Many Job Corps centers have designed innovative and successful programs. If you would like your program to appear on this page contact the Job Corps Health webmaster.

• Loring JCC—Not on Tobacco (NOT) Region 1 Boston
• David L. Carrasco JCC—Reassignment of TUPP Principles and Goals Region 4 Dallas
• Mingo JCC—Smoking Cessation Program Region 5 Chicago
• St Louis JCC—Stop Smoking Cards Region 5 Chicago

Loring JCC—Not on Tobacco (NOT)

Purpose and Scope: Not on Tobacco (NOT), a program of the American Lung Association, is held twice per week for 10 weeks. The program is required for students on nicotine replacement therapy (patches) for tobacco cessation.

Steps Required to Implement Practice: Students are informed of this program in several ways. The health and wellness manager (HWM) introduces the program during the orientation to wellness center services, the TEAP specialist talks about NOT during the TEAP orientation, and health and wellness staff encourage smoking cessation during student encounters, especially when the encounter is for a respiratory condition exacerbated by tobacco smoking. The center physician makes the decision to place the student on nicotine replacement therapy providing the student meets the criteria for use.

Resources Required to Implement Practice: The American Lung Association provides group training for NOT coordinators and, in some cases, will come to Job Corps centers to provide training. The Association provides all of the necessary materials, i.e., teacher's manual, information sheets for distribution to participants, posters, and several incentives for enrollees. All materials are free of charge, and handouts are distributed according to NOT steps. The first 4 weeks of the program prepare students to stop smoking tobacco, participants sign a contract and quit smoking during week 5, and the last 4 weeks of the program are provided for support. Relaxation exercises are taught and are an integral part of the program. Most third-party insurance providers and Medicaid pay for this therapy.

Evidence of Success: The American Lung Association believes that individuals who complete the program and reduce the amount of tobacco use are successful. Student motivation and participation at this center has been high. There are usually two different groups of participants. As many as 15 students are enrolled at any given time. Much like the trainee employee assistance program (TEAP), NOT provides the students with programmatic components such as education, counseling, intervention, and relapse prevention. The HWM is currently the NOT coordinator, but when the TEAP coordinator completes his training, he will become the NOT coordinator.

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David L. Carrasco JCC—Reassignment of TUPP Principles and Goals

Purpose and Scope: To maintain a low smoking rate on center by staff and students.

Steps Required to Implement Practice: Five tasks as outlined in PRH for TUPP are assigned to department heads:

• Educational materials and activities that support delay and/or cessation of tobacco use
• A smoke-free and tobacco-free environment that prohibits use of all tobacco products in center buildings and vehicles
• Designated smoking areas
• Prohibition of sale of tobacco on center
• Adherence to federal and state law regarding minors
• Resources Required to Implement Practice: Available through community contacts and on center.

Evidence of Success: The center now wants to become a nonsmoking center. All center staff are involved in the program.

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Mingo JCC—Smoking Cessation Program

Purpose and Scope of Practice: Approximately 70 to 75 percent of students who enter the center regularly smoke tobacco cigarettes and have been doing so at least 2 to 3 years prior to their program entry. By this time, they are usually beginning to experience chronic upper respiratory problems. The goals of our program are as follows:

• Increase student participation in the smoking cessation program
• Increase awareness related to the dangers of smoking
• Provide education to the participants related to the hazards of smoking, and identify smoking triggers and the type of smoker they are
• Increase motivation in smoking cessation
• Provide helpful direction in smoking cessation without medications or patches

The smoking cessation program does not utilize drugs and is strictly voluntary for student participants. The program has been successful for many students who are sincere in their desire to quit this health hazard or cut down on their intake of cigarettes with the ultimate goal of quitting.

Steps Required to Implement Practice: The TEAP specialist attended an in-service presented by The American Cancer Society Fresh Start Smoking Cessation Program, which provided guidelines for creation of the center's smoking cessation program. The program participants are primarily students who want to improve their health status and want help to quit smoking. The health and wellness staff also provides referrals to students with asthma and/or other chronic respiratory symptoms to take part in the educational component of the program.

