. When she is done, Sue will have a plan that fits her and can help her:

  • Set a quit date
  • Tell family and friends - identify who she can call on for support
  • Anticipate challenges - make a plan for dealing with cravings
  • Remove all tobacco products from her environment

Let's join Sarah for the final step.

Counselor S: Congratulations, you have a quit plan! (Graphic: Text box - ASSIST)

Patient 2 (Sue): Thanks!

Counselor S: Remember, quitting is a process and it can be hard at times. Just refer to the things you identified when you have the urge to smoke. Take it one day at a time. I know you can do it!

Patient 2 (Sue): Yeah, I think that this will work, just one day at a time.

Counselor S: This is a great start/ And if you slip, don't feel bad about it. Call me and we'll go through it again. You can also call the North Carolina Tobacco Use Quitline to get help with your quit plan. In fact, if you are interested and since you plan to quit within 30 days, would you like me to make a referral to the Quitline? (Graphic: Text box - ASSIST)

Patient 2 (Sue): Maybe, what do they do?

Counselor S: A trained quit coach will call you to check on your progress and help you through your quit plan. You can call them any day from 8AM until Midnight. But remember, I'm always here to help.

Patient 2 (Sue): Okay. I'll do that.

(Scene: Sarah hands patient Quitline Referral Form and pen)
Counselor S: Great! Would you sign this referral form to give me permission to send your information to the Quitline, so that they can call you? (Graphic: Text box - ARRANGE)

Patient 2 (Sue): Sure.

Counselor S: Write down when you want them to call you. Then I'll fax it to the Quitline. At your next visit, we'll check on your progress.

Patient 2 (Sue): Okay, great!

Counselor S: Super!

(Scene: Sarah and patient shown in background during counseling session - freeze frame and fade - while narrator speaks)
Narrator: Remember, the woman is the only one who can decide to quit. It looks like Sue is preparing to become an ex-smoker. If she follows her plan, the next time Sarah sees her, Sue will be in ACTION!

(Scene: Counselor and patient 4 are sitting at a desk. Freeze - frame session between Counselor K and Patient 4. Narrator in foreground holding folder.)
Narrator: Sometimes women who quit while they are pregnant are tempted to start smoking again after the baby is born. Use family planning or post-partum visits to check on your patient's smoking status and to address secondhand smoke. That is what Kathy is doing.

(Scene: Resume family planning counseling session)
Counselor K: Do you have any more questions about how to use this method? (Graphic Text box - ASK)

Patient 4 (Judy): No, I think you answered them all.

Counselor K: Okay. So how is life as a non-smoker? (Graphic Text box - MAINTENANCE)

Patient 4 (Judy): Now that I've had the baby, I am so tempted to start smoking again. And it sure would make losing weight easier.

Counselor K: Remember, it took a while to gain that weight. So be patient about losing it and besides, nursing uses extra calories and can make it easier for you to lose some of the weigh that you gained. What are you doing for exercise? (Graphic: Text box - ADVISE)

Patient 4 (Judy): I walk a little.

Counselor K: Well, that's good, keep at it. And I know it can be difficult to stay quit, so I'm glad to hear that you haven't started again. (Graphic: Text box - MAINTENANCE)

Patient 4 (Judy): Well, it has been hard. But I did quit smoking for my baby's health.

Counselor K: That's really important and now, you'll want to keep her away from secondhand smoke too. (Graphic: Text box - ADVISE)
Did you know that nicotine can be passed in to the baby through breast milk? So, if you stay quit, you'll continue to benefit and so will your baby. You know, you can also make a plan to lose weigh just like you did with quitting smoking.

Patient 4 (Judy): Oh really?

(Scene: Narrator is standing in the foreground; Kathy and patient freeze-frame in background, faded)
Narrator: Kathy is trying to keep her patient from RELAPSE. If a patient can stay quit, she will be in MAINTENANCE.

(Scene: Female narrator is standing in foreground; Counselor D and Patient 5 freeze-frame in background, faded)
Narrator: Assistance and information to stay quit is essential for patients in this stage.

RELAPSE happens to many former smokers, but it does not mean they can't quit and stay quit. Sometimes a woman's readiness to change is evident, but we recommend that you ask patients which statements best describe her. Don is assessing her patient's stage in the change process.

