How to Promote Non-Smoking in a Group of Smokers - Term Paper Example

You are a health psychologist working in a smoking cessation programme. You are asked to design a research project to promote non-smoking in a group of smokers 1. Introduction Within modern society, the development of diseases has been considered to be related with the various aspects of daily life referring especially to the style of life of each particular person but also the relevant environmental conditions (we could refer here to the case of modern cities where pollution is extremely high with all the consequences on the health of their citizens). In this context, smoking has been considered to be one of the most severe problems for people around the world no matter the level of development of technology. In a survey published by the National Statistics Online (UK, 2008) it is revealed that ‘in 2006, 68 per cent of smokers who were asked said they wanted to give up; nine in ten mentioned at least one health related reason for doing so’. In accordance with the above, the expansion of smoking as a common daily activity for millions of people cannot be doubted. In fact, smoking has been closely related with all aspects of daily life. For this reason, in the above survey it has been found that ‘in 2006, 59 per cent of smokers felt that it would be difficult to go without smoking for a whole day’ (National Statistics Online, UK, 2008). Although the above statistics refer to Britain, it has to be noticed that smoking is not related with a particular country. In a similar survey conducted in USA it was revealed that in the specific country ‘an estimated 25.9 million men (23.9 percent) and 20.7 million women (18.1 percent) are smokers’ (National Health Interview Survey (NHIS), 2005, National Center for Health Statistics, in American Health Association, 2008). It is clear from the above statistics that smoking is a severe problem the expansion of which cannot be easily controlled. The specific problem has a series of consequences that are not limited to the damages of health but they can also take the form of the financial damage the person involved (cost of cigarettes – cost of treatment for diseases developed because of smoking). For the countries around the world, smoking has been proved to be a severe problem leading to a continuous increase of the cases handled by the hospitals and other medical treatment providers internationally. As an example, for England the cost of medical treatment provided to smokers has been proved to be extremely high. In a relevant survey it has been found that ‘in England, 364,000 patients are admitted to NHS hospitals each year due to diseases caused by smoking; this translates into 7,000 hospital admissions per week, or 1,000 day; for every death caused by smoking, approximately 20 smokers are suffering from a smoking related disease’ (ASH, 2006). After taking into consideration the above, the following conclusion can be made: smoking is a severe health problem which should be appropriately handled both at a personal and at a governmental level. In other words, specific measures should be proposed by states while each person should make the necessary efforts in order to stop smoking – the professional support in this case is considered as necessary in order for new daily habits to be developed improving the personal health both in the short and the long term. For this reason, the presentation of a potential plan of action against smoking has been regarded as extremely valuable initiative offering the appropriate information on a series of methods that could be adopted by smokers internationally in order to give up smoking. The relevant plan is divided into two parts: in the first part the major risks related with smoking are presented while in the second part specific initiatives are proposed taken into consideration the modern conditions of life and the level of support provided by the state. 2. Smoking and its effects The improvement of health as a result of give up smoking has been extensively proved in practice. However, every person that starts a relevant effort should take into consideration the fact that many constraints could possibly appear during the development of the above initiative in order for the latter to be led into failure. In a relevant research published by National Statistics Online (UK, 2008) it was revealed that ‘around 530,000 people set a quit date through NHS stop smoking services in England in 2004/05; when followed up four weeks later, 56 per cent were still not smoking’. In other words, a significant percentage of those that start the relevant effort is likely to abandon it and for this reason sufficient and appropriate support should be provided by the state and by the professionals that are called to offer their advice to smokers. Generally, it should be highlighted that the level of death rates related with smoking is extremely high. In many cases the statistics revealed regarding the percentage of smokers and the effects of smoking around the world are not accurate due to the intervention of a series of factors. Towards this direction, it has noticed that ‘previous estimates of a doubling of deaths from smoking (from 5 million per year to approximately 10 million per year by 