Campus Wellness: The Problem with Tobacco Frank T. Leone, MD, MS Comprehensive Smoking Treatment Program University of Pennsylvania Philadelphia, PA PENN STOP

So… Why DO People Smoke?

Why is nicotine addictive? Nicotine releases “gratification” producing chemicals in the brain. Long term use of nicotine produces changes in brain function and structure. Addictive properties related to rate of delivery to the brain.

Mesolimbic Dopaminergic system Memory Motivation Emotion

Eur J Clin Pharm 2000; 55:

This Begs the Question… If smokers smoke for nicotine, why is nicotine replacement therapy not 100% effective?

The answer is in the backstory

Conditioned Place Preference

What is her Conditioned Place Preference?

Decision Balance Theory Motivation Disincentive More Likely Less

Eliminate the 3 Main Disincentives to Quitting Individual –Compulsion to Smoke Offer Treatment –Information Inertia Drive a Conversation –Disrespect Causal Controlability

Disincentives to Quitting Organizational –Smoke-free Campus Adopt a position and communicate it clearly Remove salient cues –Employee Health Resolve disparities

Disincentives to Quitting Institutional –Identity Issues Leaders / Thinkers Environmental stewards Artists / Academics –Community Partners Build a better workforce

Social Environmental Model

Comprehensive Smoking Treatment Program “If we always do what we’ve always done, we’ll always get what we’ve always gotten.” - Anonymous PENN STOP