Smoking Cessation in Adolescents - Coursework Example

INTRODUCTION It has been reported that in the United Kingdom, over 106,000 premature deaths occur due to smoking. About one fourth of those deaths occur as a direct result from cancer with a fifth resulting from emphysema and bronchitis. Over 87% percent of the lung cancer deaths were due to the habit of smoking and 86% of deaths obstructive lung disease, which includes bronchitis and emphysema. In 1995 smoking resulted in 120,000 deaths in UK, which means that, one in every five deaths was due to smoking. In those 46,500 i.e. 30% of the deaths were from lung cancer and 40,300 of them died from circulatory diseases. In a study it has been revealed that the percent of smoking among adults has considerably decreases in the late seventies and eighties but was leveled in the nineties. Though in late nineties the percentage of smokers had dropped a bit it was estimated that the situation wouldn’t improve further. If the effects of smoking can be quantified, then we will be talking of one of the most expensive pastimes in our time. It is approximated that in United Kingdom alone, the government spends close to a million Euros in intervention measures aimed at smoking cessation. This cost does not reflect the amount spent by other interest groups such as Non governmental organizations, research firms and private charity organizations. Speaking qualitatively, smoking causes more deaths all over the world than HIV/Aids. Of all smokers, a considerable percentage is drawn from adolescents but past smoking cessation programs have not targeted this age group but concentrated in other groups such as adults. This has contributed to a significant drop in the number of adult population smokers but of significance to this essay is the fact that, the prevalence of smoking amongst the adolescents has remained high or plummeted altogether. Substances which adolescents often abuse are referred to as psychoactive substances meaning that when taken, they have the capability to change an individual’s consciousness, mood or thinking process. They suppress a part of the brain whose usual function is normally to regulate the functions of the mood, thoughts and motivations. Cigarette smoking is one of the leading causes of deaths in the world. But sadly enough, those are deaths which are very preventable if smoking cessation is fully appreciated by the governments and other stake holders like education sector, religious organizations and charities. Studies indicate that in the United States of America alone, cigarette smoking cause up to around 400,000 deaths a year. These deaths in turn cost the government in excess of billions of dollars a year. The story is similar all over the world and the world is in dire need of effective smoking cessation by all means possible. I would want to believe that, for a case like that of US, smoking cessation should be given prominence equal to if not more than that given to the war on terrorism for smoking takes away more lives annually than terrorism has, in its entire history. According to reports from Office of National Statistics (ONS) there is an alarming rate of increase in adolescence smoking in UK. Over 10 percent of 11-15 years olds are into regular smoking , over 9% are of all adolescent smokers are boys while interestingly over 12% of girls smoke. The report further ascertains that 8% of boys and 8% of girls are only occasional smokers. The report noted that of those interviewed, in the age bracket of11-15 years, that is 54% boys and 51% of girls confessed to having never smoked. To have a clear picture of the smoking problem, stratification was done based on geographical areas and every region was coordinated by its regional NHS office. From this study, it was discovered that in 1998, Anglia and the Oxford regions had the highest number of smokers aged 16 and above while the area falling under the North West regional Office had the lowest number of smokers in the age 16 and above category. The government acting on the recommendations of the NHS report beeped up smoking cessation services which included more awareness campaigns, training of qualified professions to cope with the challenges amongst others. All these interventions were aimed at smoking related deaths as well to achieve prevention by creating a high awareness level. Besides the government made sure that all cessation services were accessible regard less of ones predisposition. All efforts smoking cessation efforts are geared towards achieving one or all of the following, minimizing the harmful effects of smoking, controlling short term, and social consequences like crime. Substance misuse is caused by a number of reasons including family