2020) might be an underestimate because of the high prevalence of smoking among young girls compared with adult females, the high susceptibility of smoking among never smokers, and high levels of exposure to secondhand smoke and pro-tobacco indirect advertising’ (Global Youth Tobacco Surveillance, 2000–2007, January 25, 2008 / Vol. 57 / No. SS01, in CDS, 2008). In accordance with the above, smoking should be given up the earliest possible in order to avoid reaching irreversible health problems. Indicatively, it is noticed by Vollset et al. (2006, 381) that ‘continuing smoking strongly increased and smoking cessation decreased the risk for death between 40 and 70 years of age for both women and men’. On the other hand, it is noticed that ‘both active smoking and ETS exposure are associated with the progression of an index of atherosclerosis; smoking is of particular concern for patients with diabetes and hypertension’ (Howard et al., 1998, 119). Many studies have been conducted regarding the direct and the indirect effects of smoking on health. In accordance with a report published by the Centers for Disease Control and Prevention (2008) ‘smoking harms nearly every organ of the body; causing many diseases and reducing the health of smokers in general; the adverse health effects from cigarette smoking account for an estimated 438,000 deaths, or nearly 1 of every 5 deaths, each year in the United States’. The effects of smoking on health are extensively analyzed in a relevant report of the Surgeon General in 2004 in which it is noticed that ‘the list of diseases caused by smoking has been expanded to include abdominal aortic aneurysm, acute myeloid leukemia, cataract, cervical cancer, kidney cancer, pancreatic cancer, pneumonia, periodontitis, and stomach cancer; these are in addition to diseases previously known to be caused by smoking, including bladder, esophageal, laryngeal, lung, oral, and throat cancers, chronic lung diseases, coronary heart and cardiovascular diseases, as well as reproductive effects and sudden infant death syndrome’ (2004 Surgeon General’s Report—The Health Consequences of Smoking, in Centers for Disease Control and Prevention, 2008). To a more specific research it has been revealed that ‘smoking may increase risk for breast cancer in families with multiple cases of breast or ovarian cancer, especially those with the strongest apparent familial predisposition’ (Cough et al., 2001, 527). It is clear that smoking causes a series of severe health problems – most of which request a long term treatment while others are irreversible leading even to death. Another issue that should be mentioned here is the fact that smoking has severe effects not only on the smokers’ health but also to other people that are in the same place with the smoker. In this context, it is noticed that ‘the National Toxicology Program estimates that at least 250 chemicals in secondhand smoke are known to be toxic or carcinogenic (cancer causing)’ (United States Department of Health and Human Services, 2008). Specifically for the children it has been found that ‘children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, ear problems, and more severe asthma; smoking by parents causes respiratory symptoms and slows lung growth in their children’ (United States Department of Health and Human Services, 2008). In other words, second hand smokers can suffer more severe health problems than the first hand smokers. Indeed, in most studies that have been conducted regarding the particular issue, it has been revealed that ‘the cardiovascular system—platelet and endothelial function, arterial stiffness, atherosclerosis, oxidative stress, inflammation, heart rate variability, energy metabolism, and increased infarct size—is exquisitely sensitive to the toxins in secondhand smoke’ (Barnoya et al., 2005, 2684). The above research refers to an extensive research – research on the literature published since 1995 regarding the specific issue has been made by the above researchers; the results of this study are similar with the ones presented above. Smoking has severe effects not only on the health of smokers but also on the health of all people living with smokers (or even just being at the same place with smokers when smoking is in progress). 3. Potential anti-smoking policies – effects and implications Because of the dependency that smoking causes to smokers, the design and the development of appropriate policies regarding the limitation of smoking are rather challenging tasks. An appropriate plan of action could include the steps suggested by Dr. Rob Hicks (2001): ‘Get more active - walk instead of driving or taking the bus and use the stairs instead of the lift; Exercise helps you relax and boosts morale; Change your routine to break the association of smoking with certain times of day or places; Change your surroundings when the urge to smoke seizes you. Research has shown that even a short walk can quash nicotine cravings’ (Dr. Rob Hicks, 2001, revised in 2005, in BBC, 2008). Apart from the above initiatives, appropriate pharmaceutical support is available to smokers in order to give up smoking and not suffer (as possible) from the negative side effects – that every such effort is related to. In accordance with the above, the use of