A student first initiates their desire to participate by contacting the TEAP specialist. Students initially attend a small group with no more than two to four individuals. The first session is very comprehensive and lasts about 2 hours in duration. During this initial session, educational information about all forms of tobacco smoking hazards are covered, assessments are completed, and initial baseline information and recommendations are made on methods to assist students in reaching their individual goal. Students view a video entitled "Teen Files: Smoking Truth or Dare," which is very impacting in its content. This video is a great source of education about the hazards of smoking and also serves to increase the motivation the viewer has to quit this habit. After viewing the video, the students complete an assessment that helps them to identify the type of smoker they are and the need(s) that smoking fills for them. Their smoking triggers and associations that are identified are examined. Students complete a diary in which they take a "typical" day by hourly increments from the beginning to the end of the day. The amount of cigarettes they smoke and the times they smoke are analyzed and examined. This assists students in determining the situations in which they routinely engage in smoking behaviors. The results of these assessments are explained and discussed with each student individually so that they become more aware of the situations, times, and other triggers that predispose them toward smoking behaviors. Recommendations are made on behaviors that the participants need to pursue to help them deal with those first stressful days. Recommendations are made to each individual based upon the assessment information. Examples of behaviors that are typically suggested are to eat a well-balanced diet, get plenty of rest, avoid smoking areas, start a new hobby, engage in an exercise program, and stay away from people who are smoking.

After this information is examined and discussed, the students select the method they would like to use to quit smoking by a stop date or to gradually cut down their intake. Students are then contracted on this behavior. Typically, if a student wants to gradually cut down, they will agree to decrease their intake of the cigarettes that they normally consume on a daily basis in half or more. Students are asked to become each other's mentors and sources of support during this process. Students are dispensed smoking cessation aids--cinnamon stick, mints and, in some cases, chewing gum. Participants are advised on how to use these items. The cinnamon stick is used for two purposes. The first is they are good substitutes for the "handling" aspect of tobacco smoking. Handling refers to the tactile need, shape, and size of stick cinnamon, which is very similar to tobacco cigarettes. The second purpose is its effect when combined with the taste of tobacco. Students are instructed that any time they smoke a cigarette, they need to have a small piece of stick cinnamon in their mouth so that the taste of the tobacco is altered. If students choose not to use the cinnamon sticks, they are advised to use mints, sour candies, or some item that will alter the flavor of the tobacco taste. Mints or candy can also be used as substitutes for cigarettes, and this technique is explained to them. Students are advised of behaviors such as establishing a new routine, postponing or making access to cigarettes more difficult, or having only the agreed upon number of cigarettes in their possession to help them reduce their tobacco consumption. Some students even voluntarily agree to be placed on a no-smoking restriction from the health and wellness department. These are just some of the techniques that have been successfully utilized to assist smoking cessation participants to cut down on their overall cigarette intake.

Participants can also elect to turn in their cigarettes to HWC staff members to hold until a certain date or time when the temptation is too great. Participants are encouraged to report in weekly, at a minimum, or whenever they need a refill on their smoking cessation aids. When students report in, information is gathered on their cigarette intake since their last visit as well as any other issues that need to be addressed such as informing staff of their intent to reduce their consumption of cigarettes from the last visit. Each participant's needs are taken into account, and each one is the driving force behind how rapidly they reduce their tobacco consumption. Students are encouraged to stabilize their intake for a period of 2 to 3 weeks or more if additional time is needed. Once they stabilize and maintain at a set number of cigarettes and reach three cigarettes per day, it is typically not too difficult for a student to go from three cigarettes per day to none.

Resources Required to Implement Practice:

• American Cancer Society Fresh Start Smoking Cessation Program
• National Association on Drug Abuse and the American Lung Association
• Teen Files: Smoking Truth or Dare
• Individual Assessments (Mingo Job Corps TEAP Specialist)
• Loyola University

Evidence of Success: Since the beginning of the last program year (July 2002-June 2003), a total of 99 students signed up to participate in the smoking cessation program. Of this number, approximately 46 percent have successfully cut down their cigarette consumption from their initial visit, and 8 percent have totally quit smoking and successfully abstained from smoking for several months.

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St Louis Stop Smoking Cards

The center mental health consultant has ordered free stop smoking cards that can be distributed to students. The card shows the number, 1-800-QUIT-NOW, to a free smoking cessation resource that supplies health information and support to those who wish to quit smoking. The call is answered by a tobacco cessation representative in the caller's state. This hotline is available from the National Cancer Institute (NCI) 24-hour hours per day, 7-days a week.

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