factors which mean that for those parents who abuse or misuse, there is a very high probability that adolescents belonging to those families are at a higher risk of starting the use of illicit drugs. According to Hawkins et al 1987, attitudes and early drinking behaviors appear to be shaped more by parents and relatives than by peers. (Hutchings, Hall, & Lovelady, 2003), stressed that those children from families with unbalanced parental care, love and supervision, severe or inconsistent disciplining practices are at risk of delinquency and drug abuse. Truancy and early drop out from school are factors associated with substance abuse. This turn results from environmental factors such as disorganized and marginalized communities such as the minority, blacks, illegal immigrants ,those with high neighborhood crime rates and also lack informal social controls have less ability to limit drug abuse among adolescents . Adolescents tend to increase use of drugs due to the influence of friends and they also tend to choose friends who reinforce their own harmful drug use behaviors. In line of those findings there is a need for the government to ensure that the smoking cessation efforts address the underlying factors contributing to smoking amongst youths. This needs to be approached from a different angle from that taken while addressing same issue in other groups such as adults. Special needs also need to be identified amongst the youths since as is clear from the 1998 NHS study, the problem of smoking in adolescents is more pronounced in some areas than others. The geographical factors need to be analyzed so as to come out with the factors causing these disparities. It will not be surprising to find that smoking cessation cannot be successful if the intervention measures are applied blindly and uniformly to all areas. Tobacco misuse amongst adolescents is as harmful as other diseases due to the many diseases associated with it. These ranges from behavior disorders, such as high crime incidences such as being involved in fights, carrying weapons, engaging in high-risk sexual behavior and using alcohol and other drugs.Nicotine an active ingredient in tobacco is potent and powerful against several sub populations of nicotine necessities of the cholinergic nerves system (Bifulco& Moran 1998). Smoking cessation in adolescents is not yet lost a lost war, the following measures are necessary if the focus on smoking cessation in adolescents is to yield fruits. The first measure is to ensure that all programs targeting the adolescents bear in mind their special needs, developmental needs( since they are in Avery crucial development stage where one is often disillusioned and overwhelmed by the sudden change in their body develops, society’s high expectations and peer pressure. The program managers need also to note that for adolescents, they want to be involved in activities which are fun and energizing so even when they attend counseling sessions, these need to be tailored to suit their high expectations hence the need for training of nurses to specifically attend to adolescents with smoking needs. Adolescent smoking cessation efforts should be coupled with real social supports systems which would help them to persevere during the whole hard process of quitting smoking. Such support systems would include community open days, games day, sporting events, peer groups which would be controlled by specialists and also religious activities tailored to meet adolescent’s needs as well as addressing pertinent challenges facing the adolescents in regard to substance misuse. Smoking cessation need also to incorporate in the adolescents a sense of responsibility since this will always drive them to act responsibly as well as making responsible decisions. Adolescents need to be initiated into utilizing available community resources. The resources available include community libraries and local theatres where valuable knowledge on smoking effects can be learned. Smoking cessation will not succeed if treatment of nicotine dependence is not made available in every region, for instance it is hard for any one to travel all the way from Oxford to Anglia to seek treatment necessitated by smoking effects. Mostly many adolescents who owned up to smoking do not think it is a serious matter which can be solved by therapy just as the 1998 study findings showed leave alone traveling thousands of miles to seek treatment of nicotine replacement therapy such as nicotine gum and transdermal path. The other burning issue is just how well the UK classification of harmful drugs is helping. To this end, there is a need for the government to act tougher on legislation especially on advertisements about smoking which always