Peers Helping Peers: Ways to Quit Tobacco with Rx for Change

Karen Balsamico started smoking when she was a senior at San Francisco State in 1972, because a dorm mate said it would help her keep weight off. She continued to smoke for 31 years long after finishing her BA and MA in Theatre Arts.

In July of 2003 Karen contacted Beth Lillard, at Bay Area Community Resources, to help her quit smoking. As fate would have it, she had a heart attack Labor Day weekend, making for a profound wake up call. Due to the heart attack she “quit for good” September 30, 2003.

Once she was tobacco free, she offered to volunteer for BACR. Her first assignment as a volunteer was a 3‐minute statement to the Marin County Board of Supervisors in December of 2003. Since then she has been a guest speaker, sharing her experience at numerous Tobacco Quit Groups. 

In 2009, she started a tobacco cessation support group at Enterprise Resource Center, where she was a Peer Counselor until February 2011. Karen has spoken at several conferences over the years such as the Annual meeting of the National Board of Smoking Cessation Leadership Center in the year 2008, and the NAMI National Convention in San Francisco in 2009.

This year Karen has been the Peer Coordinator for the Tobacco Cessation Needs Assessment Project at Bay Area Community Resources.

Ken Duckworth, MD, serves as the medical director for NAMI, the National Alliance on Mental Illness. He is double board certified in adult and child and adolescent psychiatry. He has also completed a forensic psychiatry fellowship.

Dr. Duckworth is currently an Assistant Clinical Professor at Harvard University Medical School, and has served as a board member of the American Association of Community Psychiatrists. Dr. Duckworth has held clinical and leadership positions in community mental health, school psychiatry and now also works as Associate Medical Director for
Behavioral Health at Blue Cross and Blue Shield of Massachusetts. Prior to joining NAMI in 2003, Dr. Duckworth served as Acting Commissioner of Mental Health and the Medical Director for Department of Mental Health of Massachusetts, as a psychiatrist on a Program of Assertive Community Treatment (PACT) team, and Medical Director of the Massachusetts Mental Health Center.

Dr. Duckworth attended the University of Michigan where he graduated with honors and Temple University School of Medicine where he was named to the medical honor society, AOA. While at Temple, he won awards for his work in psychiatry and neurology. 

He is also a family member of a person living with mental illness.

Karen S. Hudmon, DrPH, MS, RPh, CTTS, is Professor of Pharmacy Practice at the Purdue University College of Pharmacy and Clinical Professor at the University of California San Francisco School of Pharmacy. She’s a licensed pharmacist and a cancer prevention researcher with 30 years of tobacco research experience and has personally provided tobacco cessation training to more than 30,000 health professionals.

Karen was one of the original authors of the Rx for Change: Clinician-Assisted Tobacco Cessation training program, which is used globally to train students and licensed clinicians to apply evidence-based approaches for helping patients quit. Currently, Karen’s research is funded by the NIH and the Indiana State Department of Health. She testified in favor of legislation to advance Indiana pharmacists’ role in prescribing cessation medications, was instrumental in drafting the statewide protocol, and is leading statewide training efforts.

Beth Lillard began her career as behavioral health educator, counselor, and group facilitator in Germany in the late 1970’s, working for the U.S. Army as a civilian
alcohol/drug counselor.

Since then, she has developed programs and provided direct services in New Mexico and California for: residential and out-patient substance use programs; jail inmate education;
homeless shelters; and HIV/AIDS agencies, among others.

In 1994, she returned to Europe to live, moving to Portugal where she taught English at International House for 7 years. Beth believes this experience has greatly influenced her design of effective health education programs, with particular focus on encouraging peer to peer participation.

Since 2003, Beth has been Project Director of Adult Tobacco Cessation Services at Bay Area Community Resources in San Rafael, California. In addition to her community capacity-building work with agencies and medical clinics, she conducts tobacco cessation classes throughout Marin County, primarily for underserved populations. Beth has presented at national and regional conferences on creating “quit-friendly” environments within the mental health community and has organized several local conferences, as well.

Beth’s goal? Hundreds, even thousands, of mental health and substance use peers trained as cessation support counselors and community advocates for their “right to quit”, in spite of institutional barriers.

Frank Vitale, National Director of the Pharmacy Partnership for Tobacco Cessation, has worked in the smoking cessation field since 1987 designing cessation programs, educating over 20,000 health professionals in how to help patients stop tobacco use, and counseling nearly 10,000 patients to quit. He received a B.A. in Liberal Arts from St. Vincent College in 1974 and a Master’s Degree in Psychology from Duquesne University in 1988. He entered the field as a Health Educator, then as Clinic Coordinator for the Lung Health Study, researching the differential effects of smoking cessation and an inhaled medication (Atrovent) on the prevention of COPD in identified high risk individuals. Frank followed this by becoming Project Director of Lung Health Study II.

Subsequently he created a six-hour CE program, the International Smoking Cessation Specialist Program, designed to teach pharmacists how to do smoking cessation counseling, writing the patient support booklets that accompany this training as well as all auxiliary materials. This program has been presented throughout the U.S., Puerto Rico, Spain and the United Kingdom. In addition, he contributed content material for the RX for Change curriculum. From 2007- 2012 Frank continued to provide cessation counseling training to pharmacists through various project with the CS2Day program. Recently he designed a cessation training program and intervention protocol for psychologist in Beijing, China as well as for the HY VEE grocery chain in eight Midwestern states.

He is currently a Clinical Assistant Professor at Purdue’s College of Pharmacy working on a myriad of projects designed to train pharmacists, physicians, respiratory therapists, and other clinicians interested in adding cessation counseling to their practice.