Smoking among Youth - Research Paper Example

The impact of smoking among 13-19 year old Caucasian Boys in the UK Introduction Often, the health needs of the young generation are not given enough attention – like those of other groups – by medical personnel and policy makers. However, taking into account that the healthcare needs of this group are so important to the society (during the planning of policy development and the planning done for care services), the situation needs to be addressed. Further, the delivery of effective and adequate health services to this adolescent group will return major dividends for the group, as well as the society as a whole, noting that the effects of administering poor healthcare services to the young can last a lifetime, and affect the society in different ways (MacPherson, 2005). One of the major problems with the delivery of care and services to this group is that, policy makers view the adolescent group as a part of the wider children’s group, which is completely flawed. The DH/CF & M (2010) explained the case of the teenagers group in the UK, as being a forgotten class in society, caught between childhood and adulthood; the space between the two is filled with professional centers of influence and bureaucratic obstructions. For this group, tobacco smoking is one of the major avoidable causes for untimely death, and further health complications for this group (Warren et al, 2006). The studies done in the area, among developing and also developed countries like the UK have shown that there is a high prevalence of smoking in this group. Many of the adult smokers in society report that they started smoking, during their adolescent years, or later as young adults (Dearden et al., 2007). A report by the office of the national statistics showed that 22 percent of the youths between the ages of 16 and 19 in the UK had started smoking (Fuller, 2011). Through this study, the author will explore the factors that influence the uptake of smoking among the youth, and also discuss the impacts of smoking among the people aged between 13 and 19 in the UK, with the aim of developing solutions to the pressing problems caused by the behavior, among the group. The current research aims to expose the impacts of smoking among the Caucasian teenage boys aged between the ages of 13 and 19 years of age, which can help in addressing the factors behind the increasing levels of smoking. The extensiveness of this research project will be hindered by the limited time available for study and also the limited budget allocated for financing it. Literature Review DH/CF & M (2010) emphasizes that policy makers and health personnel in the UK classify adolescents under the same classification as children, despite the fact that their needs are distinct and differentiated. The alienation leaves the group a forgotten one, facing the double pressures of childhood and adulthood. The study by White and comrades (2002) showed that many of the people that smoke during adulthood start by smoking cigarettes during adolescence or young adulthood. The study emphasized the importance of addressing the factors underlying smoking, as a way of countering the increasing levels of smoking among adults. Fuller (2011) reported that 22 percent of the UK youth group between the ages of 15 and 19 years were already smokers, and that the number of smokers increased rapidly during the high school years. The factors reported to cause these youths to start smoking included the exposure to smoking at home and deficiencies of self-image. Nichter et al. (2005) reported that the factors underlying the increased uptake of smoking among students, notably those between the ages 13 and 19 included the increased exposure to pro-smoking advertising and exposure to cigarette smoke at their homes. Other factors include the need to relieve stress, eliminating boredom and the need to enhance their self-image. In other countries, including the US, a range of strategies has been used to counter the increasing levels of smoking among adolescent youths. These have included the institution of anti-smoking campaigns, educational programs, and the use of fiscal regulation to increase the prices of cigarettes (Chen et al., 2003). In order to counter the increasing levels of smoking among the youths aged between 13 and 19 years in the UK, it is important to administer a study exploring the reasons and the beliefs underlying smoking among this student group (Amos and Hastings, 2009). The study will expose the factors and beliefs fueling smoking among Caucasian youths, and that will help during the formulation of a culture-specific program to solve the problem. Robinson and Bugler (2008) reported that more than 207,000 children begin smoking in the UK annually. Among adult smokers, about 67 percent reported that they started smoking before reaching the age of 18 years. More than three-quarters reported that by the age of 20 they were smokers, and about 40 percent reported that they had started smoking before the age of 16 years (Robinson and Bugler, 2008). The school-based study of English schools done annually has showed that more than 27 percent of students have smoked at least once, and more than 5 percent smoke more than one cigarette in a week (Colilla, 2010). Rozi et al (2005) reported that the rates of smoking among UK teenagers – like the adult population – are highly dependent on the ethnic grouping of the different people; smoking levels are highest among Bangladeshi, Irish and Pakistani groups. More regular smokers smoked about 37 cigarettes over a five-day week. Very few students at the age of 11 smoked, but after the age of 11, the levels of smoking increased constantly with advances in age. As of 2010, more than a tenth of the students aged 15 years were regular smokers (HSCIC, 2014). The evidence reviewed showed that teenagers are disregarded in policy and health circles in UK, despite that many cases of adult smoking can be traced to adolescence. More than 22% of UK’s adolescents are smokers, and the number increases as age advances. The factors underlying teenage smoking include self-esteem problems, and that