pharmaceutical supplements – even if not combined with any physical activity or change to the style of life – can effectively help smokers to give up smoking. A drug that is suggested by the British Heart Foundation is Zyban. It should be noticed that the particular type of therapy (using pharmaceutical supplements) has been proved to be extremely helpful for smokers. For this reason, it is supported that ‘tests show if used correctly it can really make a difference’ (British Heart Foundation, 2008) The above suggestions are in accordance with the ones made by Directgov (UK, 2008). More specifically, it is mentioned that the following types of treatment are available to smokers that are interested in give up smoking: a) non-carcinogenic Nicotine Replacement Therapy (NRT) products can help reduce withdrawal symptoms - they come in the form of patches, gum, inhaler, nasal spray and lozenges; b) the drug bupropion is a non-nicotine tablet which also works to inhibit nicotine cravings’ (Directgov, UK, 2008). The appropriateness of medical treatment as a method to give up smoking has been doubted by scientists around the world. Towards this direction, it is noticed that ‘many people don’t like the idea of using any kind of medication to quit; they feel the whole idea is to get away from using drugs; Counselling is an effective alternative for these people but it has to be intensive and ongoing; Both individual (one-on-one) and group programmes can double the chances of successfully giving up compared to no treatment (Lavelle, 2006, online article). All the above views lead to the conclusion that an appropriate method for give up smoking is difficult to be identified; each one of the relevant solutions could also have its own negative side effects (or it could be just rejected by smokers). A combination of changes in a person’s daily activities – avoiding activities that are related with smoking, such as coffee and so on – with an appropriately customized medical therapy would be the most effective support to smokers that are interested in give up smoking. 4. Conclusion Give up smoking is a challenging effort; the conditions of a person’s life can be adverse regarding the achievement of the specific target; in the long term the success of the relevant initiative cannot be guaranteed. In a relevant report published by GlaxoSmithKline (Australia, 2008) it is noticed that ‘smoking is an addictive behaviour, so using some form of assistance besides your own willpower is not a sign of weakness’. In most countries around the world, smoking in public places is not permitted – in England, as an example, smoking is not permitted since the 1st of July of 2007. Taking into account not only the financial effects of smoking (give up smoking would be equal with a pay rise of 9.5 percent, Medical News Today, 2008) but mostly the effects of smoking on health, smokers around the world could be persuaded in order to stop this ‘habit’ the earliest possible asking for any necessary support. References ASH (2006) Smoking Statistics, illness and death, online, available at http://old.ash.org.uk/html/factsheets/html/fact02.html Barnoya, J., Stanton, G. (2005) Cardiovascular Effects of Secondhand Smoke. Circulation, 111: 2684-2698 BBC (2008) Treating Addictions, online, available at http://www.bbc.co.uk/health/conditions/addictions/treatmentaddiction_toptips.shtml British Health Foundation (2008) Replacement Therapy, online, available at http://www.bhf.org.uk/smoking/how_replacement.asp Centers for Disease Control and Prevention (2008) Fact Sheet, Health Effects of Cigarette Smoking (updated January 2008), online, available at http://www.cdc.gov/tobacco/data_statistics/Factsheets/health_effects.htm Couch, F., Cerhan, J., Vierkant, R., Grabrick, D., Therneau, T. (2001) Cigarette Smoking Increases Risk for Breast Cancer in High-Risk Breast Cancer Families. Cancer Epidemiology Biomarkers & Prevention, 10: 327-332 Directgov, UK (2008) Health and Well Being, Smoking, online, available at http://www.direct.gov.uk/en/HealthAndWellBeing/HealthyLiving/DG_4002727 GlaxoSmithKline, Australia (2008), online, available at http://www.giveup.com.au/ Global Youth Tobacco Surveillance, 2000–2007, January 25, 2008 / Vol. 57 / No. SS01, in CDS, 2008, online, available at http://www.cdc.gov/tobacco/data_statistics/MMWR/2008/ss5701a1_highlights.htm Howard, G., Evans, G. (1998) Cigarette Smoking and Progression of Atherosclerosis. The Journal of the American Medical Association, 279(2): 119-124 Lavelle, P. (2006) How to give up smoking, online, available at http://www.abc.net.au/health/thepulse/s1717039.htm Medical News Today (2008) Smokers Give Up For Good And Pocket A Packet - In More Ways Than One, online, available at http://www.medicalnewstoday.com/articles/100148.php National Health Interview Survey (NHIS), 2005, National Center for Health Statistics, American Health Association, 2008, online, available at http://www.americanheart.org/presenter.jhtml?identifier=4559 National Statistics Online, UK (2008) Smoking habits in Great Britain, online, available at http://www.statistics.gov.uk/cci/nugget.asp?id=313 Vollset, S., Tverdal, A. (2006) Smoking and Deaths between 40 and 70 Years of Age in Women and Men. Annals of Internal Medicine, 144)6): 381-389 Read More