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Love My LifeTobacco Free!

is a regional project of the East Tobacco Control Area Network

Evidence Brief
What is LML?
Guided by the ministrys Comprehensive Tobacco Control Guidance Document (Comprehensive Tobacco
Control Working Group, 2010), Love My LifeTobacco Free! (LML) is a comprehensive health
promotion approach to tobacco prevention among children, youth and young adults that fosters
community partnerships and youth engagement to enhance supportive social and physical
environments and influence policies which support healthy living for the mind, body and spirit.
Supportive environments are important and a worthy focus. The US Surgeon Generals Report suggests
the teen brain is particularly susceptible to social and [physical] environmental influences to use
tobacco (U.S. Department of Health and Human Services, 2012, p.460).
LML is about normalizing tobacco free living through youth voices. By tapping into their strengths and
interests, LML is able to link opportunities, educate on tobacco and facilitate health promotion. LML is
an opportunity to tackle multiple tobacco contexts by addressing the challenges it poses to both physical
and social environments. It also brings on a cultural conversation with youth about the connection
between mental health and healthy lifestyles.
The LML campaign gives youth the freedom of creative self-expression to deliver authentic messaging in
the promotion of tobacco free social and physical environments. LML meaningfully engages youth of
varying social identities in expressing their personal stories to reshape knowledge into something
meaningful.
Participating youth move through grassroots projects as a full-circle experience. It is platform for them
to artistically or otherwise creatively express themselves freely and openly as informed critical thinkers.
Their revelations have the power to transform their surroundings into supportive environments which in
turn leads back to the ultimate form of positive self expression: healthy behaviours.
Strategic partnerships and collaborations make this an effective and sustainable health promotion
strategy with whole-community impact.

Why positive self-expression?


LML offers a progressive platform to meaningfully engage youth of varying social identities in positive
self-expression. Rescue Social Change Group (2013) has identified peer crowds as a reliable
measurement of tobacco risk level. The LML campaign gives youth the freedom of creative selfexpression to deliver authentic messaging that speaks to their respective peer crowd and aligns with
their personal values.

Prepared by Jenna Chisholm, Youth Engagement Coordinator, Eastern Ontario Health Unit

2015-09-01

Love My LifeTobacco Free! is a regional project of the East Tobacco Control Area Network
LMLs tailored messaging, via the youth voice, recognizes that youth within different contexts and
subcultures have different patterns of tobacco use and reasons for them (Colgan, Turnbull, MikockaWalus, & Delfabbro, 2010). Engaging youth in sharing their educated beliefs is a form of social
marketing, effective in behaviour change (Turning Point Social Marketing National Excellence
Collaborative, n.d.). Thomas, McLellan, and Perera (2015) found that combined social competence and
social influence interventions achieve best results in tobacco prevention. This supports growing LMLs
progressive platform to meaningfully engage youth.

Why mind, body and spirit resiliency?


The Centre of Excellence for Youth Engagement (2003) supports empowering youth through mastery
experiences, positive social persuasions and modeling to encourage resilience. Woodgate and Skarlato
(2015) and Resiliency Initiatives (2012) suggest beneficial outcomes for moving beyond looking at
adverse health issues and behaviours to focus on maintaining good overall health and developing assets
within supportive environments.
A study by Ward, Muller, Tsourtos, Hersh, Lawn, Winefield, and Coveney (2011) of ex-smokers and
never-smokers revealed the importance of exploring, in policy and practice, how individual internal
assets interact with external factors. Ward et al. (2011) support an approach that includes selfreflection as a broad 'project of the self' and supportive environments to reach resilience to smoking.

Why such a broad approach to tobacco prevention?


Research also shows that unconventional initiatives are perceived as most effective at reducing tobacco
use (Mendenhall, Harper, Henn, Rudser, & Schoeller, 2013). The health risks associated with tobacco
use and exposure are well known; therefore, messaging should creatively channel social issues and
interests such as animal rights, as suggested in an Ontario study (Rescue Social Change Group, 2013).
LML is a vehicle for this as well as other areas that match youth interests and values.
LML meets each of the 5 recommendations listed on page 8 of the 2010 literature review by the Ontario
Tobacco Research Unit for the Canadian Public Health Association (Borland & Schwartz, 2010):

Borland and Schwartz (2010)


Recommendations

LMLs
Implementation

1. Build upon elements of existing programs


that have been shown to be effective rather
than repeating methods that have achieved
limited success.

LML collaborates with


partners on existing
initiatives to increase
capacity and
sustainability.

2. Programs need to be flexible to the


variability between communities so that the

LML is non prescriptive.