requires an understanding of culture-specific interventions. Research Methodology This study entailed the administration of a cross-sectional survey at two high schools at Cheadle in the United Kingdom, during 1st to – 13th of May 2014. The data collected from the survey was complemented by the information gathered through focus group discussions. The main aim of the survey was to establish the numbers of regular smokers covered by the study group, as compared to the number found in the control group, and the impacts of smoking (Rozi et al., 2005). During the study, questionnaires were circulated, completed and collected after three days, at the two schools. The study had been taken through the approval of the institutional review boards, and the schools covered by the study were chosen on the basis of accessibility and convenience. The names of the schools and the subjects of the study were kept secret, for reasons of confidentiality. The project was administered as a student project, and the Chealde School was used as the primary sample school. The study compared the students from the different schools covered by the study; to show the differences and the similarities between the different cases. The study sample comprised of Caucasian and non-Caucasian students between the ages of 13 and 19 years. After giving their informed consent, the students were served with the questionnaire, which they filled anonymously. A total of 235 out of the 250 students surveyed, completed the questionnaire, marking a response rate of 94 percent. The focus groups were composed of Caucasian and non-Caucasian boys; the focus groups were aimed at exposing the issues related to and the impacts of smoking among teenage Caucasian boys. Out of the 235 boys, all participated in 7 focus groups at their respective schools. The settings for the focus groups were informal, which was aimed at offering the best environment for the disclosure of the controversial information related to their smoking behaviors. The teachers of the two schools helped in the selection of the students assigned to 7 focus groups, in varying group sizes between 20 and 40 members. The selection was done on the basis of age, irrespective of race, so as to cover smoker, non-smoker and mixed groups. Flexible guide questions were used to initiate the discussions. The topic areas of discussion were selected from literature reviews and engagements with more experienced researchers in the area of study, including sociologists and psychologists (Colilla, 2010). The open-ended questions that had been deliberated over, before the start of the discussions, among Caucasian and non-Caucasian boys from the two schools, aged between 15 and 16 years, were used as the guides for the exploration of the various topic areas. The same case topics were covered among the members of the various groups, and that offered an account for comparison. However, there were optional questions to be used to probe discussion in the different topic areas. The topics of discussion were not covered in any particular order (Rozi et al., 2005). Characteristics of the two study groups Racial Classification and School sample Age group Total Sample size per school School Sample size 1 (120) 2 (115) Caucasian 11-15 (56) 16-19 (60) 116 (49 percent) Non-Caucasian 11-15 (65) 16-19 (55) 119 (51 percent) Taking into account the exploratory outlook of the study, the researcher did not do a sample size calculation; the sample was maximized, so as to make the findings highly robust. The questions of the Questionnaire were derived from a model used by WHO in studying the impacts of tobacco smoking among healthcare officials, but the current questionnaire mainly enquired about smoking status, smoking beliefs, ethnicity and the impacts of smoking. The questionnaire consisted of 10 questions, which took about 2-3 minutes to fill. The data collected was analyzed descriptively for the different samples. Research time table Activity Estimated time and Date of work Draw and fine-tune research objectives ½ day (1st May) Formulate research protocol ½ day (1st May) Design instruments 1 day (2nd May) Recruit Focus group and questionnaire facilitators 1 Day (5th May) Training research facilitators (including the areas of revising and pretesting instruments) 2 Days (6th and 7th May) Collect data 2 Days (8th and 9th May) Preliminary field analysis 1 day (10th May) Prepare for presentation 1 Day (12th May) Prepare report 1 Day (13th May) Evaluation of the effectiveness of timetable implementation During the first day (half-day) of administering the project (1st May), the researcher developed the research objectives of the study, to ensure that they were in line with the aims of the research project. During the second half-day of the first day, the researcher formulated the research protocol, including securing the permission of oversight agencies before starting the research. During the second day of the project (2nd May), the researcher designed the research instruments for the research, including the questionnaires and the focus group questions. The questions for the focus groups were formulated successfully, with the help of a select sample group of students. During the third day of the research (5th May), the researcher successfully recruited the facilitators to aid during the research. During the third and fourth day of the project, (6th and 7th May) the researcher successfully recruited the facilitators of the project, and started by informing them of their duties (Rozi et al., 2005). During the fifth and sixth day of the project (8th and 9th May) the researcher and the facilitators collected the data successfully, and started the primary analysis. During the seventh day of the project (10th May), the team did the preliminary field analysis of the data successfully, which allowed it to proceed to the preparation for presentation during the 8th day of the project. On the eighth day of the project (13th May), the team prepared the report and closed the project. Analysis of findings From the survey, the data collected showed that the boys belonging to more socioeconomically deprived families, from the