(Scene: Counselor D and Patient 5 are sitting at a desk. The conversation has already begun as the camera zooms in)
Counselor D: Senora Sanchez, when I read the statement that best describes you, let me know. (Graphic: Text box - ASK)
"I'm not ready to quit smoking yet." (Graphic: Text box - PRE-CONTEMPLATION)
"I'll be ready to quit smoking soon." (Graphic: Text box - CONTEMPLATION)
"I'm ready to quit smoking now." (Graphic: Text box - PREPARATION)
"I recently quit smoking'." (Graphic: Text box - ACTION)
"I used to smoke but I quit six months ago." (Graphic: Text box - MAINTENANCE)
"I did quit, but now I've gone back to smoking." (Graphic: Text box - RELAPSE)

Patient 5 (Senora Sanchez): The last one. I had quit but I started all over again. (Graphic: Text box - RELAPSE)

Counselor D: Hummmm. It is hard to quit especially because nicotine is so addictive. Many women try and quit a few times before they stop smoking for good. So, I encourage you to try quitting again. (Graphic: Text box - ADVISE)
Senora Sanchez, do you know why you went back to smoking?

Patient 5 (Senora Sanchez): Um, we moved. And then. You know, I got all stressed out again...

Counselor D: Well, when you quit earlier, did you make a list of the things you could do instead of smoking when you felt stressed? (Graphic: Text box - ASSIST)

Patient 5 (Rosa Sanchez): No really.

Counselor D: Well, what worked for you when you quit before?

Patient 5 (Rosa Sanchez): Well...um...
(Session fades out - narrator is walking toward camera)

Narrator: Let's see how [effective counseling[ can be used in more difficult situations. Refer to the Counseling Guide for more in-depth coverage of challenging situations.

(Scene: Counselor and a pregnant patient are sitting at a desk - session is in progress)
Patient 6 (Brenda): ...And I've been thinking about what you said last time, about smoking cigarettes. I'm thinking about switching to chewing tobacco instead.

Counselor S: I'm glad that you want to stop smoking. But chewing tobacco isn't any safer than smoking cigarettes. Did you know you can get gum disease and cancer from chewing tobacco? Your baby will still get nicotine. So it's better for you not to chew or smoke. So, let's talk some more about your plans to quit. (Graphic: Text box - ADVISE) (Graphic: Text box - PREPARATION)

Patient 6 (Brenda): Well, I've cut back to five cigarettes a day. But I do look forward to my cigarette breaks.

Counselor S: That's great, I'm glad that you cut back. Would you be willing to consider quitting completely and finding other things to do instead of smoking or chewing tobacco during your breaks? (Graphic: Text Box - ASSESS)

Patient 6 (Brenda): Yeah, I think I'll be ready to quit smoking soon. But I'm trying to figure out how I'm going to tell everybody.

Counselor S: Do you think your family will be supportive? (Graphic: Text box - PREPARATION)

Patient 6 (Brenda): I'm not sure. My family has been growing tobacco for years and it paid the bills. Here I am trying to quit smoking. I don't think they'll try to keep me from quitting but I'm not sure they'll help either.

(Scene: Narrator is sitting on a stool)
Narrator: Sometimes a woman is so tired of quitting and starting again that she is discouraged from even trying to quit. Let's explore this RELAPSE situation.

Note: Patient is an older person
(Scene: Counselor and patient sitting at a desk)
Patient 7 (Sheila): I have tried to quit so many times I've lost track. Last time I quit, it lasted for six months. Then I got promoted at work and there was more stress. So I started smoking again.

Counselor K: Jobs can be stressful. But there are other healthier ways to handle stress besides smoking. Have you ever thought of your other attempts to quit as practice sessions? Each time you learn more about what does and doesn't work for you, and apply what you learned to the next time you try to quit. This way, you are more likely to quit for good. (Graphic: Text box - ASSIST)

Patient 7 (Sheila): I just thought I was too hooked to quit. (Graphic: Text box - RELAPSE)

Counselor K: Quitting can be difficult and nicotine is a powerful drug. But you've quit before. We just need to figure out what works best for you. Have you tried to plan out when you would quit and what you would do instead of smoking? (Graphic: Text box - ASSIST)

Patient 7 (Sheila): Yes, but what if I fail again?

Counselor K: As long as you are trying to quit, you're not failing.

Patient 7 (Sheila): That's a better way to look at it.

Counselor K: I can help you develop your quit plan. Would you be interested in trying some medications that can help you quit smoking? (Graphic: Text box - ASSIST)

Patient 7 (Sheila): I tried the patch but that didn't work. I saw on TV there's some medicine you can take to quit smoking. Your doctor can help you determine what medicine might work best for you. I can make a referral if you like.

