Bucket Approach Continues to Help People Across Wisconsin Quit Smoking

The Bucket Approach, developed by retired UW-CTRI researcher Dr. Bruce Christiansen and advocated by UW-CTRI staff, continues to help behavioral health providers and their clients in two counties along the shores of Lake Superior. The approach is an evidence-based strategy to treat tobacco use among clients in a systematic, efficient way.

“The staff love that it’s a very specific approach that’s very well set up,” said Valerie Levno, Comprehensive Community Services (CCS) Administrator at Ashland Comprehensive Community Services and Bayfield Comprehensive Community Services. “There are forms and dialogues that we can review and are easy to follow.

“Before the Bucket Approach, we always asked about tobacco use, would refer to one of the local DHS 75 clinics and it ended there.”

Now, they ask every patient at every visit about tobacco use—then follow up every six months. Service facilitators administer the screening and substance abuse counselors follow up with those who want support with commercial tobacco cessation.

The team at Bayfield Comprehensive Community Services has implemented the Bucket Approach and seen how it can help clients with their tobacco use. 
The team at Bayfield Comprehensive Community Services has implemented the Bucket Approach and seen how it can help clients with their tobacco use.

People with behavioral health diagnoses smoke at much higher rates than the rest of the population and have a harder time quitting. That said, two clients in Bayfield County have quit thanks to the Bucket Approach, and several clients in Ashland County have reduced their smoking and maintained that progress.

“It works,” Levno said.

The idea behind the approach is that behavioral health patients who smoke can be sorted by inclination to quit into “buckets” to best empower them to quit. All interventions are tailored to people who smoke and are affected by mental illness and/or other addictions.

“This has really been helpful,” Levno said. “Especially helpful for clients who want it. During the pandemic, more people were concerned about breathing and smoking. So the timing has been good.”

They’ve personalized the approach to the individual client, too. For example, one client wanted to simplify the process, so they worked together to boil down the Bucket Approach to one Post-It note, and that patient has nearly worn out the note using it as a reminder to stay smoke-free.

Levno said that rural clinics can struggle with access to valuable trainings due to their remote locations. Now, the Bucket Approach Training is a FREE online training for healthcare providers that includes free CE credit, sponsored by the Wisconsin Department of Health Services.

“I’m glad the state has stepped up to make it accessible and sustainable,” Levno said, adding she hopes they’ll use that same online training model for other topics.

“Absolutely, it works. You can use the Bucket Approach to treat other things, it doesn’t have to be just tobacco.”