ACT Center helps tobacco users say no to nicotine - for good
By Matt Westerfield
A tobacco-treatment center that originated with a dentist and a psychologist encouraging smokers to kick the habit has just passed its 10-year milestone while at the same time expanding its services to more locations than ever before.
Located in the Jackson Medical Mall Thad Cochran Center, the University of Mississippi Medical Center's ACT Center opened in 1999 with a mission to help Mississippians quit using tobacco - and to stay tobacco-free -through education, training and research.
Dr. Karen Crews, director of the center, spearheaded the project while she was on faculty in the School of Dentistry. As a young practitioner working at a corrections facility where 80 percent of the inmates smoked, Crews said she witnessed first-hand the havoc tobacco wreaked on the oral cavity.
"Among many other things, tobacco use is a dental problem," Crews said.
Realizing that most smokers need help to quit, she later launched a tobacco education program at the dental school. Then, in July of 1997, the state reached a settlement with the four biggest tobacco manufacturers in the country, a lawsuit launched by then-Attorney General Mike Moore. Shortly after the settlement, Crews said she received a phone call from Moore asking her to write a proposal for a tobacco-cessation program.
Thanks to a key partnership with Dr. Thomas Payne, a clinical psychologist who had created a tobacco-treatment program at the VA Medical Center, that proposal evolved into the ACT Center.
Payne, a professor in the department of Otolaryngology and Communicative Services, serves as associate director and director of clinical research. The center is part of the Division of Oral Oncology and Biobehavioral Medicine within the Department of Otolaryngology and Communicative Sciences.
ACT Center staff include, clockwise from top left, Dr. Monica Sutton, coordinator of community services; Dr. Natalie Gaughf, coordinator of clinical services; Debbra Hunter, director of clinical operations; Dr. Karen Crews, director; and Dr. Thomas Payne, associate director.
Since its inception, the ACT Center has been funded primarily with appropriations from the state's tobacco settlement.
"We see about 240 new patients a month throughout our network, and we also follow up with them for about a year afterward," said Dr. Natalie Gaughf, assistant professor of otolaryngology and coordinator of clinical operations. A one-year quit rate is the gold standard in determining whether a patient has really quit, Gaughf said. "We expect this number to increase substantially by next year."
The center's average patient is 46 years old and has a high level of addiction, smoking for more than 24 years.
The intensive treatment program consists of an initial intake session followed by six sessions of education, cognitive-behavioral counseling and, where necessary, medication. The numbers indicate the approach works.
"Only 3 to 4 percent of smokers who try to quit on their own succeed long-term," Gaughf said. By comparison, last year the ACT Center had a quit rate of 44 percent.
Since the ACT Center program is available to any Mississippi resident, Crews and Payne wanted it to be conveniently accessible to all Mississippians.
"Our goal is that NO Mississippi resident should have to travel more than 30 minutes for this treatment," Payne said.
To that end, a fundamental mission of the ACT Center has been to offer the service at strategic locations around the state and to train health-care providers at those locations.
Last month, 13 additional sites began providing services, combining for a total of 27 ACT Center-supported locations at hospitals and universities across the state.
Apart from treatment and training, the ACT Center is involved in a variety of research efforts on tobacco use, the biggest of which concerns the genetics of nicotine dependence.
"Over the past 10 years, we've produced 15-20 papers that have identified several novel genetic factors that relate to the development and expression of nicotine dependence," said Payne. "Our lab and other labs are finding that nicotine dependence is a very complex condition."
Along these lines, Payne also studies how genes predict an individual's response to medications. He said this will help to identify which medications work best for certain individuals.
Payne said the ACT Center will be one of about 20 centers nationwide to participate in a Phase III clinical trial for the drug NicVAX. An ad campaign will soon be launched to attract participants around March1, he said.
According to the Centers for Disease Control and Prevention, the direct medical costs of smoking reaches $96 billion annually. Payne said their work is intended to show that investing in tobacco prevention and cessation has a significant reduction of health-care costs. The higher the quit rate, the greater the reduction in health-care costs.
Payne said the ACT Center and Mississippi as a whole are gaining ground.
According to the CDC, 22.7 percent of adult Mississippians smoked in 2008, the seventh-highest smoking rate in the nation. By comparison, 19.8 percent of adults smoked nationwide. But Payne points out that Mississippi was ranked third the year before.
"We're hoping this is a system that will offer treatment to 8,000 to 10,000 patients per year by next year."