will attempt to target the young hence indirectly leading many to join smoking at that delicate age. Worthy mentioning here is the fact that effects related to smoking during childhood and or in the adolescence stages produces significant health problems among young people, “including cough and phlegm production, an increase in the number and severity of respiratory illnesses, decreased physical fitness, an unfavorable lipid profile potential retardation in the rate of lung growth and the level of maximum lung function” (Pirisi, Angela, 2002). Here we are talking of effects in adolescents specifically! In its part NHS has not been sleeping on its job and that is why it is offering its smoking cessation services using all means possible including prescription methods NHS has resorted to prescription because this is a dimension not hitherto utilized but which studies have proved to be one of the best smoking cessation ways. NHS has further alluded to incorporate Patient Group Directions in the programme so as to make the services to as many needy people as possible. Although most smokers want to quit smoking for good, they lack the right advice and support; this is where nurses come in. Being the largest healthcare work force Nurses are the largest healthcare workforce, and not only the largest but also the only group in health care involved in almost all levels of the healthcare system, surely more attention need to be focused in their training and resource allocated increased in order to tap the potential in them. Research carried out on the role of nursing in smoking cessation has shown that advice and other forms of support from nurses can significantly increase people’s success in their attempts to quit smoking( Rice and Stead, 1987). The chances increase if such advice and support is offered in a hospital environment which is where the most nurses operate. On top of the above nurses are available in the grassroots especially playing the role of health checks and other prevention activities this will have many advantages since the service can reach the marginalized communities in a better manner. The advice and support given by nurses however brief should not be taken for granted since if integrated to the so called intensive interventions will yield into a solution. The other reason nurses need to come into the fore front in smoking cessation efforts is the fact that because they are acquainted with the daily patient care of patients suffering from tobacco related illnesses. Rice and Stead found a significant increase for the possibility of smokers quitting smoking with a nurse-delivered smoking cessation intervention. As the largest group of healthcare professionals, nurses come in contact with more patients across healthcare settings than any other group of healthcare providers. Smoking cessation will succeed if smoking behavior monitoring and other smoking cessation interventions are recognized so that all programs are designed to be user friendly as part of standard practice such user friendliness may include issues like giving patients the opportunity to freely talk about their experiences in smoking as well as being given advice and other support forms and regular follow ups. It is also important for further research to be carried out in order to find out emerging trends and new challenges. The government and other stakeholders should reinforce their campaigns against substance abuse. The legislation on smoking should constantly be upgraded to reflect on emerging trends and address fresh challenges. It is questionable as to whether the NHS regional offices are doing the job effectively this point to the need for setting up of more treatment and rehabilitation centers which are ideal centers for supporting nurses and even nursing students in their endeavor to intervene in smoking cessation. Conclusion. Smoking cessation in adolescents is every ones responsibility and the mistake of treating it a governments concern would be the wrong way to go. The government, despite the fact that in the past has only concentrated on adults in its programs related to smoking cessation does not mean all is lost. The recent introduction of smoking cessation training in nursing schools is a sigh of relief for it seems after all nurses can offer the best support and advice geared to smoking cessation. It will now be possible to integrate nicotine replacement therapy under Patient Care Initiatives. Therefore the school of nursing should incorporate in nurses a culture of leadership and advocacy for a smokeless society something which will lead to motivation of adolescents to quit smoking. BIBLIOGRAPHY Barnes, P. (Ed.). (1995). Personal, social and emotional development of children. Oxford: