Duke-UNC TTS: Where Training Meets Transformation
- Rachael Joyner
- 1 hour ago
- 4 min read
Rachael Joyner’s journey from learner to Duke clinician showcases the transformational impact of the Duke-UNC Tobacco Treatment Specialist Training Program
The Duke-UNC Tobacco Treatment Specialist Training Program celebrates its 10th year anniversary in 2026. We could share a lot of wonderful facts and figures about our reach, but I think one of the best ways to illustrate the impact of our program is to share the stories of participants who have taken the training and gone on to do great things in tobacco treatment. We get a lot of these stories.
I am one of those stories.
I found the Duke-UNC Tobacco Treatment Specialist Training Program through a web search. I was finishing my doctoral degree and working as a Family Nurse Practitioner at a rural primary care practice in North Carolina. I became interested in how to improve smoking cessation treatment from my firsthand experience at work.
More than 50% of our patients were daily cigarette smokers. They had significant smoking-related health issues – heart and lung disease, cancer, high blood pressure, peripheral arterial disease requiring limb amputations – and I was struck by the fact that we weren’t helping treat one of the root causes, their smoking.
Sure, we explained how smoking was impacting their health, but we didn’t do anything concrete to address this or help them stop. Some of the providers at the clinic didn’t even mention it during their visits. The attitude was, “Why bother asking anymore? They aren’t going to quit.”
Like many of my clinician colleagues, my training as a nurse and nurse practitioner had included very cursory information on treating tobacco use. I remember a lot of information on harms caused by smoking but very little about how to effectively treat tobacco dependence. As I searched the web for best practices and guidelines for treating smoking, I came across the Duke-UNC Tobacco Treatment Specialist Training Program. I saw they offered scholarships for providers working with underserved populations and had a flexible, virtual training schedule. This was in 2020, shortly after the pandemic started.
The training was excellent and made me feel confident to provide evidence-based tobacco treatment. After completing the training, I sat for the national exam to become a certified Tobacco Treatment Specialist. I joined a listserv for clinicians treating tobacco use (I made that connection through Duke-UNC TTS) and later heard about an opening at Duke with their Smoking Cessation Program. I e-mailed the hiring manager and mentioned I had attended the Duke-UNC TTS training. I was granted an interview and by December 2021 I was part of the team.
“Finally,” I thought. “I can give patients something that actually works.”
As I celebrate my 5 year anniversary with the Duke Smoking Cessation Program, I feel it’s very fitting that the Duke-UNC TTS Program is celebrating its 10-year anniversary. Taking that TTS training years ago really set the course of my professional career. I’ve worked in a lot of jobs – both as a nurse and a nurse practitioner – but I have found my calling with tobacco treatment at Duke.
This is the most fulfilling and impactful position I’ve ever held. The opportunity I have to help patients every day, share evidence-based tobacco treatment through educating other clinicians, and do translational research in this sub-specialty is priceless.
I am humbled when I remember I am now on the leadership team and faculty for the Duke-UNC TTS Training Program. What a difference five years and one training can make!
Do you have a story to share about your journey as a tobacco treatment professional? We’d love to hear it! Please submit your story here!
🎉 A Decade of Impact—And a Special Thank You to Our Community
As we celebrate the 10th anniversary of the Duke-UNC Tobacco Treatment Specialist (TTS) Training Program, we want to thank the thousands of professionals who have helped build an extraordinary community dedicated to reducing the burden of tobacco use.
To show our appreciation, we're launching a 10-Year Anniversary Appreciation Sale!
🚨 Register for a Duke-UNC TTS CE Short Course by December 31, 2026, and get $50 off course fees!* 🚨
Upcoming CE Short Courses include:
Intensive Behavioral Health Approaches to Tobacco Treatment, September 16, 2026
Mindfulness Training for Smokers Facilitator Training, December 1, 2026
Tobacco Treatment in Adolescent and Young Adult Populations, January 26, 2027
Tobacco Dependence Pharmacotherapy, March 31, 2027
Use promo code ANNIVERSARY10 to access the discount. See below for Terms and Conditions.
Visit our CE Short Courses page for more information about our virtual CE Short Courses.
About the Author
Rachael Joyner, DNP, FNP-BC, APRN, is a family nurse practitioner with the Duke Smoking Cessation Program. She holds a National Certification in Nicotine and Tobacco Treatment and received her Doctorate in Nursing Practice from the University of Florida. She loves working collaboratively with patients to help them become tobacco free.
*Anniversary Sale Terms and Conditions: Anniversary sale promotion cannot be combined with any other offers or discounts. Applicable only to CE Short Courses. Limit of two $50 discounts per individual. Both discounted registrations must be for the same participant and cannot be transferred to another person.