Needs assessments

Prepared by Jenna Chisholm, Youth Engagement Coordinator, Eastern Ontario Health Unit

2015-09-01

Love My LifeTobacco Free! is a regional project of the East Tobacco Control Area Network
different components of a given program can
be modified to achieve acceptability.

ensure that initiatives


are appropriately
tailored.

3. Developmental work with representative


samples of the target audience to ensure
appropriate messages and activities are
implemented.

LML engages peer


crowds in creative selfexpression to deliver
authentic messaging.

4. Program messages and activities should be


guided by theoretical constructs about how
behaviours are acquired and maintained (i.e.,
Social Learning Theory).

LML is guided by the


empowerment theory
and the social
development model.
These are further
discussed below.

5. Community activities must reach the


intended audience if they are to be successful
in influencing the behaviour of the intended
audience.

Community, school and


online initiatives,
events and projects
reach youth and
stakeholders.

LMLs is based on Empowerment Theory (Perkins & Zimmerman, 1995) by which people gain a sense of
themselves and influence others. LML applies this theory at the individual, organizational, community,
societal and cultural levels. LML acknowledges that this theory may limit the extent of evaluation and
standardized outcome measures. Adapting Perkins and Zimmermans (1995) Empowerment Theory
assumptions to LML would mean that:
1. The issue of tobacco among youth is best addressed by youth.
2. Youth possess valuable knowledge about their own needs.
3. Youth have strengths to be built on.
4. Youth will come out of the process as critical thinkers.

LML is also guided by the social development model (Hawkins & Weis, 1985) which suggests that by
developing a sense of belonging and connectedness through youth engagement in positive self
expression, youth are more likely to behave according to tobacco free living norms and beliefs. Further
support to social approaches is shown in a review by Seo and Huang (2012) who found that smoking
behaviours likely decrease by strengthening peer networks and connectedness.

Prepared by Jenna Chisholm, Youth Engagement Coordinator, Eastern Ontario Health Unit

2015-09-01

Love My LifeTobacco Free! is a regional project of the East Tobacco Control Area Network

What does LML have to do with mental healt h?


Tobacco use is linked to poor mental health among youth (Kirst, Mecredy, & Chaiton, 2013). It is often
used as a coping strategy and is linked to regular tobacco use later in life. There is great overlap in
mental health and tobacco issues. LML addresses them as co-related health promotion topics.
Best practice guidelines for mental health promotion (Centre for Addiction and Mental Health, 2014)
identify social inclusion as one of the most important determinants of mental health. It is broken down
into three elements: social connectedness, networks and engagement. These align with LMLs culture of
positive self-expression and supportive environments.
A survey of all 36 Ontario health units revealed a wide range of mental health related activities, many of
which primarily focused on correlated risk factors such as tobacco, with a secondary gain in mental
health promotion (CAMH Health Promotion Resource Centre, Ontario Agency for Health Protection and
Promotion, & Toronto Public Health, 2013). Similarly, LML addresses multiple aspects that contribute to
health through a holistic lens.

Why LML aims to increase tobacco free environments?


Tobacco free policies create social and physical environments supportive of healthy living. A tobacco
free environment also supports the process of normalizing tobacco free living by removing tobacco use
role-modeling.
Studies show that students who are exposed to smoking even at the periphery of school grounds are
more likely to engage in smoking behaviour (Leatherdale, Brown, Cameron, & McDonald, 2005).
Strengthening the current restrictions imposed by the Smoke-Free Ontario Act to reduce social modeling
would be beneficial (Leatherdale & Manske, 2005).

Why go about tobacco free schools through LML?


Strong tobacco policies in combination with cessation are linked to lower smoking rates (Sabiston et al.,
2009). Furthermore, it is shown that tobacco related beliefs and perceptions in the school context and
school connectedness heavily influence student tobacco use (Kaai, Manske, Leatherdale, Brown, &
Murnaghan, 2014). LML engages youth at a grassroots level in the creation of tobacco free schools in a
positive light to encourage ownership and connectedness with increased awareness and referrals to
cessation services.
Schools, in partnership with public health, are uniquely positioned to influence the health and wellbeing
of youth. Tools are available to motivate school and other community partners based on matching core
values: Foundations for a Healthy School; Promoting a Positive School Climate; Provincial legislation;
Indigenous Wellness Framework; Keeping Youth Connected, Healthy and Learning;
http://www.lmlontario.com/resources.html, Ontario Curriculum.
Prepared by Jenna Chisholm, Youth Engagement Coordinator, Eastern Ontario Health Unit

2015-09-01

Love My LifeTobacco Free! is a regional project of the East Tobacco Control Area Network

Why go cross-pillar from tobacco prevention to cessation?