(Scene: Shows Narrator)
Narrator: For severely addicted women, some pharmaceutical therapies may be useful. To learn more about this, talk to your medical advisor or refer to the Guide for Counseling Women Who Smoke.
To promote continuity when counseling patients, be sure to record your counseling session in the patient's chart. Include:

  • Patient's stage of change
  • Actions that the patient has taken to quit or cut down such as their quit date, what support systems they have in place, their plan for handling cravings, etc.
  • Recommended follow-up at the next visit.

(Scene: Narrator - pointing to NC Quitline poster)
Narrator: In this video, some counselors provided information about the North Carolina Tobacco Use Quitline. Remember, the Quitline can be used to supplement the face-to-face counseling that you do with your patients, not to replace it.
(Scene: Show Quitline screen while narrator describes it)
Narrator VO: For information about the North Carolina Quitline, refer to the Video User's Guide, the Counseling Guide for Women Who Smoke or call the Quitline at 1-800-QUIT-NOW or 1-800-784-8669. (QUITLINE logo)
North Carolina Tobacco Use Quitline
8 AM - midnight
7 days a week
English, Spanish and Other Languages
TTY-1-877-777-6354

www.QuitlineNC.com

Narrator: We hope the techniques modeled in this video are helpful as you counsel women who smoke or use tobacco products. These examples reflect situations faced by healthcare providers like you.
Practicing what you've seen in this video can help you improve your counseling skills and can significantly improve your patients' chances of quitting smoking for good.

(Scene: Ripples in pond)
Narrator VO: For information about: How to order this video or who to contact for smoking cessation training using A Guide for Counseling Women Who Smoke, contact the N.C. Division of Public Health Women's and Children's Health Section - Women's Health Branch (919) 707-5700 http://wch.dhhs.state.nc.us/whs.html (NC Division of Public Health logo)

Counseling from the Heart:
Helping Women Eliminate Tobacco Use and Exposure

June 2007

(NC Division of Public Health Logo)(NCHSF logo)

End Credits

Actors: The roles in this video are performed by actors.

Narrator: Yolanda W. Rabun
Narrator/Counselor Don: Eric Morales
Counselor Kathy: Heidi Lawson
Counselor Sarah: Leanne Bernard

Patient 1 - Linda: Palmyra Romeo
Patient 2 - Sue: Brianne Godwin
Patient 3 - Kate: Tonya Daniel; Daughter: Madison Daniel
Patient 4 - Judy: Hannah Oliver
Patient 5 - Senora Sanchez: Leonor Clavijo
Patient 6 - Sarah: Lauren
Patient 7 - Sheila: Chie M. Handy

Assistants:
Katie Biggerstaff, Kazuko Capel, Leslie Council, Vivian Muzyk, Palmyra Romeo

Locations:
Willow Creek Offices
Franklin Studios
House of Palmyra Romeo

Producer:
Christine O'Meara, MA, MPH
North Carolina Healthy Start Foundation
Raleigh, NC
www.NCHealthyStart.org

Producer:
Jackson Media Solutions
Chapel Hill, NC
www.Jacksonmediasolutions.com

Video:
Cirque Productions
Chapel Hill, NC
www.CirqueVideo.com

Video Editors:
Brian Oliver
Leon Godwin
Adam Staelin

Camera:
Brian Oliver

Sound/Gaff:
Bradley Wilson
BradleyWilson.com

Make-up:
Brianne Godwin

Studio:
Franklin Studios, Raleigh

Original Music:
"Pura Vida"
Jonathan Stickley
Raleigh, NC - April 2007

Graphic Design:
Michael Ng
Designgrows
www.designgrows.net

ACKNOWLEDGEMENTS
Advisors and Reviewers:
Joanne Carl, BSN, MSPH
Mildred Carraway, RN, BSN
Donna Dayer, RRT
Jana Johnson, MD, MPH
Janice Freedman, MPH
Ann Houston Staples, CHES
Karla Kreblein, MA
Mona Brown Ketner, RN, MSN
Kristy A. Lowther, BSBA
Suzanne LeDoyen, BS
Merry-K Moos, RN, FNP, MPH, FANN
Judy Ruffin, MPA
Carol Ripley-Moffitt, DIV
Robert H. Shipley, Ph.D
Adonna Simpson, BS
Patricia Stillwell, RNC, BSN, MDIV
Margaret Watkins, MS
Betty West, MS
Diane Yelverton, MS, RNC, FMC