two groups were more likely to be current smokers and also to remain smokers until adulthood. The survey indicated that the differences in the patterns of cigarette consumption for the different group arose from the perceived effects of smoking. For example, among the two groups – Caucasian and non-Caucasian teenage boys, those from households of manual workers were more likely to be smokers, as compared to the case of those coming from professional and managerial households. Among the teenage Caucasian boys, like those from the non-Caucasian backgrounds, the groups from manual workers’ backgrounds had started smoking at the age of 16 years (Colilla, 2010). The levels of self-reported smoking were higher among some ethnic groups, as compared to others. For example, the teenage boys that reported the highest levels of smoking included the Bangladeshi, Irish, Pakistani, black Caribbean; black African and then Indians (in descending order from to high smoking levels to lowest levels). However, from a comparative point of view, the Caucasian group reported starting smoking at an earlier age, and maintaining their smoking behaviour, as compared to the control group. For example, among the Asians, there were significantly lower levels of smoking, but the differences between the teenage boys of African origin were most times similar to those of the Caucasian group (Rozi et al., 2005). One of the impacts of smoking among the Caucasian and the non-Caucasian teenage groups was that, the teenagers that reported smoking were most likely those exposed to smoke by their fathers (36 percent of sample), and mothers ( 35 percent). The level of smoker representation evidenced by the study was relatively higher than the national levels for both men and women. Among the subjects that reported smoking in the past and currently, 57 percent of them lived in homes where it was allowed to smoke in the house. An extra 85 percent of the smokers covered by the study reported that they had spent time in places where smoking was taking place (smoky places) apart from their home environment. Among the subjects covered by the study, 40 percent of those that reported smoking in the past and currently included those that had encountered smoky conditions at other places, including public transport areas, pubs, cafes, the houses of family members and other public places. The majority of the teenagers that had taken to smoking were those that had witnessed their fellow students smoking at the school environment or in other surroundings, including youth centres. There was another trend arising from the smoking behaviour witnessed at the school and other surroundings, including that the number of teenagers experimenting with smoking was increasing from one year to another. This was reported, as the fact that the subjects covered by the study witnessed more and more smoking behaviours at the school environment than they did during the previous year, and about 70 percent of the subjects had experimented with cigarette smoking. According to the self-reported experimentation done with cigarette smoking, the number of smoking cases witnessed at school had increased by double (Rozi et al., 2005). The evidence in support of this position was that, about 23 percent of the subjects reported witnessing peer smoking at the school during the past school year, but more than 52 percent reported witnessing their peers smoking at the school environment or other surroundings. In a similar fashion, due to the increased exposure to the stimulus calling for experimenting with smoking, the number that had experimented with smoking had increased significantly to the level of taking place weekly and in some cases daily, among the non-smokers group. About 28 percent of the teenage boys covered by the study had engaged in smoking on a daily basis. The effects of temporal smoking among the subjects by the study were also a major influencer for the increase in the levels of smoking reported among the subjects of the study. For example, more than 40 percent of the subjects reported that the stimulus to experiment with smoking had resulted from the exposure to second-hand smoke among their peers, or at the home environment (White and comrades, 2002). Summary of the Research Project Focus of the study The focus maintained by the study was that teenagers between the ages of 13 and 19 have been neglected by policy and healthcare personnel in the UK, and that has left them in a certain form of attention gap, where different problems, including peer and adult pressure have not been explored sufficiently. Building on that theme, the study sought to explore the impacts of smoking among the Caucasian teenage boys in the UK, including that adult and peer pressure can play a significant role in explaining the increasing threat of health impacts for this group (Colilla, 2010). The problem of smoking has been a major threat to the health and the wellbeing of this group, and therefore this study seeks to explore the impacts of smoking, so as to help in informing the strategies used to address the problem in the UK. Agreement between the literature reviews, aims of the study and the results of the study The different literatures explored, including Rozi et al (2005) pointed out that health and policy makers in the UK view adolescents like children, and that has left them in a form of attention gap, which has left them not catered for during service delivery. The literature also pointed out that the factors underlying the increased consumption of cigarettes among teenagers, including the Caucasian teenage boys under study, include the increased exposure to pro-smoking advertising and exposure to cigarette smoking at school and at their homes. These different sources point to the fact that, the impacts of smoking among teenage Caucasians include that the experience of smoking around their environment increases their vulnerability to developing the habits of smoking. Through establishing the impacts and the factors underlying the increased levels of smoking among teenage Caucasian boys, policy makers and healthcare personnel will help with the formulation of the