With policies driving tobacco use off of school grounds it is important to offer a comprehensive
approach that supports cessation (Watts, Lovato, Card, & Manske, 2010). Cessation also speaks to the
sustainability of the campaign and a comprehensive approach to tobacco control.

Is LML Sustainable?
LML follows the 5 categories of influences identified by Centre for Addiction and Mental Health
Provincial System Support Program (2015) in their Evidence Brief on Understanding Change: What Does
the Evidence Say About Sustainability.

CAMH PSSP (2015)


Categories of
Influence

LMLs Implementation

1. Effective interventions

The campaign strategically aligns itself with


organizations for effective interventions.

2. External context

LML addresses the external context of


tobacco related behaviours through
policies and system support.

3. Internal contexts

Internal contexts are addressed through


engagement and positive environments.

4. Resources and capacity

Through the Tobacco Control Area


Network and the Smoke-Free Ontario
Strategy, LML has the necessary resources
and capacity to mobilize schools,
communities and the youth within them.

5. Process and interaction

Most importantly, LML in its very essence


is a process and interaction that is
adaptable.

Prepared by Jenna Chisholm, Youth Engagement Coordinator, Eastern Ontario Health Unit

2015-09-01

Love My LifeTobacco Free! is a regional project of the East Tobacco Control Area Network

References
Borland, T., & Schwartz R. (2010). The Next Stage: Delivering Tobacco Prevention and Cessation
Knowledge through Public Health Networks. Ontario Tobacco Research Unit for the Canadian
Public Health Association. Retrieved from
http://www.cpha.ca/uploads/progs/substance/tobacco/cpha_litreview.pdf
CAMH Health Promotion Resource Centre, Ontario Agency for Health Protection and Promotion, &
Toronto Public Health. (2013). Connecting the Dots How Ontario Public Health Units are
Addressing Child and Youth Mental Health. Centre for Addiction and Mental Health. Retrieved
from
http://www.camh.ca/en/hospital/about_camh/provincial_systems_support_program/Documen
ts/Connecting%20the%20Dots%20FINAL.pdf
Centre for Addiction and Mental Health. (2014). Best practice guidelines for mental health promotion
programs: Children (712) & youth (1319). CAMH Publications. Retrieved from
https://www.porticonetwork.ca/documents/81358/128451/Best+Practice+Guidelines+for+Men
tal+Health+Promotion+Programs+-+Children+and+Youth/b5edba6a-4a11-4197-866842d89908b606
Centre for Addiction and Mental Health Provincial System Support Program. (2015). Sustaining Change:
What Does the Evidence Say About Sustainability? Evidence Exchange Network for Mental
Health and Addictions, Retrieved from http://eenet.ca/wpcontent/uploads/2015/01/Sustainability-Evidence-Brief-Final.pdf

Prepared by Jenna Chisholm, Youth Engagement Coordinator, Eastern Ontario Health Unit

2015-09-01

Love My LifeTobacco Free! is a regional project of the East Tobacco Control Area Network
Centre of Excellence for Youth Engagement. (2003). Youth Engagement and Health Outcomes: Is There a
Link? The Students Commission. Retrieved from
http://www.engagementcentre.ca/files/litreview1_web_e.pdf
Colgan, Y., Turnbull, D. A., Mikocka-Walus, A. A., & Delfabbro, P. (2010). Determinants of resilience to
cigarette smoking among young Australians at risk: an exploratory study. Tobacco Induced
Diseases, 8(1), 7. doi:10.1186/1617-9625-8-7
Comprehensive Tobacco Control Working Group. (2010) Comprehensive Tobacco Control Guidance
Document. Standards, Programs & Community Development Branch Ministry of Health
Promotion. Retrieved from http://www.mhp.gov.on.ca/en/healthy-communities/publichealth/guidance-docs/ComprehensiveTobaccoControl.PDF
Hawkins, J. D., & Weis, J. G. (1985). The social development model: An integrated approach to
delinquency prevention. Journal of Primary Prevention, 6(2), 73-97. doi:10.1007/BF01325432
Kaai, S. C., Manske, S. R., Leatherdale, S. T., Brown, K. S., & Murnaghan, D. (2014). Are experimental
smokers different from their never-smoking classmates? A multilevel analysis of Canadian youth
in grades 9 to 12. Chronic Diseases and Injuries in Canada, 34(2-3), 121-131.
Kirst, M. Mecredy, G., & Chaiton, M. (2013). The Prevalence of Tobacco Use Co-morbidities in Canada.
Canadian Journal of Public Health, 104(3), 210-215.
Leatherdale, S. T., Brown, K. S., Cameron, R., & McDonald, P.W. (2005). Social modeling in the school
environment, student characteristics and smoking susceptibility: A multi-level analysis. Journal
of Adolescent Health, 37(4), 330-336. doi:10.1016/j.jadohealth.2004.10.008