Blackwell. Bifulco, A. & Moran, P. (1998). Wednesday’s child: research into women’s experience of neglect and abuse in childhood and adult depression. London: Rout ledge. Benowitz, N.L., Ahijevych, K., Hall, S.M., Hansson, A., Henningfield, J., Hurt, R.D., Jacob, P., Jarvis, M., LeHouzec, J., Lichtenstein, E., Tsoh, J., & Velicer, W. (2002). Biochemical verification of tobacco use and cessation. Nicotine and Tobacco Research, 149-159. Department of Health. (1989). Children Act. C.41. London: HMSO. Retrieved May 6, 2004 from http://www.gov.u4/acts/acts1989/ukpga_19890041_en_1.htm Department of Health (2000) Working together to safeguard children: a guide to inter-agency working to safeguard and promote the welfare of children. London: DoH. Hall, D.M.B. & Elliman, D. (2002). Health for all children. (4th Ed.). Oxford: Oxford University Press. Hogg, C., Chadwick, T. & Dale-Perera, A. (1997). Drug using parents: policy guidelines for inter-agency working. London: L.G.A. Hutchings, S., Hall, J. & Lovelady, B. (2003). Teamwork: a guide to successful collaboration in health and social care. Bicester: Speechmark. Lewis, K.D. & Bear, B.J. (2002). Manual of school health. (2nd Ed.). Philadelphia: W.D Saunders. Lorenz, S. (1998). Children with Down’s syndrome: a guide for teachers and support assistants in mainstream primary and secondary schools. London: Dave Fulton. Department of Health. (N. d.). NHS Stop Smoking Services & Nicotine Replacement Therapy. Retrieved July 02, 2006 from http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/Tobacco/TobaccoGeneralInformation/TobaccoGeneralArticle/fs/en?CONTENT_ID=4002192&chk=5Xx9q6 -->. Department of Health. (N. d.).Reducing exposure to secondhand smoke. Retrieved July 02, 2006 from http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/Tobacco/TobaccoGeneralInformation/TobaccoGeneralArticle/fs/en?CONTENT_ID=4080093&chk=bfqRIr --> Department of Health. (N. d.). Responses to the consultation on the smoke Free elements of the Health Improvement and Protection Bill. Retrieved July 02, 2006 from http://www.dh.gov.uk/Consultations/ResponsesToConsultations/ResponsesToConsultationsDocumentSummary/fs/en?CONTENT_ID=4122129&chk=Vk1svJ --> Department of Health. (N. d.). Smoking doesnt just affect you. Retrieved July 02, 2006 from http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4128304&chk=EqyN0i --> Department of Health. (N. d.). Statistics on NHS Stop Smoking services in England, April to June 2004. Retrieved July 02, 2006 from http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsStatistics/PublicationsStatisticsArticle/fs/en?CONTENT_ID=4091799&chk=ZbhkGm --> Department of Health. (N. d.). Teenage smoking attitudes in 1996 a survey of the smoking behavior, knowledge and attitudes of 11 to 15 year olds in England. Retrieved July 02, 2006 from http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsStatistics/PublicationsStatisticsArticle/fs/en?CONTENT_ID=4006005&chk=66UwYT --> Department of Health. (N. d.). The impact of DH-funded provision of NRT in HM prisons - Revised findings. Retrieved July 02, 2006 from http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4134514&chk=EVjkBo --> Department of Health. (N. d.). Tobacco. Retrieved July 02, 2006 from http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/Tobacco/fs/en --> Jenkins, L., Ahijevych, K. (2003). Nursing student’s beliefs about smoking, their own smoking behaviors, and use of professional tobacco treatment intervention. Applied Nursing Research. 16, 164-172. Pirisi, Angela, (2002) "Nicotine metabolism varies between different ethnic groups," The Lancet Publishing Group vol.359 pp. 234. US Centers for Disease Control and Prevention, (1984) "Smoking Attributable Mortality and Years of Potential Life Lost--United States, Rice VH, Stead LF. Nursing interventions for smoking cessation. The Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD001188. DOI: 10.1002/14651858.CD001188. Wired of Health. (N. d.). Benefits of quitting. Retrieved July 02, 2006 from http://www.wiredforhealth.gov.uk/cat.php?catid=912&docid=7331 --> Wood T, Wewers ME, Groner J, Ahijevych K. (2004). Smoke constituent exposure and smoking topography of adolescent daily cigarette smokers. Nicotine & Tobacco Research, 6, 853-862. Wired of Health. (N. d.). Diseases caused by smoking. Retrieved July 02, 2006 from http://www.wiredforhealth.gov.uk/cat.php?catid=912&docid=7328 --> Department of Health. (2001). NHS Smoking Cessation Services. Retrieved July 02, 2006 from http://www.dh.gov.uk/assetRoot/04/07/81/16/04078116.pdf Department of Health. (2000). Statistics on Smoking: England, 1978 onwards. Retrieved July 02, 2006 from http://www.dh.gov.uk/assetRoot/04/05/78/63/04057863.pdf Read More