strategies that can help to eliminate the problem of smoking in UK. For example, from the literature, it was pointed out that the Caucasian teenagers’ group is more likely to show higher levels of smoking, as compared to minority groups like the Asians and the African groups living in the UK. The information derived from these sources is in line with the results gathered from the study, including that the differences in the consumption of cigarettes among the different groups implies the importance of designing culture-specific strategies to reduce the problem of teenage smoking in the UK. Robinson and Bugler (2008) discussed that more than 207,000 children start smoking in the UK every year, and out of this number, more than 67 percent start smoking before reaching the age of 18 years. This information is in line with the research finding that, cigarette smoking experimentation has increased considerably in the past, taking into account that they are exposed to more and more adults and teenagers engaging in smoking, at different social spheres. Applicability of the research methodology to the aims and the outcomes of the research Through the administration of a cross-sectional survey coupled with focus groups, the information collected from the sampled group was highly informative about the factors fueling the increase in levels of smoking, and also the impacts of smoking in society and other spheres. For example, through the study of the sample group aged 13 to those aged 19 independently, from one another, the researchers identified the patterns of behavior triggering the adoption of smoking behaviors. Further, through the cross-examination of the different groups as distinct informant classes, the researcher exposed the effects of peer pressure, and also the role played by older children, who are in many cases the negative role models to younger boys (White and comrades, 2002). The evidence in support of this fact included that smoking increased from the ages of 13 towards 19, and in many case, it reached the smoking peak at age 16. In relating the effectiveness of the methodology with the aims and the outcomes of the study, it is important to note that the methodology was very effective in exposing the impacts of smoking among the Caucasian and the control teenage groups. Through the facilitation of the methodology, the researchers also found that the different age groups were more likely to give information more openly, in the cases where they were surveyed and questioned independent of older or younger groups. Partly, that can explain the role played by peers in the development of smoking behaviors, because it evidenced the fact that giving any kind of information was easy among the members of the same age group. The timetable of the research and the aims and the outcomes of the study The strictness of the timetable for the study clearly shows the fact that the project was carried out in a very short time and under very demanding conditions. For that reason, it is important to point out that the researcher did not have sufficient time to research details about the areas of study, and that is likely to limit the credibility of the findings (Rozi et al., 2005). Further, the fact that the study incorporated the subjects from two schools in the same region, can indicate that the outcomes of the study may not be highly credible, mainly because they may not be representative of the outlook of the entire UK. For example, the smoking trends may be true for the Cheadle region and not the entire UK. However, taking into account that it incorporated the findings collected through research tools, it is evident that the information is credible enough to warrant support and demand further study. Analysis of findings and outcomes The findings of the study, like it was discussed earlier, are reflective of an extensive research, and the outcomes of the study are fully accommodative of the demands for investigative studies. More importantly, the findings supported the outcomes sought by the study, including that the increasing cases of smoking are caused by peer pressure and the enforcement of smoking behaviour in society (White and comrades, 2002). The findings of the study met the aims of the study, including that it exposed the impacts of smoking among Caucasian teenage boys. Reference List Amos, A. and Hastings, G., 2009. A Review of Young People and Smoking in England. Public Health Research Consortium. London: Department of Health. Colilla, S. A., 2010. An epidemiologic review of smokeless tobacco health effects and harms reduction potential. Regul Toxicol Pharmacol, 56(2), pp. 197-211. Dearden, K.A., Crookston, B.T., De La Cruz, N.G., et al., 2007. Teens in trouble: cigarette use and risky behaviors among private, high school students in La Paz, Bolivia. Rev Panam Salud Publica, 22, pp. 160-8. DH/Children, Families and Maternity. 2010. Achieving equity and excellence for children. London: Department of Health. Fuller, E., 2011. Smoking, drinking and drug use among young people in England in 2010. London: NHS Information Centre. HSCIC. 2014. Smoking, Drinking and Drug Use among Young People in England. [Online] Health & Social Care Information Center. Available at: http://www.hscic.gov.uk/article/3743/Smoking-Drinking-and-Drug-Use-among-Young- People-in-England [Accessed 15 May. 2014] MacPherson, A., 2005. ABC of adolescence: Adolescents in primary care. British Medical Journal, 330, pp. 465-467. Robinson, S. and Bugler, C., 2008. Smoking and drinking among adults, 2008. Newport: Office for National Statistics. Rozi, S., Akhtar, S., Ali, S. and Khan, J., 2005. Prevalence and factors associated with current smoking among high school adolescents in Karachi, Pakistan. Southeast Asian J Trop Med Public Health, 36, pp. 498-504. Warren, C.W., Jones, N.R., Eriksen, M.P. and Asma, S., 2006. Pat­terns of global tobacco use in young people and implications for future chronic disease burden in adults. Lancet, 367, pp. 749-53. White, H., Pandina, R. and Chen, P., 2002. Developmental trajectories of cigarette use from early adolescence into young adulthood. Drug Alcohol Depend, 65, pp. 167-78. Read More