Prepared by Jenna Chisholm, Youth Engagement Coordinator, Eastern Ontario Health Unit

2015-09-01

Love My LifeTobacco Free! is a regional project of the East Tobacco Control Area Network
Leatherdale, S. T., & Manske, S. (2005). The Relationship Between Student Smoking in the School
Environment and Smoking Onset in Elementary School Students. Cancer Epidemiology,
Biomakers & Prevention, 14(7), 1762-1765. doi:10.1158/1055-9965.EPI-05-0065
Mendenhall, T. J., Harper, P. G., Henn, L., Rudser, K. D., & Schoeller, B. P. (2013). Community-Based
Participatory Research to Decrease Smoking Prevalence in a High-Risk Young Adult Population:
An Evaluation of the Students Against Nicotine and Tobacco Addiction (SANTA) Project. Families,
Systems & Health: The Journal of Collaborative Family HealthCare, 32(1), 78-88.
doi:10.1037/fsh0000003
Perkins, D. D., & Zimmerman, M. A. (1995). Empowerment Theory, Research, and Application. American
Journal of Community Psychology, 23(5), 569-579. doi:10.1007/BF02506982
Rescue Social Change Group. (2013). Ontario Youth Tobacco Use, Functional Analysis for Cultural
Interventions Research Findings.
Resiliency Initiatives. (2012). Core Character Competencies and Positive Youth Development. Resiliency
Initiatives. Retrieved from http://www.resiliencyinitiatives.ca/cms/wpcontent/uploads/2012/10/CORE_COMPETENCIES-Dec-10-2012.pdf
Sabiston, C. M., Lovato, C. Y., Ahmed, R., Pullman, A. W., Hadd, V., Campbell, H. S., Nykiforuk, C., &
Brown, K. S. (2009) School Smoking Policy Characteristics and Individual Perceptions of the
School Tobacco Context: Are They Linked to Students Smoking Status? Journal of Youth and
Adolescence, 38(10), 1374-1387. doi:10.1007/s10964-009-9422-z

Prepared by Jenna Chisholm, Youth Engagement Coordinator, Eastern Ontario Health Unit

2015-09-01

Love My LifeTobacco Free! is a regional project of the East Tobacco Control Area Network
Seo, D.C., & Huang, Y. (2012). Systematic Review of Social Network Analysis in Adolescent Cigarette
Smoking Behaviour. Journal of School Health, 82(1), 21-27. doi:10.1111/j.17461561.2011.00663.x
Thomas, R. E., McLellan, J., & Perera, R. (2015). Effectiveness of school-based smoking prevention
curricula: Systematic review and meta-analysis. BMJ Open, 5(3). doi:10.1139/bmjopen-2014006976
Turning Point Social Marketing National Excellence Collaborative. (n.d.). The Basics of Social Marketing:
How to use Marketing to Change Behaviour. Turning Point Initiative. Retrieved from
http://socialmarketingcollaborative.org/smc/pdf/Social_Marketing_Basics.pdf
U.S. Department of Health and Human Services. (2012). Preventing Tobacco Use Among Youth and
Young Adults: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and
Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease
Prevention and Health Promotion, Office on Smoking and Health. Retrieved from
http://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf
Ward, P. R., Muller, R., Tsourtos, G., Hersh, D., Lawn, S., Winefield, A. H., & Coveney, J. (2011). Additive
and subtractive resilience strategies as enablers of biographical reinvention: A qualitative study
of ex-smokers and never-smokers. Social Sciences & Medicine, 72(7), 1140-1148.
doi:10.1016/j.socsimed.2011.01.023
Watts, A. W., Lovato, C. Y., Card, A., & Manske, S. R. (2010). Do students perceptions of school smoking
policies influence where students smoke?: Canadas Youth Smoking Survey. Cancer Causes and
Control, 21(12), 2085-2092. doi:10.1007/s10552-010-9627-1

Prepared by Jenna Chisholm, Youth Engagement Coordinator, Eastern Ontario Health Unit

2015-09-01

Love My LifeTobacco Free! is a regional project of the East Tobacco Control Area Network
Woodgate, R. L., & Skarlato, O. (2015). It is about being outside: Canadian youths perspectives of
good health and the environment, Journal of Health and Place, 31, 100-110.
doi:10.1016/j.healthplace.2014.11.008

Prepared by Jenna Chisholm, Youth Engagement Coordinator, Eastern Ontario Health Unit

2015-09-01

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