Health Professionals

What is Leave The Pack Behind?


Leave The Pack Behind is an innovative, comprehensive, tobacco control
initiative designed to reduce smoking prevalence and rates among post-secondary

Key features of comprehensive tobacco control programming

  • denormalization
  • protection
  • prevention
  • cessation

To influence smoking rates in the micro-communities of university
and college campuses, these features must be adapted to the unique culture
of the campus community. This means:

  • integrating programming into
    the existing infrastructure of the campus environment
  • making programming
    responsive to the insular nature of campus life and the mobility
    of the student population.12-15

Consistent with the principals of comprehensive programming, LTPB
supports a sustained, multi-channel communication campaign, provides uninterrupted
access to numerous smoking cessation interventions, and advocates for
tobacco control policies and organizational change. In all of these
LTPB uses a peer-to-peer approach with health professional guidance.
The peer-to-peer approach is achieved by hiring a small team of students
work under the supervision of a Nurse or Health Educator from the college’s
health clinic.

Communication Campaign

Student-staff design and implement continuous, campus-specific communication
campaigns to promote LTPB and denormalize ‘big tobacco.’ Besides
using mass media channels on campus, student-staff do extensive interpersonal

Mass Media Channels Interpersonal Outreach
  • campus newspapers
  • campus radio
  • banners
  • posters
  • java jackets
  • bookmarks
  • announcement boards
  • brochures
  • internet / website
  • table tents
  • banners
  • stickers
  • flyers
  • tattoos
  • email
  • ongoing, twice-per-week, interactive display tables
  • presentations
    to classes
  • appearances at campus events
  • drop-in office hours
  • information ‘walk-abouts’ in smoking
  • referrals from campus health clinics
  • carbon monoxide testing
  • support to administrative/policy issues on

All of these activities are ongoing throughout the entire school year.
The goal is to ensure that LTPB programs and services are well-known and
easily-accessible to students.

Based on the size of most campuses, patterns of student attendance and
traffic flow, and habitual gathering spots of different groups of students,
we have found that the steady use of a variety of communication channels
and locations for interpersonal outreach is the best way to reach all
students on a campus and maximize program impact. Similarly, continuous
messaging is important to reach students at the time they are most prepared
to listen (e.g., when they are ready to quit; having smoking-related issues
with friends or roommates; and so on).

Programs and Services

Self-help programs. Because post-secondary smokers,
like other smokers, express a preference for self-directed, easy-to-access
self-help programs are the mainstay of LTPB.

  • Canadian Cancer Society’s
    One Step At A Time self-help program (French & English
  • LTPB’s new Smoke|Quit self-help program addressing developmental
    issues of young adulthood).
  • Quit Kits containing educational brochures,
    quitting tips, smoking diaries and novelty items to support quitting
    are also routinely disseminated.

Let’s Make A Deal! Contest. LTPB also sponsors
an annual motivational contest held in conjunction with national non-smoking
week. Reflecting the
comprehensive approach of LTPB, the Let’s Make A Deal! contest addresses
harm reduction as well as smoking cessation.
Contestants can opt to:

  • Party Without The Pack (abstain from smoking
    when drinking alcohol)
  • Keep The Count (halve their tobacco consumption)
  • Quit For Good (stop
    smoking all together)
  • Don’t Start and Win
    (simply stay smoke-free if they do not smoke)

Because social support
is known to aid smoking cessation,19 quit-for-good contestants must
register with a ‘buddy’ who will help them
quit and avoid relapse. Thus, the contest involves non- and ex-smokers,
as well as smokers.

Proactive Telephone Support. Whether they use the self-help programs or
enter the contest, all smokers receive two proactive telephone support calls
from LTPB ‘Peer Educators’ (senior members of the student team
who receive specialized training to provide support and education to smokers).
This service is offered based on evidence that self-help interventions,
combined with brief personalized support, are effective at assisting smokers
to quit.20-22

Health Professional Advice.
Because brief physician/nurse advice is effective
at helping smokers quit,12,23 LTPB provides campus medical professionals
with accredited, continuing medical education in Clinical Tobacco Intervention
(CTI). To enhance the integration of CTI procedures into clinical practice,
LTPB also conducts follow-up training with medical professionals and supports
clinic staff to implement CTI charting procedures. Student-staff members
regularly supply campus clinics with packages of self-help and educational
materials for dissemination to patients who smoke; and a strong referral
process between LTPB and campus clinics is fostered.

Other Services. At the twice-weekly, interactive displays, LTPB student-staff
offer carbon monoxide testing to smokers and non-smokers alike. Additionally,
brochures outlining how to support a friend’s quit attempt are distributed.
When requested, members of the student team make educational presentations
to residence students during hall meetings. They support smokers who have
been referred from campus health professionals, and also make referrals
to various campus services.

Why have so many programs and services?
With this wide range of programs
and services, LTPB can offer take-away materials, peer-to-peer education,
or brief clinical interventions that are highly personalized to smokers’ needs.
This is important on a college campus for a number of reasons.

  1. Smokers who use assisted methods of quitting are more likely to succeed
    than those who do not.12,19-24 Given that most college smokers want
    to quit, but few succeed on their own,3,4,25 there is a clear need
    to disseminate
    appealing, effective interventions.
  2. Considering that many college smokers are less than daily smokers,3,4
    and that intensive clinical or pharmacological interventions may
    not be necessary or even appropriate for this group,26 offering other
    types of
    support is essential.
  3. Having a range of programs allows us to follow a stepped approach
    model where smokers can receive increasingly intensive interventions
    to match
    their level of addiction and self-efficacy for quitting.27
  4. Providing a variety of brief intervention options maximizes the reach,
    and thus population impact, of programming.12-15
  5. The diverse characteristics of young adult smokers make it unlikely
    that one type of intervention can adequately meet all their needs.


LTPB student-staff educate and support student governments
and senior administration to influence the campus agenda related
to tobacco control. Many LTPB student-staff members sit on campus committees
address health-related policies and organizational structures. LTPB
teams have also taken the lead in running student referendums, successfully
advocating for smoke-free bars, and bans of tobacco sales on campus.



Health Professionals
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